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I understand that the utility deposit must be paid at the time of application and that I must provide a copy of my photo identification and property purchase or rental agreement or utility service will not be established.*

Yes

I have received a copy of the City of Melissa Rates and Fees schedule as well as the Solid Waste Brochure. I understand that, depending on the date I request my service to begin, my first bill may not reflect my average monthly usage and may include additional days of water usage or fewer days of usage.*

Yes

I understand the utility service will remain in my name and will be my financial responsibility until I submit a Discontinuance Form along with a copy of my photo identification. *

Yes

I understand that if I vacate the property and leave an unpaid balance on my account, the City of Melissa will apply my utility deposit to the account to satisfy the unpaid debt. If there is credit after the deposit has been applied, I will receive a refund within 60-90 days. In order to ensure that I receive my refund, I must provide a forwarding address. If there is a balance after the deposit has been applied, I understand that I will receive a final bill for that balance.*

Yes

I understand that my payment is due by 5:00 p.m. on the due date stated on the utility bill and if payment is received after this date, I will be charged a fee equal to 10% of the current charge due. *

Yes

I understand the City of Melissa offers ONLY 4 Payment Arrangements per year, but in order to be granted an extension I MUST CALL OR COME INTO THE OFFICE BEFORE the CUTOFF DAY on the past due bill.*

Yes

I understand that Past Due notices are processed and posted two (2) business days after due date and disconnections will be done on or around ten (10) business days after due date. If service is disconnected, I understand that I will be charged a service fee, plus an additional fee if reconnection is required outside regular City working hours. If service is disconnected and I do not call before 10:00 pm, I understand my service will not be restored until the next business day. *

Yes

I understand that if I file, or one of my creditors files, a bankruptcy petition placing me in bankruptcy under any chapter of the Bankruptcy Code, I must provide the City of Melissa with an adequate assurance deposit (“Assurance Deposit”) in an amount determined by the City of Melissa, in its sole discretion, within twenty (20) days after the date the bankruptcy petition was filed. I understand that the Assurance Deposit is to guarantee payment to the City of Melissa for utility service after the date the bankruptcy petition was filed. This Assurance Deposit must be made to continue my utility service after the date the bankruptcy petition was filed. If I fail, for any reason to make the Assurance Deposit in a timely manner, the City of Melissa shall have the right to alter, refuse or discontinue my utility service at any time.*

Yes

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