Fillable Landlord Agreement-Continued Utility Service

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Landlord Agreement-Continued Utility Service

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20 Floral Parkway, Concord, Ontario L4K 4R1
T 416-736-0630 F 416-736-4923 E info@pemi.com W pemi.com
Landlord Agreement-Continued Utility Service
Rental Premise: Service address information
Street Number
Street Name
Suite/Unit
City
Postal Code
Landlord Contact Information
Name of Landlord (Legal owner of Rental unit)
Name of Landlord’s agent if applicable
Street Number
Street Name
Suite/Unit
City
Province, Country
Postal Code
Home Phone
Cell Phone
Landlord Agreement
Landlords: By signing this agreement you agree to be the interim account holder for the services to the Rental property. You
understand that whenever a tenant calls to close their Provident account, you will automatically assume responsibility for the
utility account and continued services starting on the Tenant’s termination date and until such time as a new tenant
establishes an account with Provident. No reconnection or new account charges will apply to you under this option.
This agreement is dates as of the _ Day of , 20_ _
X
X
Landlord (Legal Owner) Signature
Landlord (Legal Owner )Please Print
Please fax or email this form to Provident Energy Management:
416-736-4923 or customerservice@pemi.com
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Landlord Agreement-Continued Utility Service

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Completed 12 April 2021

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