IP Toll Free Customer Order Form 2/9/2007
General Information Billing Account Name:
BusOrg ID:
Bill to Site ID:
Customer PON:
TSP:
Electronic Billing:
Order Information Order Action:
Interval:
Customer Requested Date:
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 Instructions Insert special instructions here.
Terms and Conditions 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 Customer (or its affiliate if expressly provided 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) any revenue commitment made by Customer and ii) payment by Customer of any applicable disconnection charges. If this Customer Order changes pricing for existing Services, such pricing change(s) shall be effective in the next billing month 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 to such Service(s), then Level 3's standard 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 Customer’s internal use only. Any terms and conditions contained in any Customer-provided Purchase Order shall have 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 savings, loss of data or cost of purchasing replacement services, or any indirect, incidental, special, consequential, exemplary or punitive damages arising out of the performance or failure to perform under this Agreement or any Customer Order. Relevant service detail documents, including without limitation, the Customer Quote, setting forth specific information regarding the Services ordered by Customer pursuant to this Customer Order, if 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 Order shall control. 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 provided during the upcoming month, except for charges that are dependent upon usage of Service, which are billed in arrears.
Authorized Customer Signature:
Date:
Authorized Customer Name:
Title:
Level 3 Internal Use Only Customer Order # (Clarify):
Account Manager Name:
Total Sales Order Value (SOV):
Account Manager Branch:
Ramp Up Period (months):
Sales Engineer Name:
Switch Type:
VIPER
Use existing Network Profile:
Sales Engineer Branch: Yes
Account Consultant (PM) Name:
IP Toll Free Customer Order Form 2/9/2007
Configuration Name:
Account Consultant (PM) Branch:
Order Title (optional):
CPM Accept Date:
IP Toll Free Customer Order Form
2/9/2007
eneral Information
Order Information
ontact Information
pecial Instructions
rms and Conditions
ster agreement(s) and service schedule(s) (if any) between Level 3 and Customer (or its affiliate if expressly Services stated herein shall have a month to month Service Term, subject to: i) any revenue commitment made by Customer Order changes pricing for existing Services, such pricing change(s) shall be effective in the next billing
ecuted a master agreement and/or applicable Service Schedule(s) with respect to such Service(s), then Level 3's mer Order) shall govern, a copy of which are available upon request. Customer’s internal use only. Any terms and conditions contained in any Customer-provided Purchase Order shall
es for loss of profits, loss of revenues, loss of goodwill, loss of anticipated savings, loss of data or cost of purchasing punitive damages arising out of the performance or failure to perform under this Agreement or any Customer Order.
tting forth specific information regarding the Services ordered by Customer pursuant to this Customer Order, if he Customer Order and any of the attachments, the detail in this Customer Order shall control.
ment. Invoices are delivered monthly. Level 3 bills in advance for Service to be provided during the upcoming n arrears.
el 3 Internal Use Only
IP Toll Free Customer Order Form
2/9/2007
IP Toll Free Customer TN Order
2/9/2007
Customer Order Summary Order Date: Order Action: Customer Requested Date:
Level 3 Internal Use Only Customer Order #
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 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 Customer (or its affiliate if expressly provided 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) any revenue commitment made by Customer and ii) payment by Customer of any applicable disconnection charges. If this Customer Order changes pricing for existing Services, such pricing change(s) shall be effective in the next billing month 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 to such Service(s), then Level 3's standard 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 Customer’s internal use only. Any terms and conditions contained in any Customer-provided Purchase Order shall have 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 savings, loss of data or cost of purchasing replacement services, or any indirect, incidental, special, consequential, exemplary or punitive damages arising out of the performance or failure to perform under this Agreement or any Customer Order. Relevant service detail documents, including without limitation, the Customer Quote, setting forth specific information regarding the Services ordered by Customer pursuant to this Customer Order, if 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 Order shall control. 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 provided during the upcoming month, except for charges that are dependent upon usage of Service, which are billed in arrears.
