AUTUMN LKES CONDOMINIUM ASSOCIATION

UTILITY REIMBURSEMENT – WATER

(City of Aurora – Water Consumption and Fox Metro– Water Reclamation)

Home owners may submit one (1) reimbursement request per year for the excess cost associated with above average water usage for theirrigation and watering of exterior grass areas, plants, flowers, scrubs and trees during the following summer months

(City of Aurora service/billing periods MAY –JUNE JULY - AUGUST)

TO QUALIFY FOR REINBURSEMENT

Home owners must submit a completed and signed copy of this form along with applicable copies of the City of Aurora – Utility Invoice (water) and the Fox Metro – Water Reclamation bill by DECEMBER 1stof the CURRENT YEAR in which exterior watering has occurred and reimbursement is requested. Request received after December 1st can not behonored due to annual budget constraints.

DESCRIPTION OF REIMBURSEABLE WATER USAGE

City of Aurora – Water Usage

Water usage is reimbursable for the (summer) months indicated above. It is computed by comparing the difference in the(summer) month's water consumption to the water consumption occurring during the preceding winter (base) months of January and February. It is the net difference between the summer months minus the winter base month’s water consumption. The additional consumption and cost for the summer months is considered reimbursable when it exceeds that of the winter (base) months.

Fox Metro – Water Reclamation

Water reclamationcosts are approximately one halfof the City of Aurora water consumption cost. The Fox Metro reimbursement is determined by comparing the City of Aurora water consumption costduring the winter base month’s to the summer month’s usage as described above. The additional cost of City of Aurora water consumptionduring thesummer months will be factored by .5 to determine the Fox Metro portion of the reimbursement.

Home owner reimbursement is limited to a maximum of $100 per year.

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Home Owner to Complete the Following (Information directly from your utility invoice)

City of Aurora – Utility Invoice (water consumption)

SERVICE PERIOD TOTAL CURRENT WATER USAGE

CHARGE CONSUMPTION

MAY - JUNE $______$______CCF

(Summer months)

JULY – AUGUST $______$______CCF

(Summer months)

JANUARY – FEBRUARY $______$______CCF

(Base months - winter)

+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

Fox Metro –Water Reclamation District

SERVICE PERIOD CURRENT BILLED AMOUNT

MAY – JUNE $______CCF

JULY – AUGUST $______CCF

Service Periods are approximate as the billing/service periods for the City of Aurora and Fox Metrobilling dates may vary slightly. It should be noted that the reimbursements are intended to represent and cover the majority of the summer months as indicated above.______

HOA to Complete

SERVICE PERIOD WATER WATER REIMBURSEMENT

CONSUMPTION CONSUMPTION

(Summer months) (Base months)

Jan/Feb

MAY – JUN $______minus $______= $______

JUL – AUG $______minus $______= $______

CITY OF AURORA - WATER CONSUMPTION REIMBURSEMENT

TOTAL (May/June & July/August) $______

FOX METRO ADJUSTMENT FACTOR WATER REIMBURSEMENT

(.5times thewater consumption reimbursement total) $______

HOME OWNER TOTAL REIMBURSEMENT (Aurora and Fox Metro) $______

Association monthly dues are current and paid to date; Yes______No______

(If NO – Reimbursement will be applied to the outstanding association balance as credit)

APPROVED BY______Date______

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Submitted By:

REQUEST MUST BE SUBMITTED BY DECEMBER 1ST

Home Owner Name ______

Address______

Home Owner Signature______

CBR Tel Number______Date Submitted______

Send to;

Baum Property Management, ATTN; Loree King,

Telephone number 630-897-0500 FAX number 630-270-1879