WATER SERVICE AGREEMENT

301 MAIN PO BOX 1277 892-2531

ATMOS ENERGY: 1-888-363-7427 XCEL ENERGY: 1-800-895-4999 A REFUNDABLE DEPOSIT OF $75.00 PER UNIT IS REQUIRED TO CONNECT SERVICE THE FOLLOWING INFORMATION IS CONFIDENTIAL AND IS NOT SHARED WITH ANYONE ELSE.

DATE______ACCOUNT NO.

FIRST NAME______LAST NAME______

SERVICE ADDRESS______HOME PHONE______

MAILING ADDRESS______WORK PHONE______

SOCIAL SECURITY NO.______DL #______D.O.B.______

EMPLOYER______EMPLOYER ADDRESS______

SPOUSE NAME______SPOUSE EMPLOYER______

PREVIOUS ADDRESS______

This form shall evidence agreement between the herein named customer and the City of Idalou, TX, for water, sanitary sewer and trash collection services. This agreement is NON-TRANSFERABLE.

(EXAMPLE ONLY) Customer agrees to pay the City of Idalou the following monthly charges, which are determined by the City Council.

Water (Base amount) $31.88 Water usage is billed at an additional charge Sewer $21.30 per 1,000 gallons used. Sewer is billed at an Trash $19.00 additional rate after the first 5,000 gallons Tax $ 2.07 Spraying $ 1.00 Service outside the City Limits will be at Total Minimum Mo. Bill $75.25 an additional rate.

Water meters are read around the 15th of each month and bills are due on the following dates:

Total Bill Due: 1 st of each month 15% penalty added if not paid by: 10 th of each month Service Disconnected with no notice if not paid by: 15 th of each month

A $25.00 Reconnect Fee plus current bill due will be required to restore service if disconnected A Reconnect Fee of $50.00 will be required to restore service after 5:00 p.m. & on weekends.

DO NOT ATTEMPT TO TURN YOUR OWN WATER OFF OR ON AT THE METER. CALL CITY HALL FOR ASSISTANCE. VIOLATORS WILL BE FINED UP TO $500.00.

______TERMS ACCEPTED BY CUSTOMER CITY OF IDALOU AUTHORIZED AGENT

Deposit Amount Rec.______CUSTOMER SERVICE AGREEMENT

I. PURPOSE. The CITY OF IDALOU is responsible for protecting the drinking water supply from contamination or pollution which could result from improper private water distribution system construction or configuration. The purpose of this service agreement is to notify each customer of the restrictions which are in place to provide this protection. The utility enforces these restrictions to ensure the public health and welfare. Each customer must sign this agreement before the CITY OF IDALOU will begin service. In addition, when service to an existing connection has been suspended or terminated, the water system will not re-establish service unless it has a signed copy of this agreement.

II. RESTRICTIONS. The following unacceptable practices are prohibited by State regulations.

A. No direct connection between the public drinking water supply and a potential source of contamination is permitted. Potential sources of contamination shall be isolated from the public water system by an air-gap or an appropriate backflow prevention device. B. No cross-connection between the public drinking water supply and a private water system is permitted. These potential threats to the public drinking water supply shall be eliminated at the service connection by the installation of an air-gap or a reduced pressure-zone backflow prevention device. C. No connection which allows water to be returned to the public drinking water supply is permitted. D. No pipe or pipe fitting which contains more than 8.0% lead may be used for the installation or repair of plumbing at any connection which provides water for human use. E. No solder or flux which contains more than 0.2% lead can be used for the installation or repair of plumbing at any connection which provides water for human use.

III. SERVICE AGREEMENT. The following are the terms of the service agreement between the CITY OF IDALOU (the Water System) and ______(the Customer).

A. The Water System will maintain a copy of this agreement as long as the Customer and/or the premises is connected to the Water System. B. The Customer shall allow his property to be inspected for possible cross-connections and other potential contamination hazards. These inspections shall be conducted by the Water System or its designated agent prior to initiating new water service; when there is reason to believe that cross connections or other potential contamination hazards exist; or after any major changes to the private water distribution facilities. The inspections shall be conducted during the Water System’s normal business hours. C. The Water System shall notify the Customer in writing of any cross-connection or other potential contamination hazard which has been identified during the initial inspection or the periodic re-inspection. D. The Customer shall immediately remove or adequately isolate any potential cross-connections or other potential contamination hazards on his premises. E. The Customer shall, at his expense, properly install, test, and maintain any backflow prevention device required by the Water System. Copies of all testing and maintenance records shall be provided to the Water System.

IV. ENFORCEMENT. If the Customer fails to comply with the terms of the Service Agreement, the Water System shall, at its option, either terminate service or properly install, test, and maintain an appropriate backflow prevention device at the service connection. Any expenses associated with the enforcement of this agreement shall be billed to the Customer.

V. DELINQUENCY. The City of Idalou is a member of the Texas Revenue Recovery Association. The TRRA is a consortium of local governments formed to exercise the authorities granted under Subchapter Z, Chapter 402.910 of theTexas Local Government Code and Section 364.037 of the Texas Health and Safety Code, to work together for the collection of past due utilities or solid waste disposal fees. The City of Idalou will work with other cities that are members of the TRRA to recover any outstanding balances on accounts that are held with the City of Idalou or those cities who are members. Any accounts with outstanding balances will be reported to the TRRA and will attempted to be collected prior to new services being connected. Also, any prior outstanding balances with the City of Idalou will be collected prior to new services being connected as well.

CUSTOMER'S SIGNATURE DATE