669 DUTTON ISLAND RD WEST GATE - COMMERCIAL SERVICE APPLICATION COMMERCIAL SERVICE
APPLICATION
Building Community® f\Goov (
C9CO3-1 I-(-I2-00
DATE 2/zs //i ELECTRIC WATER SEWER
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TYPE OF ENTITY CORPORATION PARTNERSHIP INDIVIDUAL
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Please Print (Complete lines 1-5 if applicable.)
1. Name �/ r
2. Business Name C( .D-eAc
3. FEI/EIN Number Phone Number �d j/. 2-4 U-1 - 5g2 A0
4. Service Address 66 9 ►)cJ r /3 (4-,d 6 &v S7Effective Start Date
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5. Mailing Address low S e. • fk-0
STREET ADDRESS
44 /1-,j)-C- 3c & � 3 /2- 33
CITY STATE ZIP CODE
PLEASE READ REVERSE BEFORE SIGNING
By my signature, I submit this application for service provided by JEA. I agree to be responsible for payment of all billing
rendered for this service together with all costs of collection Incurred by JEA, its successors or assigns, including the
reasonable attorney's fees, in the event of default in this agreement. I agree to abide by the Laws of the State of Florida,
Rules and Regulations, and Policies of JEA and by my signature acknowledge the receipt of a copy of the JEA Rules and
Regulations
NAME/TITLE (PLEASE PRINT) EM NUMBER
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SIGNATURE
66133 72OO
FOR OFFICE USE ONLY
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(Please read before signing application.)
Establishment of Credit JEA
COMMERCIAL SERVICE APPLICATION
• Thank you for giving us the opportunity to provide your electric / water service.
• JEA has a responsibility as a utility to adopt rules and regulations governing its relations
with customers as are necessary and which are not inconsistent with the laws of the
State of Florida and the rules and regulations of the Florida Public Service Commission.
• Utility service is rendered to you on a credit agreement; you are billed for water and/or
electricity after you have used it. As a result, deposit coverage shall be established.
• JEA has three methods by which an applicant for Commercial / Industrial service may
establish deposit coverage. These are:
1. Payment of a cash deposit not less than two (2) times the average bill as estimated by
JEA or as thereafter ascertained based upon consumption.
2. Posting of a Surety Bond by an Insurance Company or Irrevocable Letter of Credit
executed by an approved banking institution equal to at least two (2) times the average
monthly bill as estimated by JEA or as thereafter ascertained, provided the Surety is
licensed to transact business in the State of Florida.
The purpose of a deposit is to protect the Utility and Its customers against those who use
electricity / water and then leave without paying their final bill. Such losses must ultimately be
spread among all customers and increase their cost of electricity / water service.
AUTHORIZED AGENT'S NAME TITLE
EMAIL ADDRESS PHONE NO.
AUTHORIZED AGENTS'S NAME TITLE
EMAIL ADDRESS PHONE NO.
AUTHORIZED AGENTS'S NAME TITLE
EMAIL ADDRESS PHONE NO.
(Please read before signing application.)
Establishment of Credit JEA
COMMERCIAL SERVICE APPLICATION
• Thank you for giving us the opportunity to provide your electric / water service.
• JEA has a responsibility as a utility to adopt rules and regulations governing its relations
with customers as are necessary and which are not inconsistent with the laws of the
State of Florida and the rules and regulations of the Florida Public Service Commission.
• Utility service is rendered to you on a credit agreement; you are billed for water and/or
electricity after you have used it. As a result, deposit coverage shall be established.
• JEA has three methods by which an applicant for Commercial / Industrial service may
establish deposit coverage. These are:
1. Payment of a cash deposit not less than two (2) times the average bill as estimated by
JEA or as thereafter ascertained based upon consumption.
2. Posting of a Surety Bond by an Insurance Company or Irrevocable Letter of Credit
executed by an approved banking institution equal to at least two (2) times the average
monthly bill as estimated by JEA or as thereafter ascertained, provided the Surety is
licensed to transact business in the State of Florida.
The purpose of a deposit is to protect the Utility and Its customers against those who use
electricity / water and then leave without paying their final bill. Such losses must ultimately be
spread among all customers and increase their cost of electricity / water service.
_ / e-ei
AUTHORIZED AGENT'S NAME TITLE ,a-`- i-e
EMAIL ADDRESS PHONE NO. -
AUTHORIZED AGENTS'S NAME TITLE
EMAIL,ADDRESS PHONE NO.
AUTHORIZED AGENTS'S NAME TITLE
EMAIL ADDRESS PHONE NO.
1