Authorized Customer Signature:
Date:
Authorized Customer Name:
Title:
oll Free
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IP Toll Free Information Sheet 2/9/2007
Toll Free Number IP Toll Free (if new)
TF Number Quantity
New or Ported?
RespOrg (Customer or L3)
Area of Service
Responsible Organization Letter of Authorization Toll Free Portability _________________(FAX)
ELS Portability _________________(FAX)
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 acting Level 3onCommunications, (“Level 3”)the to be the Org Responsible including my behalf, and atLLC my (KSW01) direction, to transfer Resp functionsOrganization (“Resp Org”) for the following Toll Free service numbers, to
Current Carrier___________________________ New Resp Org ID: KSW01 Toll Free Number(s) Ring To Number(s) Area of Service __ __-__ __ __-__ __ __ __
__ __-__ __ __-__ __ __ __
U.S
CANADA
CARIBBEAN
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U.S
CANADA
CARIBBEAN
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CANADA
CARIBBEAN
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U.S
CANADA
CARIBBEAN
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U.S
CANADA
CARIBBEAN
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U.S
CANADA
CARIBBEAN
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U.S
CANADA
CARIBBEAN
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U.S
CANADA
CARIBBEAN
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U.S
CANADA
CARIBBEAN
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U.S
CANADA
CARIBBEAN
Customer Information Print Customer Name________________________________________________________________________________ (As it appears on customers bill copy) Address _________________________________________________________________________
City _________________________________________ State ___ ___ Zip ___ ___ ___ ___ ___ - ___ ___ ___ ___
Customer Contact ____________________________________Phone (___ ___ ___) ___ ___ ___ - ___ ___ ___ ___
Billing Account Number ________________________________Delivery Date: ___ ___ / ___ ___ / ___ ___ I attest under penalty of law and as an authorized employee, or an authorized representative, of the Customer that the Customer is the exclusive enduser 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 understand that 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 the above as my Resp Org for the Toll Free numbers listed above.
Authorized Signature ___________________________________________________Date _______________________
Print Name ___________________________________________________________Title ______________________________
Blocking Form IP Toll Free 08/09/2006
Customer Information Toll Free Number
Customer Name
Product Instance ID (PIID) Request Date
Requested Due Date
Requestor
Contact Phone
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Comments/Special Instructions Insert special instructions here.
Account Manager
Internal Information Account Manager Phone
State
LATA
Account Manager Fax
Account Manager Email
SMS EXCEPTION REQUEST
New Request
Change Request
RESPORG EXCEPTION Please add the following RespOrg Ids to the SMS exception table to allow the associated customer to place orders on the Level 3 Communications CIC. Customer:
RespOrg ID:
TOLL FREE NUMBER The following Toll Free Numbers are included on the above request (Select 'ALL' if blanket approval is requested.) 8XX #:
ALL
Requested Effective Date: Requested Effective Time:
CUSTOMER APPROVAL
The Customer agrees that, in order to protect the integrity of the Level 3 network, it will not direct its RespOrg to route any toll free traffic to the Level 3 network until such toll free numbers have been provisioned and are active on the Level 3 network. Further, the Customer agrees that it will direct its RespOrg to remove SMS routing to the Level 3 CIC prior to disconnecting any toll free numbers previously provisioned on the Level 3 network. The Customer agrees to assist Level 3 in resolving any issues that may arise between Level 3 and the Customer's RespOrg pertaining to misuse of the Level 3 CIC that occurs as a result of this exception privilege. The Customer understands that Level 3 Communications, Inc. cannot be held responsible for any commitments made by other Carriers. Finally, the Customer understands that any changes to this arrangement are subject to approval by Level 3 Communications, Inc.
Authorized Customer Signature: Printed Name: Customer Phone Number: Date:
TollFree TN Port Out Form New Resp Org ID Release Date Bill Stop Date Toll Free TN Begin 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30
Toll Free TN End
Port out? (Y/N)