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<br />r~~-~-2~~~ 12:~~ <br /> <br />CENTERPOINT MINNEGASCO <br /> <br />612 321 4806 <br /> <br />P.12I4 <br /> <br />, <br />\ <br />" <br /> <br />AUTHORIZATION TO DISCONNECT GAS SERVICE <br />I authorize Cente~Point Energy to lock the gas meter( s) at my rental property listed bel~w. <br /> <br />Rental Property Street Address <br /> <br />Rental Property City, State and Zip Code <br /> <br />Rental Property Meter Number <br />\ <br />I <br />I agree to provide CenterPoint Energy access to my rental properly so that the meter(s);can be <br />locked. CenteIl'oint Energy will notify me if access cannot he gained. <br /> <br />I agree that I am responsible for any loss or damage that results from lack of heat. <br /> <br />, <br /> <br />To Tesume gas setvice, 1 agree to notify CentllrPoint Energy. Ifreconnection if being done in my <br />name or my company name, I agree to pay a reconnection fee. . <br /> <br />Name <br /> <br />, <br />'. <br /> <br />Mailing Address <br /> <br />Business Telephone <br /> <br />Signature' . <br /> <br />Date <br /> <br />CenterPoint Energy Representative <br /> <br />TOTAL P.04 <br />