Www.chooseowasso.com
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COMMERCIAL UTILITY SERVICE APPLICATION
$10 Non Refundable Service Initiation Fee Required for New Service and Transfers
$125 Deposit required on all Commercial Property
For Office Use Only: RT #___________________ Account #_________________________
Service Requested Date: __________/_________/__________
Business Name:__________________________________________________________________________________
Service Address: ________________________________________________________________________________
City_________________________________________________State____________________________Zip________
Mailing Address (if different):_______________________________________________________________________
City__________________________________________State____________________________Zip_______________
Corporation: _________Partnership__________Sole Proprietor: _________
Name of Person(s) with authority to sign or terminate business on your behalf:
_________________________________________________________________________________________________
_________________________________________________________________________________________________
State Sales Tax # Issued by the Oklahoma Tax Commission:_________________________________________________
Business Phone #: (______) ________________-_________________
Cell Phone #: (______) ________________-_________________
Alternate Phone # (______) ________________-_________________
Work Phone # (______) ________________-_________________
E- Mail Address: ___________________________________________________________________________________
Name of Personal Guarantor: ________________________________________________________________________
Guarantor (s) Address: ______________________________________________________________________________
City__________________________________________State____________________________Zip_______________
Guarantor Phone #: (______) ________________-_________________
The above responsible party agrees to pay the established rates set for by the City of Owasso ordinances and agrees to regulations governing said service. This application becomes a contract upon the establishment of service.
Customer understands interest received by OPWA on this deposit of $100 will be retained by the OPWA to defray cost of maintenance, repair and depreciation of water meters. Deposit shall be refunded upon termination of service after deduction there from, if any, for unpaid charges for water, sewer, or refuse service.
Customer Signature______________________________________________________________________Date____________
200 S Main Owasso, OK 74055 – Main Number 918-376-1500 – Fax Number 918-376-1551
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