Leak Adjustment One-Time Request Form

Central Arkansas Water (CAW)

Leak Adjustment Form

CAW understands unexpected water leaks can result in a higher than average billing statement. To help ease the burden if you have experienced a qualifying leak, you can submit a one-time request for a leak adjustment.

Please complete the form below to request a review of your account. All requests will be evaluated according to CAW's Leak Adjustment Policy.

Customer Name

First NameLast Name

Customer Account Number

Service Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Email

example@example.com

Date Leak Discovered:

Date

Date Leak Repaired:

Date

Leak Repaired By:

Please select the correct repair:

*If selecting "other", briefly describe specific details about the repair: Share your details here..

Comments - briefly share any additional helpful information about your leak event.

Leak Repair - Acceptable Receipt Documentation Guidance:

Please Note: CAW's Leak Adjustment Policy requires a copy of the paid repair bill and/or receipts, or acknowledgement citing an unavailable leak repair statement.

CAW will accept the following receipt documentation:

1. Copy of the paid repair bill and/or receipt(s) and photos of the repair.

2. Itemized receipt for materials or parts purchased.

3. Propery Owner's written statement describing the nature of the leak, date it was discovered, and the date repairs were completed.

4. Inspection report or notice from a licensed contractor or property manager confirming the leak repair.

All documentation must include the service date, repair location, and a description of the issue corrected.

Please upload your leak repair documentation:

Leak Repair Certification:

Repair Statement Acknowledgement:

Payment Responsibility Acknowledgement:

Leak Adjustment Guarantee Absence Acknowledgement:

Leak Adjustment Timeframe Acknowledgement:

Leak Adjustment Policy Guidelines Acceptance:

Signature

Central Arkansas Water Leak Adjustment Policy

Central Arkansas Water’s Leak Adjustment Policy offers a courtesy adjustment to our valued customers.

Central Arkansas Water will provide a courtesy adjustment for only ONE billing cycle during a leak episode*.

Property Owner and/or Accountholder Responsibilities if a Water Leak Occurs:

1. Ensure proper maintenance of plumbing systems on the premesis. This includes proactively monitoring plumbing systems with regular inspections, promptly addressing timely repairs, and completing any necessary upgrades to prevent potential leaks and conserve water.
2. Regulary monitor your account online for unusually high water usage which may potentially indicate water wastage.
3. Contact Central Arkansas Water Customer Service staff immediately if you notice abnormal account activity.

Should any questions arise which require assistance in understanding responsibilities regarding plumbing maintenance, please do not hesitate to reach out to Central Arkansas Water Customer Service staff:

LIVE CHAT IS AVAILABLE DURING THE FOLLOWING BUSINESS HOURS:
7:30 a.m. to 5 p.m. – Monday through Thursday
8 a.m. to 4:30 p.m. – Friday

CALL CENTER HOURS
7:30 a.m. to 5 p.m. – Monday through Thursday
8 a.m. to 4:30 p.m. – Friday
501.372.5161 OR toll free 1.855.742.0309

*Please Note - This courtesy adjustment is NOT dependent on the severity of the leak nor a leak that occurred over a long period of time.

Leak Adjustment One-Time Request Form

Central Arkansas Water

New Service

Leak Repair Information:

Leak Repair Certification Information:

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