Clean-Up Utility Service Request

Clean-up applicants will have the utility service for 30 days only, starting on the service start date. Clean-up request fee is $20.00 (non-refundable) which will be applied on the first utility bill. A photo copy of the applicant's driver's license is required to initiate service. The first bill will have the application fee and other services that are attached to the account. If applicant needs longer than the required 10 business days, a full deposit will be required for the utility account.

Please fill in the information below for a clean-up request. Once received, a confirmation e-mail will be sent to validate we have the request.

Terms and Conditions

I, the undersigned customer, acknowledge and agree that I shall be financially responsible for any amounts due for utility services provided to my account and any accrued late fees or charges until termination of services is requested. The City hereby reserves the righ to terminate or suspend any delinquent utility account and may assess late fees for any unpaid balances due as set forth under the Winter Springs City Code and the customer may appeal such delinquency or termination pursuant to the Winter Springs city Code. the City or its assignee shall be entitled to enforce any claims or rights in order to collect any debt owed to the City under this account and may undertake the collection of any debt against you and this account by any lawful means. Should the City take action to collect a debt on your account, you agree that the City shall be entitled to collect from you any and all costs associated with the collection of said debt including, but not limited to, reasonable attorney's fees, court costs, collection agency fees, and other debt collection expenses incurred by the City.

Your utility bill is due upon receipt. Your account is considered late 20 days from the bill date. A late fee of $5.00 or 5.0% per month, whichever is greater, will be assessed on any amount past due.

In addition to the terms and conditions set forth in this application, the Winter Springs City Code, as may be amended from time to time, shall govern building, collection, and termination of service for non-payment of utility bills. Customers have the right to appeal their current month's bill by making a written application to Utility Billing Customer Service requesting a review within ten (10) days after the date of the bill.

Signature:

Today's Date:

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