Application For Service - Midland Power Utility Corporation

Owner/Tenant*

Owner
Tenant

Address For New Service*

Street Address APT/Unit # City Province Postal Code

Previous Address

Please complete if you are currently or have ever resided in Midland.

Street Address APT/Unit # City Province Postal Code

Effective Date*

Account #

Lawyer Name (Please complete if you are purchasing)

Lawyer Phone

Landlord Name (Please complete if you are renting)

Landlord Phone

Owner/Tenant 1*

First Name Last Name

Owner/Tenant 2

First Name Last Name

Mailing Address

(Please complete if your bill should be mailed to an alternate address)

Street Address Address Line 2 City Province Postal Code

Primary Phone*

Secondary Phone

Other Phone

Email*

Driver's License # or Other ID for 1st Applicant*

Date of Birth for 1st Applicant*

Driver's License # or Other ID for 2nd Applicant

Date of Birth for 2nd Applicant

Security Deposit

A Security Deposit may be applied to your first bill. Deposits may be waived with a good credit reference letter from another utility. Deposits will be waived for any low income designated residents. Please contact your Support Worker to send us a low income letter.

Third Party Notification Authorization

To protect your privacy our staff will not discuss details of your account with anyone other than those listed on your account. If you wish to designate a third party, who our staff can contact regarding your account for various reasons, you may give authorization below

Contact Name

First Last

Phone

Terms and Conditions

The authorized Hydro rates shall be the rates authorized from time to time by Ontario Energy Board (the OEB). The authorized rates are subject always to revision and adjustment from time to time by the OEB

The customer shall commence paying at the authorized rates from the date the Corporation is ready to service the Customer. The Corporation shall be deemed ready to serve the Customer on and after the date on which meter is installed and the Customer's service is connected to the Corporation's power line

This contract, when executed by Customer and Owner and by the Corporation, shall be binding upon them and their heirs, executors, administrators, successors, and assigns respectively, and on their property mentioned in the contract and the vacating of said property or change in occupancy of ownership thereof shall not release said property and its owner from this contract except at the option of and with the written consent of the Corporate

The contract shall not be binding upon the Corporation until executed by it by the signature of its proper officer, and shall not be modified or affected by any promise, agreement or representation by any agent or employee of the Corporation unless name is in writing and made part of this contract

The point of delivery shall be the point on the Corporation's line adjacent to the Customer's premises where the Corporation from time to time shall decide, the Customer shall take delivery at said point and shall from said point provide all works necessary and shall construct, maintain and operate said works safely and efficiently with proper devices, all in accordance with the Rules and Regulations of and satisfactory to the Corporation

The Customer aggress to provide, free of rental or other charge, convenient and safe space for the meters, wires, appliances and other equipment of the Corporation on or in said premises, and further agrees that no one who is not a properly authorized agent of the Corporation or otherwise lawfully entitled to do so shall be permitted or suffered to repair, remove inspect or tamper with an of said equipment and that the properly authorized agents of the Corporation shall, at all reasonable hours, have the right to read, inspect, repair, replace and remove any of said equipment and have free access for that purpose to said premise

All equipment of the Corporation on or in said premises shall be in care and at risk of the Customer, if any of said equipment is destroyed or damaged other that by ordinary wear and tear, the Customer shall pay to the Corporation the value of such equipment or the cost of repairing or replacing the sam

The Corporation agrees to use reasonable diligence to providing a regular and uninterrupted supply of electricity but does not guarantee a constant supply of electricity or the maintenance of unvaried frequency or voltage and will not be liable in damage to the Customer by reason or any failure to respect thereof

The corporation from time to time may take tests, to determine the Customer's maximum demand or power and energy and may install and use maximum demand or curve drawing meters and other measuring devices and equipment and may do anything else it may deem necessary to fix the basis of billing. After maximum demand has been so determined, the Customer shall not make any changes in or additions to the Customer's works or equipment without written consent of the Corporation

All electrical and mechanical equipment used by the Customer shall be subject to the reasonable approval of the corporation and the Customer shall take and use energy as not to endanger the equipment or other works of the Corporation or cause any wide or abnormal fluctuation of its line voltage. All such equipment of the Customer shall be selected with reference to securing highest feasible power factor at all loads. Maximum power of factors when operating the Customer's Maximum load shall be 50% up to 10 horsepower and over 10 horsepower shall be in accordance with Corporation requirement

Deposits - As a condition of supply of service, the Corporation requires the Customer pay a deposit, the amounts outlined in the Corporations Conditions of Service. The Corporation may waive the said deposit at its discretion, however, it reserves the right to re-implement the deposit, at anytime. Failure to maintain the deposit at the lever set by the Corporation may result in service disconnection

Accounts in areas that are forwarded to the credit bureau will also include collection fees incurred (a minimum of 30 percent of the areas balance

Accounts in default will be subject to further administration costs

Agreement*

This application once submitted by the customer and approved by the Corporation is a contract between the customer and the Corporation as governed by the provisions of the Ontario Business Corporation Act and other applicable Ontario acts. The customer and the Corporation shall comply with the conditions on the reverse side, which conditions form part of this agreement. I (we) understand and agree that all the information above pertaining to I (we) the undersigned will be used as necessary for collection purposes. I (we) give Midland Power Utility Corporation permission to use any information pertaining to me (us).

I agree

Customer Consent

MIDLAND POWER UTILITY CORPORATION is pleased to be your provider of electricity distribution services. To provide you with a reliable source of electricity, MIDLAND POWER UTILITY CORPORATION needs to collect and use certain personal information about you. As of January 1, 2004 the federal legislation protecting your privacy requires that MIDLAND POWER UTILITY CORPORATION obtain your written consent to collect, use and disclose your personal information for identified purposes. We invite you to read this notice carefully to understand our policies and practices with respect to personal information.

The nature of personal information we collect may include:

Information we receive from you such as your name, address, contact information and general financial, credit and reference information;
Facts about your historical and current consumption of power;
Information about your transactions with us, such as meter number, account number, account balances, payment history, and account activity;
Identifying information, such as a driver’s license.

MIDLAND POWER UTILITY CORPORATION uses the information we collect for the following purposes:

To provide you with continuous electric services and to bill you for those services;
To assist us in the collection of accounts;
To respond to your inquiries about energy use and billing;
To prevent fraud with respect to both you and our company;
To provide The Corporation of the Town of Midland with information;
To meet legal and regulatory requirements.

Because of the structure of the electricity sector in Ontario, it may be necessary to share your billing and consumption information with third party billing and settlement agencies. For example, your billing and consumption information may be provided to a retailer with whom you have chosen to enter into a separate contract. Your information may also be disclosed or shared with other agencies or organizations as required by law, agreement or regulation.

We have developed and implemented a Corporate Privacy Policy for maintaining the confidentiality and security of your personal information. At any time, you have the right to request access to your personal information, which we have collected, and to request amendments to personal information about you to ensure its accuracy and completeness. To make a request for access to personal information we may have collected, disclosed or used about you or to request that your personal information be amended, please contact Christine Bell, our Privacy Officer.

Agreement*

I have read and understood this statement of MIDLAND POWER UTILITY CORPORATION regarding the collection, use and disclosure of my personal information, and I hereby consent to have MIDLAND POWER UTILITY CORPORATION collect and use my personal information for the purposes stated above.

I agree