STATE OF TEXAS § LAK E WAY MUNICIPAL UTILITY DISTRICT § …€¦ · • Prior LMUD Payment...

Lakeway Municipal Utility District (LMUD) Application and Service Contract for Water and Wastewater Service of 4

_____________ Customer Initials (Form Last Updated: 10/17/19)

STATE OF TEXAS § LAK E WAY MUNICIPAL UTILITY DISTRICT

§ (LMUD)

§ APPLICATION AND

§ SERVICE CONTRACT FOR

§ WATER AND/OR WASTEWATER

COUNTY OF TRAVIS § SERVICES

DATE SERVICE IS REQUESTED TO BEGIN:

(month/day/year)

CUSTOMER INFORMATION (please print or type):

CUSTOMER #1 CUSTOMER #2:

NAME: NAME:

Last Name Last Name

First Name First Name

Middle Initial Middle Initial

IDENTIFICATION.: (PROVIDE ONE) IDENTIFICATION.: (PROVIDE ONE)

Social Security # Social Security #

Driver’s License # State of Issuance Driver’s License # State of Issuance

Other Government Issued Id. # and Description Other Government Issued Id. # and Description

SERVICE ADDRESS:

Street Address:

City: State: Zip Code:

Telephone (main): (cell):

Email Address:

BILLING ADDRESS:

Same as Service Address: □ yes □ no (if no, complete the following section)

Street Address:

City: State: Zip Code:

Telephone (main): (cell):



PAYMENT:

LMUD accepts payments made by credit card or debit card (one-time or automatically recurring), personal

check, cashier’s check, money order, bank draft (one-time or automatically recurring), or online. A return

item fee will be assessed if payment is rejected. A late fee may also be assessed.

Paperless (emailed) Billing Requested: □ yes □ no

If yes, provide a valid email address under the Customer Information section, above.

Automatically Recurring Payment Requested: □ yes □ no

If yes, complete the Authorization for Automatic Payment Form and return it to LMUD.

CUSTOMER OBLIGATIONS:

ALL CUSTOMERS:

Customer must pay a nonrefundable Service Fee, which is due at the time of submittal of an Application

and Service Contract. In addition, once service commences, Customer must pay all rates, fees, and charges

and comply with all rules and regulations of LMUD now existing or as may be revised in the future.

WATER CUSTOMERS:

Customer shall install, at Customer’s own expense, a tap (if no tap is preexisting), a water service line

commencing at LMUD’s water meter and connecting to the Customer’s home or place of use, and a cut-off

valve. Customer shall be fully responsible for the service line from the water meter to Customer’s home or

place of use, including the installation of an approved back-flow device if required. Tampering with LMUD’s

water meter or using LMUD’s water cutoff valve is prohibited.

WASTEWATER CUSTOMERS:

Customer shall install, at Customer’s expense, a tap (if no tap is preexisting) and a back-up relief valve,

and must request inspection of same by LMUD after installation. More information is available on

LMUD’s website at: www.lakewaymud.org/service-providers/guideline-requirement-documentation/

wastewater-back-up-relief-valve-installation-guide

Grinder Pumps:

□ yes

• This section to be completed by Customer: Is there a grinder pump at the Service Address?

□ no □ unsure

• Important Note: If a grinder pump is present or required, LMUD will provide maintenance per the FY 2019/2020 Rate Order update.

➢ For LMUD-installed grinder pumps, additional installation fees may apply.

➢ For customer-installed grinder pumps, some repairs may require additional fees.➢ For all customers with a grinder pump, please call us to request a work order for

maintenance to be performed.

