IP Toll Free
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Transcript of IP Toll Free
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General Information
Billing Account Name: BusOrg ID: Customer PON:Bill to Site ID: TSP:
Order Information
Order Action: Interval: Customer Requeste
Contact Information
Primary Contact: Technical Contact:
Work Phone: Work Phone:
Email Address: Email Address:
Product Acceptance: Billing Contact:
Work Phone: Work Phone:
Email Address: Email Address:
24-Hour Contact: Fraud Contact:
Work Phone: Work Phone:
Email Address: Email Address:
Special InstructionsInsert special instructions here.
Terms and Conditions
Authorized Customer Signature: Date:
Authorized Customer Name: Title:
Cu
The Service(s) identified in this Customer Order are governed by and subject to the master agreement(s) and service schedule(s) (if any) between Level 3 and Custoprovided for under such affiliate master agreement) applicable to such Service(s). The Services stated herein shall have a month to month Service Term, subject toCustomer and ii) payment by Customer of any applicable disconnection charges. If t his Customer Order changes pricing for existing Services, such pricing change(smonth following Level 3's acceptance of this Customer Order.
In the event that Level 3 and Customer (or its affiliate as the case may be) have not executed a master agreement and/or applicable Service Schedule(s) with respecstandard Master Service Agreement/Service Schedule(s) (as of the date of this Customer Order) shall govern, a copy of which are available upon request.
Any Customer-provided Purchase Order referenced in this Customer Order shall be for Customers internal use only. Any terms and conditions contained in any Cushave no force or effect.
Notwithstanding any other provision hereof, neither party shall be liable for any damages for loss of profits, loss of revenues, loss of goodwill, loss of anticipated savireplacement services, or any indirect, incidental, special, consequential, exemplary or punitive damages arising out of the performance or failure to perform under thi
Relevant service detail documents, including without limitation, the Customer Quote, setting forth specific information regarding the Services ordered by Customer puattached hereto, are incorporated herein. In the event of conflict between the detail in the Customer Order and any of the attachments, the detail in this Customer O
Level 3 installation date to be communicated pursuant to the terms of the master agreement. Invoices are delivered monthly. Level 3 bills in advance for Service to bmonth, except for charges that are dependent upon usage of Service, which are billed in arrears.
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IP Toll FreCustomer Order For
2/9/20
Configuration Name: Account Consultant (PM) Branch:
Order Title (optional): CPM Accept Date:
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Customer Order Summary Level 3 Inte
Order Date: Customer Order #
Order Action:
Customer Requested Date:
Customer Information
Organization Name:
Bus Org ID:
Site Name:
Address:
City:State:
Zip:
Primary Contact:
Phone:
Fax: (optional)
E-mail:
Customer Service Name:
(if applicable)
Special Instructions:
Insert special instructions here.
Market Information
See attached Market Summary Sheet. (must be included for proper processing of the order)
Customer Approval
C
The Service(s) identified in this Customer Order are governed by and subject to the master agreement(s) and service schedule(s) (if any) between Level 3 and Customeprovided for under such affiliate master agreement) applicable to such Service(s). The Services stated herein shall have a month to month Service Term, subject to: i) Customer and ii) payment by Customer of any applicable disconnection charges. If this Customer Order changes pricing for existing Services, such pricing change(s) shmonth following Level 3's acceptance of this Customer Order.
In the event that Level 3 and Customer (or its affiliate as the case may be) have not executed a master agreement and/or applicable Service Schedule(s) with respect tostandard Master Service Agreement/Service Schedule(s) (as of the date of this Customer Order) shall govern, a copy of which are available upon request.
Any Customer-provided Purchase Order referenced in this Customer Order shall be for Customers internal use only. Any terms and conditions contained in any Customhave no force or effect.
Notwithstanding any other provision hereof, neither party shall be liable for any damages for loss of profits, loss of revenues, loss of goodwill, loss of anticipated savingsreplacement services, or any indirect, incidental, special, consequential, exemplary or punitive damages arising out of the performance or failure to perform under this Ag
Relevant service detail documents, including without limitation, the Customer Quote, setting forth specific information regarding the Services ordered by Customer pursu
attached hereto, are incorporated herein. In the event of conflict between the detail in the Customer Order and any of the attachments, the detail in this Customer Orde
Level 3 installation date to be communicated pursuant to the terms of the master agreement. Invoices are delivered monthly. Level 3 bills in advance for Service to be month, except for charges that are dependent upon usage of Service, which are billed in arrears.
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Toll Free Number New or Ported? Area of Service
IP Toll Free (if new)
IP Toll FreeInformation Sheet
2/9/2007
TF NumberQuantity
RespOrg(Customer or L3)
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Responsible Organization Letter of Authorization
As the end-user subscriber, or the authorized representative of an end-user subscriber, of certain Toll Free service numbers (the Customer), I hereby
authorize Level 3 Communications, LLC (KSW01) (Level 3) to be the Responsible Organization (Resp Org) for the following Toll Free service numb
New Resp Org ID:KSW01
Toll Free Number(s) Ring To Number(s) Area of Service
Customer InformationPrint Customer Name_____________________________________________________________________________
(As it appears on customers bill copy)
Address __________________________________________________________
City _____________________________________ State ___ ___ Zip ___ ___ ___ ___ ___ - ___ ___ ___ ___
Customer Contact ___________________________________Phone (___ ___ ___) ___ ___ ___ - ___ ___ ___ ___
Billing Account Number _______________________________Delivery Date: ___ ___ / ___ ___ / ___ ___
Authorized Signature __________________________________________________ Date _______________________
Print Name __________________________________________________________ Title ______________________________
Toll Free Portability _________________(FAX) ELS Portability _________________(FAX)
to
Current Carrier___________________
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I attest under penalty of law and as an authorized employee, or an authorized representative, of the Customer that the Customer is the exclusive end-user subscriber of the Toll Free service numbers listed above. The Customer assumes all liability for the use (including without limitation, authorized,
fraudulent or misappropriated) of traffic of any other end-user subscriber with regards to the Toll Free service numbers listed. In addition, I understandthat this request for a Resp Org change does not constitute an order for disconnect of service with my existing carrier(s). I, on behalf of the Customer,continue to accept responsibility for notifying my existing carrier(s) of any intention to disconnect and/or change my Toll Free service after designating thabove as my Resp Org for the Toll Free numbers listed above.
U.S CANADA CARIBBEA
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U.S CANADA CARIBBEA
U.S CANADA CARIBBEA
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Customer Information
Customer Name Toll Free Number
Product Instance ID (PIID)
Request Date Requested Due Date
Requestor Contact Phone
Blocking Information
Block Action Type State LATA
Comments/Special Instructions
Insert special instructions here.
Internal Information
Account Manager Account Manager Phone
Blocking FormIP Toll Free08/09/2006
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Account Manager Fax Account Manager Email
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TollFree TN Port Out FormNew Resp Org ID
Release Date
Bill Stop Date
Toll Free TN Begin Toll Free TN End Port out? (Y/N)
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