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2. LEAD SERVICE LINE REPLACEMENT AGREEMENT

4. The Customer elects for the City to replace the Customer’s lead water service line: 

   The undersigned customer(s), whose name(s) appear in the signature block at the bottom of this page (the “Customer”) grants to the City of Bluffton (the “City”) and to its approved contractors and/or subcontractors an Agreement to enter upon the Customer’s property at the address shown below (“Property”) for the purpose of connecting the Customer’s residence to the City’s water service line adjacent to the Property, at no cost to the Customer.

6. Property Street Address:*
7. City*
8. Zip Code*

10. The Customer represents that the Customer is/are the sole owner(s) of the Property at the address shown above and has/ have sole authority to enter into this Agreement with the City. 

    The term of this Agreement shall be twelve (12) months following the date set forth below.

    The City or its approved contractors and/or subcontractors will replace the City service line from the City’s water main to a City meter or valve installation (“Installation”) at or near the Customer’s Property line at no cost to the Customer. The City, in the City’s sole discretion, will determine the location of the Installation. The City’s service line and the Installation will be owned and maintained by the City.

    The City or its approved contractors and/or subcontractors will install a Customer connecting line from the Installation to the inside of the Customer’s residence (“Connecting Line”). The Customer’s Connecting Line is currently and will continue to be owned and maintained by the Customer.

12. CUSTOMER AGREES TO ALLOW THE CITY OR ITS APPROVED CONTRACTORS AND/OR SUBCONTRACTORS TO TAKE PHOTOS OR VIDEOS AT THE PROPERTY AS NECESSARY FOR RECORD KEEPING PURPOSES. THE CITY AGREES THAT THE PHOTOS WILL NOT BE SHARED PUBLICLY.

    CUSTOMER ACKNOWLEDGES THAT IF ANY UPGRADES TO THE CUSTOMER’S INTERNAL PLUMBING (Connecting Line and/or plumbing from the City’s meter or the Installation to the Customer’s plumbing beyond the point of the City’s meter or Installation) ARE REQUIRED, IT WILL BE AT THE SOLE COST OF THE CUSTOMER. THIS INCLUDES, BUT IS NOT LIMITED TO, ANY REQUIREMENT BY A GOVERNMENTAL ENTITY FOR THE CUSTOMER TO MEET APPLICABLE PLUMBING CODE(S).

    CUSTOMER ACKNOWLEDGES THAT IF ANY EXISTING BURIED CONNECTING LINES THAT ARE NOT MARKED OR OTHERWISE MADE OBVIOUS TO THE CITY OR ITS APPROVED CONTRACTORS AND/OR SUBCONTRACTORS ARE DAMAGED DURING CONSTRUCTION, IT WILL BE AT THE SOLE COST OF THE CUSTOMER TO REPAIR THE DAMAGED INSTALLATIONS.

14. Upon completion of the work necessary to affect the new connection, the City will restore the Customer’s  Property as nearly as practicable to its former condition. The City warrants the workmanship of its installation of the Customer Connecting Line for a period of 12 months following the date set forth below, with the City’s liability limited to the cost of repairing or replacing the Customer Connecting Line. 

    If flow and/or pressure issues are experienced as a result of the installation of the Connecting Line, Customer has 20 days from the work completed date to file a claim.

16. THE CUSTOMER ACKNOWLEDGES THAT THE CUSTOMER HAS RECEIVED THE “IMPORTANT NOTICE ABOUT YOUR WATER SERVICE AND LEAD” INFORMATION SHEETS PROVIDED BY THE CITY.

    IN CONSIDERATION FOR PERFORMING THE WORK TO INSTALL THE CONNECTING LINE AT THE CITY’S COST AND THE CITY’S AGREEMENT TO PROVIDE A 12-MONTH LIMITED WARRANTY THAT THE CITY’S WORK WILL BE FREE FROM DEFECTS IN WORKMANSHIP, THE CUSTOMER AGREES TO INDEMNIFY, RELEASE AND HOLD HARMLESS THE CITY AND ITS AFFILIATES AND AGENTS FROM AND AGAINST ALL CLAIMS, LIABILITY AND COSTS (“CLAIMS”) RESULTING FROM ACTS AND OMISSIONS OF THE CITY AND/OR ITS APPROVED SUBCONTRACTORS IN INSTALLING THE CUSTOMER CONNECTING LINE.

18. Customer Name:*
20. Is this a rental property?*

    1. Yes
    2. No
21. Are you the Property Owner or Tenant?

    1. Property Owner
    2. Tenant
23. Property Owner Phone Number:*
25. Property Owner Email:*
27. Tenant Phone Number (if different than Property Owner):
29. Tenant Email (if different than Property Owner):
31. Does your home have a basement and/or crawl space?*

    1. Yes
    2. No
33. Do you have any buried installations that may be affected by digging (i.e. electric dog fence, sprinkler system, etc.)?*

    1. Yes
    2. No
35. Does your home have any hidden hazards that the City should be cautious of during construction?*

    1. Yes
    2. No
37. Describe the potential hidden hazzards:
41. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
43. Property Owner's Signature:*
44. Date:*
    Date:
Leave This Blank:


46. 1. Receive an email copy of this form.
47. Email address

    This field is not part of the form submission.

48. Submit

* indicates a required field