This section to be completed by LMUD:

□ LMUD-maintained grinder pump is already present at Service Address.□ New LMUD-maintained grinder pump is required to be installed for service.□ No grinder pump is present at Service Address, and none is required to be installed.□ Notes:



GENERAL TERMS OF SERVICE:

After approval of this Service Contract by LMUD, LMUD will sell and deliver water and/or wastewater to the

Customer, and the Customer shall receive and pay for such service(s) in accordance with LMUD’s most current

Rate Order, other orders, rules and regulations, policies, guidelines, Water Conservation Plan, and Drought

Contingency Plan, as the same may be amended from time to time by LMUD in its sole discretion. As

evidenced by its signature below, Customer expressly agrees to comply with and be bound by LMUD’s Rate

Order, other orders, rules and regulations, policies, guidelines, Water Conservation Plan, and Drought

Contingency Plan, as the same may be amended from time to time by LMUD in its sole discretion, and agrees

to the imposition and payment of fines and penalties for noncompliance.

LMUD has the authority to discontinue service to any Customer not complying with LMUD’s Rate Order,

policies, rules, or regulations, or for non-payment of utility fees and other LMUD charges. If service is

discontinued, service will not be re-established until Customer has corrected all conditions that caused the

termination. In some cases, a new Application for Service and Contract for Service must be submitted.

RATES, FEES, AND CHARGES:

LMUD’s rates, fees and charges shall be those adopted by the LMUD Board of Directors in its Rate Order,

which may be revised from time to time by LMUD’s Board of Directors in its sole discretion. A brief

summary LMUD’s current rates, fees and charges fees are available at LMUD’s Administrative Offices and

online at www.lakewaymud.org.

EASEMENT:

By the signature(s) below, the Customer(s) hereby grant(s) to LMUD any easements or rights-of-way required

for the purpose of installing, inspecting, maintaining, and operating pipelines, meters, valves and any other

equipment that may be required to extend or improve service by LMUD to Customer.

NOTICE OF RIGHT OF CONFIDENTIALITY:

Section 182.052 of the Texas Utilities Code requires LMUD to notify customers of their right to confidentiality.

You are hereby informed that you have the right to request confidentiality of your address, telephone number,

social security number and any information relating to the volume or units of utility usage and the amounts

billed to or collected from you for utility usage, as contained in LMUD’s records. To exercise your rights,

please complete the Request for Confidentiality Form and return it to LMUD.

CUSTOMER CERTIFICATION AND SIGNATURES:

By my/our signature(s) below, I/we hereby certify the information provided herein and following

statements are true and correct:

I/we am/are the ( ) OWNER(S) or ( ) LESSEE(S) of the property located at the Service Address listed above

[referred to as the "Customer" herein].

Customer desires to contract with Lakeway Municipal Utility District (LMUD) to receive water and/or wastewater

service from LMUD to the property located at the Service Address listed above.

Customer hereby agrees to pay all rates, fees, and charges and to comply with all Rate Orders, other orders, rules,

regulations, codes, and guidelines of LMUD now existing or as may be revised by LMUD in the future in LMUD’s

sole discretion. Customer further agrees to comply with and be bound by LMUD’s Rate Order, other orders, rules

and regulations, policies, guidelines, Water Conservation Plan, and Drought Contingency Plan, as the same may be

amended from time to time by LMUD in its sole discretion, and agrees to the imposition and payment of fines and

penalties for noncompliance.



CUSTOMER AGREES TO WAIVE, RELEASE, AND HOLD LMUD HARMLESS FROM ANY CLAIMS AND

DAMAGES RESULTING FROM MALFUNCTION, FAILURE, OR ABSENCE OF CHECK VALVES,

BACKFLOW PREVENTION DEVICES, AND PRESSURE RELIEF VALVES, INCLUDING WITHOUT

LIMITATION, DAMAGES TO PERSONS OR PROPERTY, DIRECT DAMAGES, SPECIAL DAMAGES,

INCIDENTAL DAMAGES, CONSEQUENTIAL DAMAGES, OR LOSS OF PROFIT OR REVENUE.

This Agreement shall become effective when signed by a duly authorized representative of LMUD.

