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Temporary Account Application

  1. 320 Alexandria Boulevard
    Oviedo, FL 32765
    Phone: 407-971-5535
    Fax: 407-971-5806

    Office Hours:
    Monday-Friday
    8 a.m. until 5 p.m.

  2. Electronic Signature Agreement*

    I, the undersigned, understand and agree that I am responsible for all the charges for the temporary utility services I am requesting. I represent to the City of Oviedo that the owner of the property has been advised of the request. The owner has given permission and understands the responsibility for any consumption of utility service. I understand that the temporary utility service charge of $35 is for a period of no more than 48 hours.

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

  3. This agreement is executed on the:

  4. This agreement is executed by (hereinafter referred to as (“Releasor”):

  5. This agreement is executed on the ____ day of _______, A.D. 20__, by ________________________ (hereinafter referred to as (“Releasor”), for the benefit of the City of Oviedo, Florida, (hereinafter referred to as “City”)

    WHEREAS, the Realtor is the lawful owner/occupant/agent of the dwelling or building (hereinafter referred to as “Property”) located at the service address noted above.
    WHEREAS, the Releasor has requested the City of Oviedo to provide and turn on water services to the property.
    WHEREAS, the Releasor as an inducement to the City of Oviedo to provide and turn on utility services to the Property, freely and voluntarily executes this Release and Waiver of Liability.

    NOW, THEREFORE, RELEASOR DOES HERBY AGREE AS FOLLOWS:
    1. In consideration of the City of Oviedo providing and turning on utility services to the Property, and other valuable consideration, receipt of which is acknowledged by the Releasor, the Releasor does hereby freely and voluntarily and knowingly execute this Release and Waiver of Liability with the express intention of releasing the City of Oviedo, ifs officials, officers, agents and employees, from al liability on any claim arising out of the action of the City of Oviedo in providing and turning on utility services to the Property.

    2. Releasor does hereby agree to indemnify and hold the City of Oviedo and its officials, officers, agents and employees, harmless from any and all liability, loss or damage the aforesaid may suffer as a result of claims, demands, costs or judgements against them arising out of the providing utility services to the Property, whether the liability, loss or damage is caused by or arising out of the negligence of the City of Oviedo or of it officials, officers, agents, or employees or otherwise.

  6. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

  7. The City of Oviedo does not accept liability for transmission of this form with confidential information. Email over the internet is NOT a secure medium and privacy cannot be assured.

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  9. This field is not part of the form submission.