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GENOA-KING FERRY WATER DISTRICT 1000 BARTNICK ROAD – GENOA, NEW YORK 13071 Agreement for Services Customer Record of Premises to be served by water: User: Owner: (if different from user) Name: Name: Number / Street: Town, State / Zip: Telephone No.: Bill to: USER I OWNER (Circle one) If the "user" to be billed is not the owner a written statement signed by both parties is required; delinquent accounts will be filed with the county. PROPERTY TAX PARCEL NUMBER: Whereas the above referenced premises is located within the Genoa-King Ferry Water District; and the Property Owner wishes to be connected to the water district system, the parties agree to comply with the rules and regulations of Town of Genoa Local Law No. 1 (most current revision). The law first defines the authority and responsibility of all water district personnel in their relations with the consuming public. Second, to provide the consuming public with a written statement of the conditions under which water service will be furnished and continued by the Genoa-King Ferry water district. (Section 1) Complete laws & regulations are available on internet website; although not a complete list the following regulations apply (condensed and edited): • Rates and fees are set by the Town Board of the Town of Genoa, • Unless provided otherwise all properties shall be metered, • Only persons employed by the Water District may install, service, adjust, repair or otherwise maintain a water meter, • Once installed the meter becomes a fixture and shall be transferred to any subsequent owners as part of the property, • Vacant properties can have service turned off (temporary) for less than the quarterly minimum fee (please schedule in advance with the Water Operator or Town Clerk). To address any concerns you may have please contact the Town Clerk at (315) 364-5505. Signature of Property Owner Date Signature of User Date