Laserfiche WebLink
<br />WATER/SAC <br />************ <br /> <br />1620 I Street, NW, Suite 500 <br />Washington. DC 20006 <br />866-h2o-ISAC <br />fax 202-785-1845 ( <br /> <br />Subscription Agreement for Individual Systems <br /> <br />WWW.Wi1tert5llC.org <br /> <br />Please complete this Subscription Agreement and send the original to: <br /> <br />WaterlSAC <br />1620 I Street, NW, Suite 500 <br />Washington, DC 20006 <br /> <br />This completed Agreement must be accompanied by: <br /> <br />1. A letter on official letterhead signed by the senior utility manager authorized to subscribe on <br />behalf of the utility (e.g.. GM. CEO). In this letter. state the utility's desire to subscribe. <br /> <br />2. A check issued to the WaterlSAC. for the appropriate fee amount (see schedule on page 2). <br />by the organization or entity authorized to subscribe. Personal checks wilrilot oe accepted. <br /> <br />Before completing this Agreement, utilities that own multiple systems should consult the Subscription Agree- <br />ment for Multiple Systems, found at www.waterisac.org/subscribe. <br /> <br />Contract operators cannot subscribe to the Water/SAC. In cases where a company operates a utility <br />under contract, then the utility itself, and not the contract operator, must subscribe. <br /> <br />When the WaterlSAC receives the completed Subscription Agreement, the utility's eligibility and the eligibility <br />and identity of each user will be verified. Once the agreement has been approved (generally within 15 busi- <br />ness days of receipt), users designated in this Agreement will receive instructions on use of the WaterlSAC. <br />The WaterlSAC reserves the right to disapprove a request for subscription, or to terminate a utility's subscrip- <br />tion. at any time, for failure to comply with the Terms and Conditions. <br /> <br />( <br /> <br />By subscribing. the utility expressly agrees that it and its designated users will fully comply with the <br />WaterlSAC's Terms and Conditions, including any future amendments thereto. <br /> <br />q 6cr b<.f <br />Date <br />c;+~ t9-f' <br />Utility Name <br /> <br />/ &"t'tJ /YJ Pr;~ <br />Mailing Address <br /> <br />Q,.jTeLV~tle <br />Sfi e..e..:/ <br /> <br />Ow+uwJ; vle <br /> <br />VV\,N <br /> <br />~OJ8' <br /> <br />Physical Address <br /> <br />Type of Utility. <br />(check one) <br /> <br />i:lil Joint Drinking WaterlWastewater Utility <br />o Drinking Water Utility Only <br />o Wastewater Utility Only <br /> <br />Service Population. Drinking Water: :; WD <br />(Number of people served, not number of accounts) <br /> <br />Wastewater: <br /> <br />'2. '-t ~i:> <br />