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2. Form Completion

   This form is required for the start service of each new tenant. 

   Please allow up to two business days in advance of the start of service for proper processing and turn on service scheduling. 

   Office Hours: Monday - Thursday 7:30am - 5:30pm. 
                             Closed Friday, Weekends, and Holidays

   If you have any questions or need more information please call or email 707-665-3631 or water@cotaticity.org

4. City Policy and Overview

   City policy requires that water and sewer bills be the responsibility of the owner of the property.

   •  Tenant Billing is provided as a convenience only and does not remove the responsibility of the property owner. 
   • Delinquent bills for water and sewer services, including late fees or penalties, will be provided as cause to stop water service to the address and can become a lien against the property, not against the tenant. 
   • Completing the Property Owners Consent to Tenant Billing form, you are authorizing the tenant or property manager to act as your agent for the management of the water and sewer utility services provided to your property by the City of Cotati.  
   • You can telephone the City during office hours to request utility billing information for your property. 
6. Property Owner Name*
7. Email Address*
9. Service Address In Cotati*
11. Tenant/Agent Name*
12. Tenant/Agent Email Address*
14. Property Owner Mailing Street Address*
16. City*
17. State*
18. Zip Code*
20. Phone Number
21. Cell Phone Number*
25. Consent and Acknowledgement
27. CONSENT - I, the owner of property address above within the City of Cotati, am responsible for payment of rates and charges of the City of Cotati for water and sewer service provided to said property and consent to the below action by the City:*
    -- Select One --I hereby request that Cotati bill DIRECTLY in the name of the agent or tenant for said property address for all charges of City of Cotati for water and sewer service.I hereby request that Cotati bill BOTH the agent or tenant for said property address and provide a copy for myself the property owner for all charges for water and sewer service. I hereby ONLY authorize the tenant at the service address to receive information ONLY regarding this account.

    Please select one action from the above for consent regarding the service address and tenant.

     - If you select to bill DIRECTLY to the agent or tenant you the property owner will not receive any copies of bills or notifications. Liability for any past due balance is not waived and this option is only a convenience for you the property owner. 

     - If you select to BOTH receive a copy of the bills the name of the account will be changed as a curtesy to the tenant, however we will additionally provide copies of the bills for water and sewer services to you the property owner. The Liability for any past due payment is still the responsibility of the property owner. 

    - If you select ONLY to receive information, you the property owner will receive the bills for water and sewer services directly but grant permission for the tenant to obtain information about the account including bill amounts, consumption, or possible leaks.

29. Acknowledgement*

    I consent to said changes and authorize the City to issue/discuss billings as indicated above to the Agent or Tenant for said property address. 

    I understand that I, as the property owner, continue to be responsible for payment of all water and sewer charges at the amount billed to the Agent or Tenant and in consideration for direct billing by the City to Tenant, I hereby waive notice from City of such charges or delinquencies as they may occur. 

    I understand that no billings will be sent to me after the date of the authorization unless I have requested so above. 

    This authorization shall be continued until revoked in writing by me. 

    1. I Agree
31. Execution Date

    This agreement is deemed to be consent provided in writing per CMC 13.03.260 and is executed as an agreement with the City effective the date of submittal. 

    Please print a copy for your records for reference in the future. 

    
    

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33. 1. Receive an email copy of this form.
34. Email address

    This field is not part of the form submission.

35. Submit Submit and Print

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