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Linebacker Protection

Enrollment Form

Payment Agreement:

Linebacker - Water - $85 plus tax / year

Linebacker Plus - Water & Wastewater - $140 plus tax / year

Linebacker Complete - All Inclusive (Water, Wastewater & In-Home Plumbing) - $185 plus tax / year

Coverage Details:

Name:

Email Address:

Telephone:

Address of Covered Property:

Street Address:

City:

State:

Zip Code:

Mailing Address if Different From Above:

Street Address:

City:

State:

Zip Code:

Enter Code (if applicable):

Referring Customer Information ( if applicable ):

Name:

Street Address:

City:

State:

Zip Code:

Lineback Referral Program

If you are already enrolled in Linebacker, you can refer family, friends, neighbors, and coworkers to Linebacker Protection plans and earn a $20 reward for each enrollment! They must be a Connecticut Water customer and the reward is in the form of a $20 credit on your quarterly water bill. More Information

I have read and agree to the terms and conditions. Please bill me in equal payments on my periodic water bill: I understand the annual price of the plan is listed below. Coverage for the new programs begin 30 days after enrollment.

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