CITY OF CONCORDIA, KANSAS
                                                       UTILITY SERVICE CONTRACT

 COLLECTION POLICY:                                                                               DATE:     October 3, 2012

    1.   Payment of account is due within 20 days following date of billing. As soon as reasonably possible after regular monthly
         billing of utility meters, the Director of Utilities is directed to send notices of all consumers who have not then paid the
         preceding month’s utility bill, or bills, notification of the total amount of utility bills then owed, advising that if such are not paid
         in full within five (5) days of the date of such notice that such utility service will be discontinued. Any consumer receiving such
         notice concerning said unpaid utility bills shall have the right to appear and be heard concerning the same prior to the
         expiration of the five (5) days by contacting the City Water/Sewer Dept. in the City Hall. If the total amount due for such
         utilities and service is not paid on or before the deadline established, the billings determined to be proper according to the
         ordinances of the City of Concordia, and the records show that the consumer has had due notice of such billings and of
         his/her right to be heard, concerning the same, then the Director of Utilities shall cause such services to be discontinued.

    2.   A disconnection charge for utilities disconnected due to delinquency shall be $30.00 per occurrence.

    3.   To have the utilities re-connected on SATURDAYS, SUNDAYS, HOLIDAYS OR AFTER NORMAL WORKING HOURS, the
         disconnect fee shall be $60.00 and the bill shall be PAID IN FULL at the Law Enforcement Center and a Call-Out employee
         dispatched to renew the service.

    4.   Prior to the connection of water service to any premises, the customer shall pay a deposit in the amount of $80.00. The
         deposit shall be held and accounted for as required by K.S.A. 12-822 and any amendments thereto. At such time as the
         customer has completed 12 (twelve) consecutive months of payment for water and sewer service without delinquency, the
         deposit and any accrued interest shall be credited to his or her account. No new service connection shall be made until the
         Service Connection fee is paid.

    5.   The INITIAL SERVICE CHARGE shall be as follows: $20.00 for any new residential or commercial customer establishing an
         account; $20.00 for an established customer moving to another address. The service connection fee is nonrefundable.

    6.   In the case of an emergency turn-off for repair of service lines, there shall be no disconnect charge.

   RATE STRUCTURES: See Water Rate schedule as set out by Ordinance No. 98-2682 adopted 5-6-98.
                    *See Sewer Rate schedule as set out by Ordinance No. 98-2680 adopted 3-25-98.

   Accepted for the City:               Director of Utilities___              By ___________________

   I, the undersigned, do hereby agree to pay the City of Concordia, Kansas, at the Water and Sewer Utility Offices, for water and
   sewer utilities services as specified above, beginning on the date of connection to premises. Payment is to be made monthly within
   20 days from date of billing or within the time specified in Section 1 hereof.

   I further state that I am not, as of this date, in arrears to the City of Concordia, Kansas for any previous utility bills.

Customer Signature                                        Service Address                                         Date Service Begins
   I agree to the above items.
(box must be checked to be valid)                         Billing Address (if different from above)
                                                                                                                  Welcome Wagon
Customer Name                                             Phone Number                                              Yes    No

City Newsletter       Yes      No                         S.S.N. #/FED ID #                                       U.S. Driver’s License #

Residential or Commercial                          Residential or Commercial                          Deposit New
Service Connection fee $20.00 _______              Service Transfer fee $20.00 _______                Service $80.00 ____________

   * The sewer amount is based on the first full month’s water consumption for new consumers and annually re-figured on the
average water consumption for Jan.-Feb. with the new sewer amount appearing on the April billing.

         CITY HALL MAILING ADDRESS: P.O. BOX 603, CONCORDIA, KS 66901 – PHONE- (785)-243-2670
            LAW ENFORCEMENT CENTER TELEPHONE 243-3131 - CITY HALL FAX NO. (785)243-3328

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