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2. City Policy and Overview

   City policy requires that water bills be the responsibility of the owner of the property. Delinquent bills for water used on the property can become a lien against the property, not against the tenant. By completing the Property Owners Consent to Tenant Billing form, you are authorizing the tenant or property manager to act as your agent to receive all water billings and/or delinquent and shut-off notices. In this circumstance, no billing will be sent to you. 

   You can telephone the City at any time to have current charges quoted to you. As an alternative to the above, if you would like to receive a copy of the statement, we will mail one to you once a separate request is provided. By receiving a copy of the statement, you can review the status of the account and take necessary action to pay any delinquent water charges or ensure it is being paid by the tenant. 

   Any delinquent balances resulting in the shut-off of water service by the City will require payment in full for all past due balances, late fees and shut off penalties before water service is restored. If any balance remains unpaid, water will remain shut off and a lien may be placed on your property for collection. 

4. Property Owner Name*
5. Email Address*
7. Service Address In Cotati*
9. Tenant/Agent Name*
10. Tenant/Agent Email Address*
12. Property Owner Mailing Street Address*
14. City*
15. State*
16. Zip Code*
18. Phone Number
19. Cell Phone Number*
23. Consent and Acknowledgement
25. CONSENT - I, the owner of property address above within the City of Cotati, am responsible for payment of rates and charges of the City of Cotati for water and sewer service provided to said property and consent to the below action by the City:*
    -- Select One --I hereby request that Cotati bill directly in the name of the agent or tenant for said property address for all charges of City of Cotati for water and sewer service.I hereby request that Cotati bill in C/O the agent or tenant for said property address for all charges for water and sewer service. I hereby authorize the tenant at the service address to receive information ONLY regarding this account.

    Please select one action from the above for consent regarding the service address and tenant.

27. Acknowledgement*

    I consent to said changes and authorize the City to issue/discuss billings as indicated above to the Agent or Tenant for said property address. 

    I understand that I, as the property owner, continue to be responsible for payment of all water and sewer charges at the amount billed to the Agent or Tenant and in consideration for direct billing by the City to Tenant, I hereby waive notice from City of such charges or delinquencies as they may occur. 

    I understand that no billings will be sent to me after the date of the authorization unless I have requested so above. 

    This authorization shall be continued until revoked in writing by me. 

    1. I Agree
29. Execution Date

    This agreement is deemed to be consent provided in writing per CMC 13.03.260 and is executed as an agreement with the City effective the date of submittal. 

    
    

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31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit Submit and Print

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