CUSTOMER #1 CUSTOMER #2

By: By:

Printed Name: Printed Name:

Date: Date:

LAKEWAY MUNICIPAL UTILITY DISTRICT

(LMUD)

By:

Printed Name:

Title:

Date:


§ (LMUD)

§ SUMMARY OF RATES AND CHARGES

COUNTY OF TRAVIS § FY 2019/2020

Lakeway Municipal Utility District (LMUD) Summary of Rates and Charges

Page 1 of 4 (Form Last Updated: 10/17/19)

FY 2019/2020 WATER RATES (IN-DISTRICT & OUT-OF DISTRICT)

WATER BASE RATE: Monthly

5/8” Meters $20.00

1” Meters (Factor 1.7) $34.00

1½” Meters (Factor 0 .3) $66.00


4” Meters (Factor 16.7) $334.00

WATER VOLUME RATE:

Residential: Bimonthly- Per 1,000 gallons

0 - 15,000 Gallons $2.50

15,001 – 30,000 Gallons $3.25

30,001 – 50,000 Gallons $4.06

50,001 – 80,000 Gallons $5.08

80,001 – 100,000 Gallons $6.35

Over 100,000 Gallons $7.94

Commercial & Irrigation: Bimonthly- Per 1,000 gallons

0 – 100,000 Gallons $3.50

Over 100,000 Gallons $4.50

FY 2019/2020 WASTEWATER RATES (IN-DISTRICT ONLY)

WASTEWATER BASE RATE: Monthly

5/8” Meters $14.00


1½” Meters (Factor 3.3) $46.20


4” Meters (Factor 16.7) $233.80

WASTEWATER VOLUME RATE: Bimonthly - Per 1,000 gallons

$2.50

FY 2019/2020 WASTEWATER RATES (OUT-OF-DISTRICT ONLY)

WASTEWATER BASE RATE: Monthly

5/8” Meters $74.00


1½” Meters (Factor 3.3) $244.20


4” Meters (Factor 16.7) $1235.80

WASTEWATER VOLUME RATE: Bimonthly - Per 1,000 gallons

$2.50

GRINDER PUMP FEE: Monthly

$5.00

Rate adjustments may be made as allowed by LMUD’s Rate Order.



FEES:

Customer shall pay a non-refundable Service Fee of $50.00 for all applications for service. The Service Fee is

due at the time of submittal of the Application for Service.

Additional service, inspection, and other fees and charges shall be assessed and must be paid in accordance

with LMUD’s Rate Order.

SECURITY DEPOSIT:

Amount:

Customers must pay a Security Deposit to begin or restore service in the applicable amount set forth below:

Meter Size

5/8” 1” 1 ½” 2” 4”

In District $200 $350 $700 $1150 $3650

Out of District Water Only $150 $250 $500 $800 $2600

Out of District Water and

Wastewater

$400 $700 $1300 $2100 $6650

Fire Hydrant Meters $150 $250 $500 $800 $2600

Waivers:

Customers may be eligible to have their Security Deposit waived by LMUD’s General Manager if they have a

satisfactory payment history with LMUD for service at another service address within LMUD’s boundaries, or

if LMUD receives a satisfactory letter of reference from the Customer’s most recent electric, gas, or water

utility provider.

• Prior LMUD Payment History:

LMUD will waive the Security Deposit if the Customer previously had an account with LMUD and the

payment history shows that there were 12 months of continuous service with no more than one late

payment, no returned checks, no rejected credit/debit card charge or bank draft, no disconnections for non-

payment, no outstanding balances, and no unlawful use of service or utility service diversion.

• Other Utility Payment History and Letter of Reference:

LMUD will waive the Security Deposit after receiving a satisfactory letter of reference from the

Customer’s current electric, gas or water utility service provider. The letter must be provided directly to

LMUD by the Customer’s current utility service provider via fax sent to (512) 261-6681. The letter of

reference must show, for the twelve (12) month period immediately preceding the requested service date:

no disconnections for non-payment, not more than one (1) late payment, the utility service provider’s name

(the utility service provider must be the Customer’s most recent utility service provider), the name(s) on

the utility service account, the type of account (residential or commercial), the service address, the service

dates, and Customer’s twelve (12) month payment history.

