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2. Account Number
3. Meter Number
4. Deposit Receipt Number
6. Name*
8. Addressed to be served*
10. Occupied as:
12. Mail bill to:*
14. Phone*
15. Date of Birth*
    Date of Birth
17. Agreement*

    The undersigned Subscriber hereby makes application for water and sanitary sewer service to be furnished by the City of Borger Water Department and agrees to take and use same, and to pay for all water and sanitary sewer service supplied to or for said premises, at the rate now fixed or which may be hereafter fixed by the City Council of the City of Borger, Texas, as bills are rendered therefor, and for water as measured by the meter, and for sanitary sewer service as the rate is set, until written notice is given by the subscriber to the City of Borger Water Department at its office, to discontinue service, and subscriber hereby expressly agrees to and this application is made subject to, all and singular, the terms and provisions of the Ordinances, Resolutions and Motions passed by the City Council of the City of Borger and all rules and regulations fixed and prescribed by the City Council for the management, operation and protection of the Water Department and the Sanitary Sewer Service branch thereof.
    
    The Subscribed hereby agrees to be held responsible for the payment of all bills rendered for water and sanitary sewer service at his premises until written notice is give by him to the City of Borger Water Department for the cancellation of this contract; subscriber expressly agrees that in the event default is made in the payment of any bill for water or any bill for sanitary sewer service, the water service may be discontinued without notice at the option of the City of Borger Water Department; this application to become a contract only upon acceptance of the same by the City of Borger Water Department.
    
    Provided, however, if sanitary sewer service is not available at the premises of applicant, then the references herein to sanitary sewer service are to be disregarded, but in the event subsequent sanitary sewer service is available and furnished to such premises, then all of the provisions hereof will be in full force and effect.
    
    Title to the water meter and connections furnished by the City of Borger, Texas, remains in said City.
    
    

    1. I agree
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