Fillable LEAK ADJUSTMENT CREDIT (Broward County)

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LEAK ADJUSTMENT CREDIT (Broward County)

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WWS Leak Adjustment Credit – Revised 10-2019
LEAK ADJUSTMENT CREDIT
BOARD OF COUNTY COMMISSIONERS
WATER AND WASTEWATER SERVICES (WWS)
BUSINESS OPERATIONS DIVISION
2555 WEST COPANS ROAD, BLDG. 1
POMPANO BEACH, FL 33069
(954) 831-3250 ● water@broward.org
(1) CUSTOMER INFORMATION CUSTOMER NUMBER: _____________________
ACCOUNT HOLDER: _________________________________________________________________________________
__
CONTACT NAME (if applicable): _____
_____________________________________________________________________
PROPERTY ADDRESS:
__________________________________________________________________________________________
STREET CITY STATE ZIP + 4
MAILING ADDRESS: _____________________________
_______________________________________________________________
SAME AS ABOVE STREET CITY STATE ZIP + 4
PHONE: HOME: (______) __________________ WORK: (______) __________________ MOBILE:
(______) _____________________
E-MAIL ADDRESS: ____________________________________________________________________________________________
__
(2) REPAIR INFORMATION
DATE OF REPAIR: ____________________ REPAIR COMPLETED BY: ______________________
____________________
PLUMBER’S LICENSE NUMBER: ___________________________________
4
TYPE OF LICENSE
(if applicable): STATE OF FLORIDA BROWARD COUNTY OTHER _________________
DESCRIPTION OF REPAIR(S): _____________________________
______________________________________________
____________________________________________________________________________________________________
_
____________________________________________________________________________________________________
__________________________________________________
___________________________________________________
_____________________________________________________________
________________________________________
I UNDERSTAND THAT I MAY BE CONSIDERED FOR A LEAK ADJUSTMENT CREDIT ONLY IF ALL REPAIRS CAUSING
THE LEAK(S) HAVE BEEN REPAIRED AND CONSUMPTION HAS DECREASED BACK TO NORMAL.
X
_______________________________________
DATE
________________
FOR INTERNAL USE ONLY:
____________ ________ _________________ ________
CUSTOMER NO. UAZ PREMISE NO. CS REP
ATTACHED:
PHOTO ID (S)
SUPP DOCS
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Date
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WWS Leak Adjustment Credit – Revised 10-2019
**WATER AND WASTEWATER SERVICES ALLOWS A LEAK CREDIT ONCE PER CALENDAR YEAR**
REQUIREMENTS
1. The above form must be completed and signed within 10 business days after notification by the Department to
the customer that a possible plumbing problem may exist.
2. Attach copies of repair bill(s) and/or a letter from the company or person(s) completing the repairs.
3. All past due balances must be paid.
WAYS TO SUBMIT
MAIL: Water and Wastewater Services
Customer Service
2555 West Copans Road
Pompano Beach, FL 33069
EMAIL: water@broward.org
IMPORTANT INFORMATION
• Possible access to your property may be needed.
• No credits are issued due to leaks caused by a third party.
• If repairs have not been completed, you will not receive an adjustment to your account.
• A leak adjustment credit request may take up to 90 days for completion. The Department will notify you regarding
any discrepancies with this adjustment request.
• Any future invoices, in addition to the agreed upon payment arrangement, must be paid in full while leak adjustment
credit approval is pending.
WATER AND WASTEWATER SERVICES POLICY REGARDING A LEAK ADJUSTMENT
• Leak adjustment credits are applied to the two invoices with the highest, consecutive consumption above the
average and rates are adjusted to the lowest allowable tier.
• Leak adjustments are considered once per calendar year.
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LEAK ADJUSTMENT CREDIT (Broward County)

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Completed 27 August 2020

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