Reestablish Service Request
*Please return this form via email, fax or mail to: Customer Care (see above).

WAIVER OF LIABILITY TO RECONNECT ELECTRIC AND WATER SERVICE

The policy of the City of East Point Electric and Water Utilities is that the service is not reconnected without a responsible party on the premises. To allow for service reconnection at any time (whether or not a responsible party is on the premises), this waiver of liability form must be completed and signed by the property owner/renter/occupants and filed with the City East Point’s Customer Care Department. This waiver must be completed every time the service is reconnected.

service(s) to be reconnected at this location at any time whether or not a responsible party is on the premises. The City of East Point Electric and Water Utilities will agree to reconnect the electric or water service(s) without a responsible party being on the premises only upon the completion and filing of this agreement with the City of East Point’s Customer Care Department.

RELEASE AND WAIVER OF LIABILITY: Property Owner/Renter/Occupant hereby RELEASES, WAIVES and DISCHARGES the City of East Point Electric and Water Utilities, its successors and assigns, and its officers, employees, agents and consultants, from all liability, loss, claims, damages, possible or actual causes of action, cost, attorneys’ fees, and other expenses arising from any actions, claims, arbitrations, demands or lawsuits that may otherwise accrue, including claims for or relating to damages, loss or injury to persons or property, in any way resulting from or related to the reconnection of the electric and/or water service to this property, from any cause whatsoever.

By signing below, I am stating that I have read this agreement and understand the possible ramifications of allowing Electric and Water service reconnection without a responsible party on the premises and that I am the owner/renter/occupant of the property listed above:

Mission Statement
To provide exceptional city services in the most professional, courteous and effective manner to enhance the quality of life in the City of East Point.

FOR OFFICIAL USE ONLY