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Bulk Water Filling Station Application
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Person Responsible for Accounts Payable
Customer accounts will be invoiced monthly for all water purchased at the Station. Invoices will include all applicable fees and charges for the gallons of water supplied to the customer as measured by the Station.
Number of Accounts Requsted
Vehicle License Plate Numbers and/or Names of Individual Account Holders
When your account is established you will receive a six (6) digit account number that will be used for PIN access at the Station. You may set up multiple accounts if you wish to track individual users or vehicles. The City maintains no responsibility for ensuring proper use of account PINs. PINs may be deactivated at any time by contacting Customer Service during regular business hours at (785) 587-2480.
Person Completing Request Form
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