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WATER/SAC ************ 1620 I Street, NW; Suite 500 Washington DC 20006 866-h20-ISAC fax 202-785-1845 Subscription Agreement for Individual Systems WWW.Waterls.4C.org Please complete this Subscription Agreement and send the original to: WaterlSAC 1620 I Street, NW, Suite 500 Washington, DC 20006 This completed Agreement must be accompanied by: 1. A letter on official letterhead signed by the senior utility manager authorized to subscribe on behalf of the utility (e.g., GM, CEO). In this letter, state the utility's desire to subscribe. 2. A check issued to the WaterlSAC, for the appropriate fee amount (see schedule on page 2). by the organization or entity authorized to subscribe. Personal checks will not be accepted. Before completing this Agreement. utilities that own multiple systems should consult the Subscription Agree- ment for Multiple Systems, found at www.waterisac.org/subscribe. Contract operators cannot subscribe to the WaterlSAC. In cases where a company operates a utility under contract, then the utility itself. and not the contract operator, must subscribe. When the WaterlSAC receives the completed Subscription Agreement. the utility's eligibility and the eligibility and identity of each user will be verified. Once the agreement has been approved (generally within 15 busi- ness days of receipt), users designated in this Agreement will receive instructions on use of the WaterlSAC. The WaterlSAC reserves the right to disapprove a request for subscription, or to terminate a utility's subscrip- tion, at any time, for failure to comply with the Terms and Conditions, By subscribing, the utility expressly agrees that it and its designated users will fully comply with the WaterlSAC's Terms and Conditions. including any future amendments thereto. '-I 6cr () '+ Date c;+~ eT Utility Name 18'~u fYJ I'n';0 Mailing Address ~ Ce-,.}TeLlh if e srr e..e:r CeN+UL.!; lLe VV\.N g)O;$[f Physical Address Type of Utility. (check one) ~ Joint Drinking WaterlWastewater Utility o Drinking Water Utility Only o Wastewater Utility Only Service Population. Drinking Water: ~<; roD (Number of people served, nol number of accounts) Wastewater: ';z...{ U)i)