Use of Security Deposit:

If after 12 months of continuous service Customer has had no late payments, returned checks, rejected

credit/debit card charge or bank drafts, disconnections for non-payment, outstanding balance, and/or unlawful

use of service or utility service diversion, LMUD will apply the Security Deposit to Customer’s account.

If after 12 months of continuous service Customer has had one or more late payments, returned checks, rejected

credit/debit card charge or bank drafts, disconnection for non-payment, outstanding balance, and/or unlawful

use of service or utility service diversion, LMUD will apply any Security Deposit on Customer’s account to

Customer’s final bill and refund any remaining balance to Customer. If no Security Deposit is on Customer’s

account, a new Security Deposit and payment of all outstanding fees and charges will be required to avoid



termination, restore service at the current Service Address, and/or obtain service at different Service Address.

BILLING CYCLE, PAYMENT OPTIONS, AND PAYMENT DUE DATES:

Charges to Customer will commence on the date service is made available, regardless of whether the Customer

connects to LMUD’s system.

Billing Cycle: LMUD utilizes a two-month billing cycle, and the volumetric portions of the bills are based

on meter readings for usage during a two-month period. The following table summarizes LMUD’s standard

billing cycle:

Billing Period Billed Usage Period Meter Reading Date

(Range)

Bills Sent Payment Due

October/November 9/21 — 11/20 November 1-5 December 1 December 20

December/January 11/21 – 1/20 January 1-5 February 1 February 20

February/March 1/21 — 3/20 March 1-5 April 1 April 20

April/May 3/21 — 5/20 May 1-5 June 1 June 20

June/July 5/21 — 7/20 July 1-5 August 1 August 20

August/September 7/21 — 9/20 September 1-5 October 1 October 20

Bill Payment Options:

Customers can conveniently pay their bills a variety of ways:

• Pay Online at www.lakewaymud.org

• Pay by Credit Card– make one-time credit card payments by phone by calling (512) 261-6222 x110. Or, authorize your account to be automatically charged for each bill by completing the Authorization for Automatic Payment Form and returning it to LMUD.

• Pay by Mail – send a personal check, cashier’s check, or money order to Lakeway MUD, Administrative Office, 1097 Lohmans Crossing, Lakeway, TX 78734-4459

• Pay in Person – by credit card, cash, personal check, cashier’s check, or money order to LMUD, Administrative Offices, 1097 Lohmans Crossing, Lakeway, TX 78734-4459. LMUD’s office hours on regular business days are Monday – Friday 8:00 AM – 5:00 PM, and the office is closed between 12:00 noon and 1:00 PM for lunch.

• Pay by Automatic Bank Drafts – have your bill automatically drafted from your bank account by completing the Authorization for Automatic Payment Form, providing a copy of a voided check, and returning both to LMUD.

Late Payments: Payment in full must be received by LMUD on or before the 20th day of the billing month

(e.g., February 20, April 20, June 20, August 20, October 20 and December 20.) Payments received by LMUD

after the payment due date are late payments. A 10% penalty is added for all late payments. Customer's

obligation to make timely payments for service is not released or diminished because a bill was not received.

Returned or Rejected Payments:

Returned checks will not be re-deposited, and bank draft and credit/debit card requests will not be reprocessed.

In the event a payment item or request is rejected, a $25.00 returned item charge will be assessed and must

be paid. A $25.00 late charge may also be assessed and must be paid in accordance with LMUD’s Rate Order.

In addition, service is subject to termination.

Non-Payment:

If payment in full is not received by the 20th day of every even-numbered month, LMUD may provide Customer



a Notice of Intent to Terminate Service and terminate service on the 10th day of the first month in the next

billing period if payment in full (including payment of late fees) is not received prior to said 10th day. A $50.00

non-payment/reconnection fee must be paid if payment in full is not received on or before the 9th day of

every odd-numbered month.

FEES TO RESTORE SERVICE:

If it becomes necessary for LMUD to shut off services to Customer's property, a fee of $50.00 (or $100.00, for

after-hours reconnections) will be charged for a reconnection of the service, a new Security Deposit, and all

late fees and outstanding balances on Customer’s account is required before service is restored after termination

of service for any reason. Payments must be received during LMUD’s normal business hours for service to be

restored the same day. If service is restored by anyone other than LMUD, the meter will be locked or removed,

and an illegal usage fee will be charged.

