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CUSTOMER’S COPY TECHNICAL TEAM’s COPY FILINVEST COPY

WATER SERVICE CONTRACT INSPECTION REPORT APPLICATION FORM


WATER SERVICE CONNECTION
1. Installation and connection. [•] FILINVEST LAND INC., through its affiliate, Countrywide Water Water Meter: ________With Existing ________ None ________ With other source
Services Inc., (hereinafter “FILINVEST”)shall determine the appropriate meter size and location, Rate Code: ( ) Residential ( ) Commercial ( ) Industrial APPLICANT’S NAME (Surname / First Name / MI) (COMPANY NAME)
and install water meter and connection. The installed water connection shall be under the custody Nature of Use: _____________________________________________________________
of FILINVEST for maintenance purposes. FILINVEST may perform repairs, and maintenance of the Type of Pavement: Length: (m) Width: (m)
waterpipes before the Customer’s water meter while the Customer shall be responsible for the Concrete of Pavement _________________________ ___________________________ APPLICANT’S BILLING ADDRESS (House No. / Street / Subd / Brgy / City or Municipality
operation and maintenance of the reticulation of the water system after the meter. Concrete of Sidewalk _________________________ ___________________________
Upon connection of customer’s meter by FILINVEST, the customer shall immediately cease to Asphalt Pavement _________________________ ___________________________
connect with other water sources, if any. Failure to do so shall mean immediate disconnection of Escrombo/Unpaved _________________________ ___________________________
water connection to FILINVEST. No pressurized pump of any kind shall be installed without prior Water Storage Capacity: _____________________________________________________
written approval of FILINVEST. The water supply shall be for the exclusive household use of Type of Watermain: Size (mm) CONTACT NO. ________________________ TIN NO.: _____________________________
customer and shall not be sold to the public, nor be transferred or distributed to party/ies without Material: ________________________ _________________________________ (To be filled out by FILINVEST Representative)
written approval from FILINVEST. Pressure within the vicinity: _________________________________ Application No.: _______________________ Application Date: _____________________
FILINVEST may control and/or cut-off water supply connection in case of failure of the Customer Estimated Water Demand: (For Commercial and Industrial Only) Account No.: ________________________
to repair any leaks in the private reticulation. _________________________________________________________________________ Rate Code: ( ) Residential ( ) Commercial ( ) Industrial
2. Water Meter. The water meter registry to measure the Customer’s consumption, shall be the Service Pipe Length – Tapping Pt. to Meter Riser _________________________________ Nature of use: _____________________________________________________________
basis for monthly billing. Recommended size of WSC _________________________________
FILINVEST shall retain ownership over the water meter and the meter set assembly. Customer Recommended size of Water Meter _________________________________
must ensure that the water meter is adequately protected against tampering and shall not be Technically Feasible: ( ) Yes ( ) No WATER SERVICE CONTRACT
transferred or relocated without prior written consent of FILINVEST. Remarks: _________________________________________________________________
Stolen meters shall be reported within 24 hours from discovery. FILINVEST shall replace the water Inspected by: ______________________________ Date: _______________________ 1. Installation and connection. [•] FILINVEST LAND INC., through its affiliate, Countrywide Water
meter at its expense provided that it is indeed stolen and there is no indication of negligence on (Name and Signature) Services Inc., (hereinafter “FILINVEST”)shall determine the appropriate meter size and location,
the part of the Customer. However, in case of succeeding event/s of stolen meter, the cost of the and install water meter and connection. The installed water connection shall be under the custody
replacement shall already be shouldered by the Customer. (To be filled by FILINVEST Representative) of FILINVEST for maintenance purposes. FILINVEST may perform repairs, and maintenance of the
3. Access to premises. Customer shall allow representative of FILINVEST to enter customer’s METER INFORMATION waterpipes before the Customer’s water meter while the Customer shall be responsible for the
premises for the purpose of meter reading, inspection of water pipes, replacement of meter and Serial Number: _____________________________ Size: _______________mm operation and maintenance of the reticulation of the water system after the meter.
