2. City of Bismarck Public Works Department
   Commercial Utility Service Agreement
   The person filling out the form is:*

   1. Owner or Landlord

   
   If you are a Renter, do not complete this form.
   Please have the owner or landlord contact the Public Works Utility Billing Department to update the utility account with your information by calling 701-355-1700, option 1. Thank you.
4. Public Works Utility Billing Account Information
   Service Address (Physical address of building)*
5. 
   Closing Date*
   
   Closing Date
7. Name requested on Utility Account*
8. Phone at Service Address*
10. Contact Person*
11. Cell Phone*
12. Contact Work Phone
14. E-mail address*
16. Agreement Type*

    1. New account for purchase of property
    2. Current account name change only
18. Mailing Address (Location to receive Utility Bill if different than service address)
20. City
21. State
22. Zip
24. Emergency Contact
    (other than aforementioned Owner or Contact Person)*
25. 
    Emergency Contact Phone*
27. Agree to Terms*

    Commercial Utility Service Agreement
    
    This agreement shall remain in effect and shall be binding until notice is given to the Public Works Customer Service Division by the customer of the termination of this agreement. Upon notice of termination by the customer, a final reading of the water meter will occur. Utility billing begins when the water meter is picked up for newly built properties. It is agreed that the undersigned will be bound by the rules, regulations, policies, procedures, and ordinances applicable to the City’s utility systems and solid waste management. The undersigned must pay for all services used and rendered through the final reading of the water meter. Should the undersigned have an outstanding balance on a previous Public Works Utility Billing account, it is agreed that the balance will be transferred to this property for payment.
    
    

    1. Yes I Agree to the Terms of this Agreement
29. Someone from the Public Works Utility Billing Department will contact you by telephone or E-mail.
    Contact will be made within 2 working days to verify this information.
Leave This Blank:


33. 1. Receive an email copy of this form.
34. Email address

    This field is not part of the form submission.

35. Submit

* indicates a required field