Please enable JavaScript in your browser to complete this form.Name *FirstLastAccount Number *Phone *Email *Service Address *Address Line 1Address Line 2CityState / Province / RegionMultiple ChoiceRushed Service – $100: Same day reconnection after 2.00 PM following non payment, charged in addition to the 25 dollar reconnection feeRushed Service – $100: Same day activation for payments received after 2.00 PM, instead of the standard 48 hour timeline.Service Call – $25: On-site visit in response to a customer report or service request where the issue is not related to PWCo equipment or service.Meter Verification – $75.00 per hour: On-site visit at the customer’s request to identify, label, trace, or confirm meter connections.What date and time are you requesting service? *DateTimeTerms and ConditionsBy submitting this request, the customer agrees to the following:Please tick ALL BOXES. *I acknowledge that the applicable service fee will be charged to my account.I understand that all fees are non-refundable once dispatched.I understand that service timelines may vary due to operational demands.I agree to provide safe and unobstructed access for PWCo staff.I acknowledge that PWCo may decline service if safety or access issues exist.Signature * Clear Signature I confirm that I have read and understood the Terms & Conditions outlined above. I agree to provide accurate information and comply with all requirements for requested service. Date / Time *DateTimeSubmit
