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2. Name of Business Entity: *
4. Name of person responsible for meter:*
6. Billing Address*
8. City*
9. State*
10. Zip*
12. Email Address:*
14. Business Phone:*
15. Cell Phone:*
17. Purpose of meter rental:*
19. Location where meter will be used:*
21. Estimated number of days meter will be rented: *
23. I both personally and on behalf of the business entity which I represent, if any, acknowledge full responsibility for returning the meter which has been delivered to me for my use by the Town of Windsor, Colorado. I understand that it is my obligation to return the meter undamaged and to pay for all services used and any damages to the meter or any damage to the fire hydrant upon which the meter is installed during the time that the meter is in my possession. Evaluation of damages will be determined solely by the Town of Windsor. By signing this agreement, I acknowledge that I have read and agree to comply with the "Fire Hydrant Meter Guidelines", a copy of which has been provided to me. I have paid a deposit of Two Thousand, Four Hundred dollars ($2,400.00) to the Town of Windsor upon my execution of this agreement. I understand that my deposit will be refunded to me, assuming that the meter is returned undamaged in a timely fashion and that all fees and charges are paid in full upon return of the meter. I hereby authorize the Town of Windsor to withhold from my deposit any unpaid fees and charges, and to pay from my deposit any repair or replacement costs resulting from damage occurring to the meter or any other Town property during the time the meter is in my possession.
25. Initial to indicate your have read and agree to the above terms.*
27. Date*
    Date
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29. 1. Receive an email copy of this form.
30. Email address

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31. Submit

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