HomeMy Public PortalAbout154-2017 - Vectren Energy - Waterfall Rd meter servicingVectren Energy Delivery of Indiana
Form 3305 (Rev. II05)
Maximo #15149872
Oracle ID #575132001
APPLICATION AND CONTRACT FOR SERVICE
The undersigned (hereinafter called the "Customer"). their successors or assigns. hereby requests
VECTREN ENERGY DELIVERY OF INDIANA
(hereinafter called the "Company") to install in accordance with the terms hereof a gas service facilities line (hereinafter called
"Facilities") to provide gas utility service (hereinafter called "Service") at the premises described as follows:
28 Waterfall Road
(STREET ADDRESS) (LOT NUMBER)
Richmond Wayne Wayne
(CITY) (TOWNSHIP) (COUNTY)
The Customer agrees to pay to the Company a nonrefundable amount computed as follows:
Estimated cost of facilities line
Less: Company's estimate of total non -
gas cost revenue from the service
for a period of 5.5 years.
Total nonrefundable amount
$ $3.610.81
$ $0
$ $3.610.81
Terms:
( I ) The Company will furnish, install, own and maintain all piping and other appurtenances to supply Service from the main up to
the outlet of the meter(s) at the above location.
(2) The Customer will at his expense. furnish, install. maintain and own all necessary piping from the outlet of the meter(s) to and
including his house piping.
(3) The Customer agrees to give, and does hereby give the Company the right to locate on the Customer's premises, at such place or
places as shall be mutually agreed upon. all facilities of the Company as shall be reasonably necessary in connection with the rendering of
Service to the Customer hereunder, the right to enter upon the premises of the Customer at all reasonable times in order to maintain, repair.
replace, or operate said facilities of the Company, and the right to remove said facilities whenever. and at any time after. Service to the
Customer is discontinued for any reason whatsoever.
(4) In consideration of the Service herein provided for. the Customer agrees to pay for Service at the rates provided for in the
Company rate schedule or such other rates as may, from time to time. be approved for such Service by any governmental regulatory agency
having jurisdiction of rates therefore. and agrees to take Service in accordance with the conditions of Service herein provided, including all
such rules and regulations as may, from time to time during the existence of the agreement. be approved in respect of such Service by any
governmental regulatory agency having jurisdiction thereof.
(5) Service furnished under this agreement is for use on the premises described herein. The Customer agrees not to resell or
otherwise dispose of said Service excepting that a tenant of said premises may assume the obligation for payment for Service rendered during
the occupancy of said tenant.
In Witness Thereof. the parties hereto have caused this agreement to be executed in duplicate by their duly authorized
representatives.
VECTREN ENERGY DELIVERY OF INDIANA
By
Authorized Agent
Date
OWNER
By
Date l