other water meter related works to gather information and/or performance of operations and Brand: ___________________________Initial Reading: ___________________ Upon connection of customer’s meter by FILINVEST, the customer shall immediately cease to
maintenance. connect with other water sources, if any. Failure to do so shall mean immediate disconnection of
4. Payments. Customer shall pay a connection fee and cash guaranty bond, as may be determined water connection to FILINVEST. No pressurized pump of any kind shall be installed without prior
and imposed by FILINVEST. The cash guaranty bond shall be answerable for any unpaid liabilities written approval of FILINVEST. The water supply shall be for the exclusive household use of
of Customer to FILINVEST. FILINVEST may adjust the cash guarantee bond based on twice the customer and shall not be sold to the public, nor be transferred or distributed to party/ies without
average monthly consumption of the Customer. The Customer shall be responsible in replenishing written approval from FILINVEST.
and at all times, maintaining the cash bond in an amount fixed by FILINVEST. Upon termination FILINVEST may control and/or cut-off water supply connection in case of failure of the Customer
of the Contract, the balance of the cash guarantee bond, after deduction of all outstanding to repair any leaks in the private reticulation.
payables to FILINVEST, shall be immediately returned to Customer. Failure of customer to adjust 2. Water Meter. The water meter registry to measure the Customer’s consumption, shall be the
the bond despite notice will give FILINVEST the right to disconnect the water connection. basis for monthly billing.
FILINVEST shall issue monthly bills reflecting Customer’s water consumption based on applicable FILINVEST shall retain ownership over the water meter and the meter set assembly. Customer
tariff rates. In the event of any increase in cost of service, FILINVEST may adjust said water rates must ensure that the water meter is adequately protected against tampering and shall not be
as necessary upon written notice to the Customer. Any increase in water rates shall be effective transferred or relocated without prior written consent of FILINVEST.
upon receipt of said notice and be applicable prospectively. Stolen meters shall be reported within 24 hours from discovery. FILINVEST shall replace the water
The Customer shall pay the water bills in full, within a period of seven (7) days from the delivery meter at its expense provided that it is indeed stolen and there is no indication of negligence on
of Statement of Account to accredited payment facilities. If the Statement of Account remains the part of the Customer. However, in case of succeeding event/s of stolen meter, the cost of the
unpaid after its payment cut-off date, C u s t o m e r s h a l l p a y i nterest for late payments replacement shall already be shouldered by the Customer.
computed from the first day after payment cut-off date at a rate of five percent (5%) per 3. Access to premises. Customer shall allow representative of FILINVEST to enter customer’s
month based on a 360-day year. premises for the purpose of meter reading, inspection of water pipes, replacement of meter and
In the event that the water meter is stolen, destroyed or found defective, the Customer shall, other water meter related works to gather information and/or performance of operations and
pending the replacement of meter, pay the water bills equivalent to average monthly water maintenance.
consumption based on the existing policies of FILINVEST. The same rule shall be applied if 4. Payments. Customer shall pay a connection fee and cash guaranty bond, as may be determined
Customer refused to allow FILINVEST from replacing the water meter. and imposed by FILINVEST. The cash guaranty bond shall be answerable for any unpaid liabilities
Any act of water meter tampering, illegal water connection or illegal transfer of water meter is of Customer to FILINVEST. FILINVEST may adjust the cash guarantee bond based on twice the
strictly prohibited and shall be subjected to a penalty amounting to PHP 20,000 and shall give average monthly consumption of the Customer. The Customer shall be responsible in replenishing
FILINVEST the right to pull-out the water meter. Request for reconnection shall be subject to and at all times, maintaining the cash bond in an amount fixed by FILINVEST. Upon termination
FILINVEST existing policies. of the Contract, the balance of the cash guarantee bond, after deduction of all outstanding
payables to FILINVEST, shall be immediately returned to Customer. Failure of customer to adjust
the bond despite notice will give FILINVEST the right to disconnect the water connection.
FILINVEST shall issue monthly bills reflecting Customer’s water consumption based on applicable
tariff rates. In the event of any increase in cost of service, FILINVEST may adjust said water rates
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FILINVEST COPY TECHNICAL TEAM’s COPY CUSTOMER’S COPY

