BULK WATER SALES CONTRACT

F 2147 (R2023-11)

The purpose of this form is for customers to apply for access to bulk water services from The City of Calgary, and to set out
the terms and conditions that will apply to bulk water services.

Applicant’s Name (Please Print) Account No. (office use only)

Mailing Address:

Phone Number: E-mail address:

Number for Text Messages:

(To receive updates and other information when required)

Term and Conditions

Prior to receiving an access card(s) for bulk water services (“Access Card”), the Applicant must submit its vehicle/trailer(s) containing the
vessels for inspection by The City to ensure compliance with the Cross Connection Control requirements in Water Utility Bylaw 40M2006,
and must modify the vehicle/trailer as necessary to meet such requirements. The Access Card(s) will be activated within one (1) business
day of receipt.

By signing below, the Applicant agrees to the following terms and conditions:

1. The Applicant shall:

a) pay any service charge associated with this Bulk Water Sales Contract;
b) pay any deposit(s) for each Access Card associated with this Bulk Water Sales Contract, which shall remain the property
of The City until refunded in accordance with Public Utility Account Bylaw 41M2006;
c) obtain water at only bulk water station locations designated by The City and comply with filling instructions provided by The
City;
d) pay in full all monthly service fees and water consumption charges when due;
e) comply with any other requirements applicable to bulk water services set out in Water Utility Bylaw 40M2006 and Public
Utility Account Bylaw 41M2006 as may be amended from time to time; and
f) be responsible for all water consumption costs resulting from a lost or stolen Access Card until such time as the Applicant
cancels the Access Card online at Calgary.ca/bulkwater.

2. The Access Card(s) is the property of The City, and failure of the Applicant to comply with these terms and conditions may result in
cancellation of the Access Card and/or its privileges.

3. The Access Card(s) may be deactivated if there is an outstanding balance on the Applicant’s bulk water account unpaid beyond
ninety (90) days. Deactivated Access Cards will not be reactivated until the outstanding balance, and any further deposits required
by The City, are paid.

4. This Bulk Water Sales Contract is accepted by the City and effective on the date the Applicant receives the Access Card(s).

To sign this digitally, please use Adobe Fill & Sign at the right using Acrobat Reader
If Applicant is an individual (Signature): If Applicant is a corporation, partnership or other entity (Signature):

I/we have authority to bind the Applicant.

Submit completed forms to the e-mail address from which this form was received.
For questions, or to close an account, please visit Calgary.ca/bulkwater.

Your personal information is being collected for the purpose of creating a bulk water account with The City so you can purchase water from The City Bulk Water
stations. This information is collected pursuant to Section 33(c) of The Freedom of Information and Protection of Privacy Act of Alberta. If you have any
questions about this collection, please contact Team Lead, Water Facilities at P.O. Box 2100, Station M, Calgary, AB Canada T2P 2M5, 403-510-1322 or
Wiliam.rathwell@calgary.ca.

ISC: Confidential