مؤسسة الإمارات لأنظمة التبريد المركزي Empower Central Cooling Systems Corporation Name of account holder: ___________________________________ Empower account number: _________________________________ Premise address: _________________________________________ Owner Tenant Reconnection Required Customer Remarks: _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ I / We above mentioned owner / tenant of the said premise undertake full responsibility of all future Empower energy solutions district cooling bills to be paid in full by each due date to avoid disconnection of cooling services and penalty charges. * Subject to Management approval ________________________ Date: ________________ Signature / Stamp (if applicable) For Empower official use only ________________________ ______________________ Employee Name Customer Service Head Date: Date: Remarks: _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ Revised 23 JAN 2023