as necessary upon written notice to the Customer. Any increase in water rates shall be effective SKETCH: 5. Termination of the contract and/or disconnection of water service. Upon notice to the
upon receipt of said notice and be applicable prospectively. Customer, and without need of court order, FILINVEST may terminate this contract and/or
The Customer shall pay the water bills in full, within a period of seven (7) days from the delivery disconnect the water service due to any of the following causes: (i) failure to pay bills for six (6)
of Statement of Account to accredited payment facilities. If the Statement of Account remains months, , (ii) non-payment of deficiency in previous billings, fees, and other penalties; (iii)
unpaid after its payment cut-off date, C u s t o m e r s h a l l p a y i nterest for late payments violation of/failure to comply with the terms and conditions of this contract, applicable laws, rules
computed from the first day after payment cut-off date at a rate of five percent (5%) per and regulations, and (iv) such other cause(s) as FILINVEST may consider sufficient to
month based on a 360-day year. warrant the termination of the Contract and/or the disconnection of water service. For these
In the event that the water meter is stolen, destroyed or found defective, the Customer shall, purposes, FILINVEST shall have full power and authority at any time to enter his premises without
pending the replacement of meter, pay the water bills equivalent to average monthly water the need to secure any order or permission from any court or authority or any other power other
consumption based on the existing policies of FILINVEST. The same rule shall be applied if than herein terms and conditions to carry out the disconnection;
Customer refused to allow FILINVEST from replacing the water meter. 6. Non-Waiver of Default. In case of non-compliance or violation by the Customer of any of the
Any act of water meter tampering, illegal water connection or illegal transfer of water meter is terms and conditions herein indicated or in the billing, invoices and notices of FILINVEST, , the
strictly prohibited and shall be subjected to a penalty amounting to PHP 20,000 and shall give failure of FILINVEST to exact strict compliance with such terms and conditions shall not be
FILINVEST the right to pull-out the water meter. Request for reconnection shall be subject to interpreted as a waiver by FILINVEST of any of its rights or remedies under law or this terms and
FILINVEST existing policies. conditions nor a waiver of any subsequent breach of the same or another stipulation in this Terms
5. Termination of the contract and/or disconnection of water service. Upon notice to the and conditions.
Customer, and without need of court order, FILINVEST may terminate this contract and/or 7. Governing law and venue. The Customer shall be covered and bound by any future policies,
disconnect the water service due to any of the following causes: (i) failure to pay bills for six (6) rules and regulations which may be adopted or issued by FILINVEST except those specifically
months, , (ii) non-payment of deficiency in previous billings, fees, and other penalties; (iii) intended to apply retroactively.
violation of/failure to comply with the terms and conditions of this contract, applicable laws, rules These Terms and Conditions shall be construed, interpreted and governed by the laws of the
and regulations, and (iv) such other cause(s) as FILINVEST may consider sufficient to Republic of the Philippines and each party irrevocably submits to the jurisdiction of the proper
warrant the termination of the Contract and/or the disconnection of water service. For these courts of Mandaluyong City, to the exclusion of all other venues, for the purpose of enforcing any
purposes, FILINVEST shall have full power and authority at any time to enter his premises without right or obligation arising herein.
the need to secure any order or permission from any court or authority or any other power other
than herein terms and conditions to carry out the disconnection; Should FILINVEST be compelled to seek judicial relief against the Customer to enforce any part of
6. Non-Waiver of Default. In case of non-compliance or violation by the Customer of any of the this Terms and Conditions, the latter hereby agrees to indemnify the former the sum of TWENTY
terms and conditions herein indicated or in the billing, invoices and notices of FILINVEST, , the FIVE (25%) PERCENT of the amount due by way of liquidated damages which in no case shall be
failure of FILINVEST to exact strict compliance with such terms and conditions shall not be less than TWENTY FIVE THOUSAND PESOS (P25,000.00) and to pay an additional amount
interpreted as a waiver by FILINVEST of any of its rights or remedies under law or this terms and equivalent to TWENTY FIVE (25%) PERCENT of the amount claimed in the complaint as attorney’s
conditions nor a waiver of any subsequent breach of the same or another stipulation in this Terms fees but in no case less than TEN THOUSAND PESOS (P10,000.00) plus cost of suit and other
and conditions. expenses which may be awarded by the appropriate court.
7. Governing law and venue. The Customer shall be covered and bound by any future policies, IN WITNESS WHEREOF, the Parties have executed this Water Service Installation Terms and
rules and regulations which may be adopted or issued by FILINVEST except those specifically Conditions on the date and at the place written above.
intended to apply retroactively.
These Terms and Conditions shall be construed, interpreted and governed by the laws of the _______________________________ _____________________________________
Republic of the Philippines and each party irrevocably submits to the jurisdiction of the proper Customer’s Signature FILINVEST Representative’s Signature
courts of Mandaluyong City, to the exclusion of all other venues, for the purpose of enforcing any Over Printed Name and Date Over Printed Name and Date
right or obligation arising herein.

Should FILINVEST be compelled to seek judicial relief against the Customer to enforce any part of Account Number: ___________________________________________________________
this Terms and Conditions, the latter hereby agrees to indemnify the former the sum of TWENTY Customer’s Name: __________________________________________________________
FIVE (25%) PERCENT of the amount due by way of liquidated damages which in no case shall be Billing Address: _____________________________________________________________
less than TWENTY FIVE THOUSAND PESOS (P25,000.00) and to pay an additional amount Connection Fee: ____________________________________________________________
equivalent to TWENTY FIVE (25%) PERCENT of the amount claimed in the complaint as attorney’s Guaranty Deposit: ___________________________________________________________
fees but in no case less than TEN THOUSAND PESOS (P10,000.00) plus cost of suit and other VAT(12%): _________________________________________________________________
expenses which may be awarded by the appropriate court. Total Amount Paid: PhP_______________________________________________________
IN WITNESS WHEREOF, the Parties have executed this Water Service Installation Terms and OR No.: ___________________________________________________________________
Conditions on the date and at the place written above. Date Paid: _________________________________________________________________

_________________________________ ________________________________________
Customer’s Signature FILINVEST Representative’s Signature
Over Printed Name and Date Over Printed Name and Date

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