ILLEGAL USAGE FEE:

Illegal Usage Fee:

Tampering with LMUD’s meter (turning on/off service) or with any other LMUD- owned or maintained utility

appurtenance will result in the addition of an illegal usage fee of $100.00 to Customer’s bill.

OTHER FEES AND CHARGES:

LMUD also assesses other fees and charges for additional services. Those rates and charges can be found in

LMUD’s Rate Order.

CONTACT US:

Visit our website at: www.lakewaymud.org

Or contact us by:

Mailing and Physical Address:

Lakeway Municipal Utility District

Administrative Office

1097 Lohmans Crossing

Lakeway TX 78734-4459

Phone:

(512) 261-6222

Fax:

(512) 261-6681

Email:

[email protected]

Questions? Call (512) 261-6222 (Form Last Updated: 10/17/19)


§ (LMUD)

§ AUTHORIZATION

§ FOR

COUNTY OF TRAVIS § AUTOMATIC PAYMENTS

CUSTOMER INFORMATION (please print or type):

Customer’s Printed Name:

Customer’s Account Number:

Customer’s Service Address:

CUSTOMER REQUEST FOR AUTOMATIC PAYMENT SERVICES:

I (printed name), Customer, hereby

authorize Lakeway Municipal Utility District (LMUD) to pay water and/or wastewater fees, rates and charges

for service at the above-referenced service address by:

[check one]

□ automatically charging my credit or debit card

□ automatically withdrawing funds directly from my bank account

I understand that the charges will be incurred or the funds withdrawn (as applicable) two (2) business days

before the payment due date, and that a return item charge and possibly a late fee will be assessed if payment

is rejected.

CUSTOMER PAYMENT INFORMATION (please print or type):

If by Credit Card:

/

• Name on Card:

• Credit card or ATM/debit card number:

• Credit card or ATM/debit expiration date (month/year):

• Card Security Code:

• ZIP code where the credit or debit card statement is mailed for payment:

If by Bank EFT:

• Bank account number:• Bank routing number:• COPY OF VOIDED CHECK MUST BE ATTACHED

CUSTOMER SIGNATURE:

Customer’s Signature

Date

If sent by mail or hand delivered:




Lakeway, TX 78734-4459

If sent by fax:

(512) 261-6681

Please do not send by e-mail.

Questions? Phone: (512) 261-6222

Email:[email protected]

(Form Last Updated: 10/17/19)


§ (LMUD)

§ NOTIFICATION OF RIGHT OF

§ CONFIDENTIALITY OF CUSTOMER

COUNTY OF TRAVIS § INFORMATION

Section 182.052 of the Texas Utilities Code requires government-operated utilities to notify

customers of their right to confidentiality. You are hereby informed that you have the right to request

confidentiality of your address, telephone number, social security number and any information

relating to the volume or units of utility usage and the amounts billed to or collected from you for

utility usage, as contained in our records.

Please be aware that if you requested confidentiality in the past, you also have the right to cancel that

request for confidentiality.

To exercise your rights, please complete the information requested on this form and return it to the

address below. If you have requested confidentiality of your account information in the past, you do

not need to resend.

□ I hereby request confidentiality.

□ I hereby cancel my request for confidentiality and give permission to disclose my information.

Customer’s Printed Name:

Customer’s Account Number:

Customer’s Service Address:

Customer’s Signature:

Date:

If sent by mail:




Lakeway TX 78734-4459

If sent by fax:

(512) 261-6681

If sent by email:

[email protected]

Questions?

Call (512) 261-6222

STATE OF TEXAS § LAK E WAY MUNICIPAL UTILITY DISTRICT § …€¦ · • Prior LMUD Payment...

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Transcript of STATE OF TEXAS § LAK E WAY MUNICIPAL UTILITY DISTRICT § …€¦ · • Prior LMUD Payment...