UFWaterShutOffRequest

Water Shut Off Request Form Submission

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Water Shut Off Request

Property Information

Community Name

Unit/Account Number

Resident/Occupant Name

Contact Phone

Contact Email Address

Property Address

Tenant(s) (if applicable)

Emergency Contact

Emergency Contact Name

Emergency Contact Phone

Emergency Alternate Contact Phone

I, , owner of the above-referenced unit, hereby request authorization for a temporary water shut-off. I understand that this completed request must be submitted at least seventy-two (72) hours before the requested shut-off date to allow the Association sufficient time to notify affected residents in accordance with the Association’s procedures. Water shut-offs are subject to Management and Association approval and scheduling. Water shut-offs are available Monday through Friday, from 9:00 a.m. to 5:00 p.m., excluding Association holidays, unless otherwise approved by the Association.

The vendor must provide the following: Copy of the current state license, a certificate of General Liability Insurance, and Certificate of Workers’ Compensation Insurance (or a valid Workers’ Compensation Exemption, if permitted by law)

Additional Insured and Certificate Holder:
Association Name & GRS Management, Inc.
15280 NW 79th Court, Suite 101
Miami Lakes, FL 33016

Requested Access Information

Owner

Tenant

Date Access is Needed*

Type Date

Time Access is Needed*

Type Time

5 plus 2 equals?*

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