CHARTER   HERTFORD: VORTHCAROURE  SERVICE APPLICATION FOR RESIDENTAL/BUSINESS ELECTRIC & WATER SERVICE  Date:  Applicant: First Company Name_ Service Address: Mailing Address Social Security/Tax ID Number_ Email Driver'sL License # Service Requested Electric Date & Time to be connected (Please Check One) Own Purchasing Renter:  Last_  MI  (This will be used for debt collections purposes)  Telephone # Water/Sewer  Work#  Garbage.  Ownership on file  New Owner: Copy of Closing Statement or Deed Renter: Copy of Lease Agreement  Name of Landlord Place of Employment Moving From  and Phone Number  Current Customer's Only  Do you want service cut off at old address?  Yes  No  Ifso, date and address    The applicant understands that the Town of Hertford must take actions and expand funds to comply with the request for service. By signing this application, the applicant signifies that he has the authority tor request electric services, both permanent and temporary to the premises identified on this application. By signing the application, the applicant requests permanent electric services to be  preceded by temporary service if needed for the location identified.  Utility service will be subject to any and all rates, rules, regulations, policies, procedures, terms, and conditions applicable to the service, and as revised by the Town of Hertford with the authority given it by NCGeneral: Statue Chapter 160A, Article 16. The rights and responsibilities of the Town of Hertford and the customer regarding electric service included those set out int the Town of Hertford's Guidelines for Customer Service Policies; a copy of which is available upon request. Those policies in effect for the date of this application may be updated or changed from time to time by the Town of Hertford. However, the terms and previsions of the manual as they might change are incorporated int this The Town of Hertford will make all reasonable efforts to provide continuous and uninterrupted electric service but cannot be liable for the loss of the damage (direct, consequential, or otherwise) caused by any failure to supply electricity or by an interruption, ifiti is due to any cause beyond the reasonable The application and the documents referred to in this application, specifically including the Town's Policies and Procedures Manual, constitute the entire agreement between the customer and the Town of Hertford with respects to the provision of utility service by the Town. Neither party shall be responsible to the other except as specifically set outi in this application and in those agreements or documents referred to in this application. Upon acceptance oft this application, the Town of Hertford Although the Town of Hertford and its customers may not always exercise the rights specified in these policies or available to them by law, that does not prevent the Town of Hertford or the customer from Please note this is a contract for utility services based on the municipality's policies and procedures. You PRIVACY/WAIVER: The NCI Legislature passed two bills in the 2001 Session dealing with the public records law.GS 132-1.1 removes from public record customer billing data for any public enterprises, including electric. GS 132-1.6 removes from public record information dealing with public security plans and drawings of public building and infrastructure facilities. Removing thisi information from public record does not automatically make it confidential. Rather, it gives the public body the opportunity to not provide the information upon request unless the public body deems disclosure appropriate. For  application.  control oft the Town of Hertford.  and the applicant form a valid contract.  exercising those rights at a later time.  have the right to review the policy manual or ask questions in our municipal office.  detailed privacy policy, please inquire. APPLICANT'S SIGNATURE  DATE