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HomeMy WebLinkAboutQWEST - CONTRACT - CONTRACT - AGREEMENT QWESTAcknowledgment Number: QWEST CORPORATION INTERSTATE PRIVATE LINE TRANSPORT SERVICES PRICING PLAN ACKNOWLEDGMENT City of Fort Collins Customer's Legal Name ("Customer") Customer hereby orders from Qwest Corporation ("Qwest") the Qwest Interstate Access Service ("Service") indicated below ("Acknowledgment"). Customer understands and agrees that Qwest provides Service solely under the regulations, rates, and charges of Interstate Access Tariff F.C.C. No. 1 ("Tariff'). In the event of a conflict between this Acknowledgment, Qwest Records and/or the Tariff, the Tariff prevails. Service is subject to the Credit Allowance for Service Interruptions in the Tariff which provides Customer's sole and exclusive remedv for interruptions of anv kind to the Service. SERVICE REQUESTED Choose one Service er form ANALOG/DATA SERVICES VIDEO DATA SERVICES HIGH CAPACITY SERVICES ❑ Analog Private Line Service ❑ Broadcast Video Service ® DS Level (Select Speed) ❑ Analog Voice Grade (Select Plan) ❑ HDTV -NET SDI ❑ SST/ (Select OC-N) ❑ SVDS / (Select Speed) ❑ SHNS/ (Select OC-N) ❑ Digital Data / Select Speed) 11 Old Town Square, Ft Provide Service between Collins and 300 Laporte, Ft Collins (Qwest will provide and maintain the Service at the locations and quantities as requested by Customer and evidenced by Qwest records, hereby incorporated by reference.) Billing No. Circuit ID Optional Features: None Comments: Contact is Paul Simon 970-221-6632 ❑ If checked, additional Service information is attached to this Acknowledgment, however, attachments will not add to or change the regulations, rates, terms, and/or charges of the Tariff. ® If checked, Customer hereby certifies that Service listed above qualifies for exemption of the Private Line Surcharge in accordance with the Tariff under exemption category Et. Written notification will be provided to Qwest at such time the exemption is no longer applicable due to changes or re -termination of any Service. RATE PLAN The following Monthly and Nonrecurring Rates ("Rates") for Service reflect the Rates currently in effect in the Tariff. Customer understands the actual Rates will be the Rates in effect in the Tariff on the first date of installation of Service, or for existing Service, the date the service order is completed by Qwest. Customer will also pay Qwest all applicable taxes, usual and customary surcharges, and all government imposed fees and charges that relate to the Service or installation rendered hereunder, excluding the Private Line Surcharge, if Customer qualifies, and if that box is appropriately checked on this Acknowledgment. Total Monthly Rate: $251.20 as of 05/14/2007 Total Nonrecurring Rate: $610 as of 05/03/2007 Customer has selected a Pricing Plan ("Plan") which protects the Monthly Recurring Rate from Qwest initiated Rate increases for 24 months ("Plan Term"). Customer understands that if Customer disconnects Service, in whole or in part, prior to the completion of the Plan Term, the Tariffs termination liability charges may apply. If Customer: (a) cancels an order for Service prior to the date Service is available for use; or (b) is unable to accept Service within 30 business days after the original service date, the Tariffs cancellation charges may apply. Customer has chosen a Plan based on a specific term commitment and as such understands the rates provided herein are based upon Customer completing an entire Plan Term for the subject Service; therefore, ANY ADDITIONS TO SERVICE WILL REQUIRE A NEW ACKNOWLEDGMENT FORM DESIGNATING THE APPLICABLE PLAN TERM. This Acknowledgment will be governed by the laws of the state of Colorado, except with regard to matters which are within the exclusive jurisdiction of the state or federal regulatory agency. Those matters alone will be governed by the laws of the appropriate jurisdiction. Any legal proceeding arising out of, or relating to this Acknowledgment, will be brought in a United States District Court, or absent federal court jurisdiction, in a state court of competent jurisdiction, in the location of the party to this Acknowledgment not initiating the action, as indicated in the Notices section. Notwithstanding the foregoing, Qwest may initiate proceedings in Denver, Colorado to collect undisputed amounts billed. Each party, to the extent permitted by law, knowingly, voluntarily, and intentionally waives its right to a trial by jury and any right to pursue any claim or action arising out of or relating to this Acknowledgment on a class or consolidated basis or in a representative capacity. This Acknowledgment constitutes the entire understanding between Qwest and Customer with respect to Service provided herein and supersedes any prior acknowledgments, agreements, or understandings. Neither party will, without the prior written consent of the other party: (a) issue any public announcement regarding this Acknowledgment or use the name or marks of the other party or its affiliates; or (b) disclose or use (except as expressly permitted by, or required to achieve the purposes of, the Acknowledgment) the Confidential Information of the other party, during the term of the Acknowledgment and for two years thereafter. Such consent may only be given on behalf of Qwest by its Legal Department. "Confidential Information" means any information that is not generally available to the public, whether of a technical, business or other nature and that: (c) the receiving party knows or has reason to know is confidential, proprietary or trade secret information of the disclosing party; and/or (d) is of such a nature that the receiving party should reasonably understand that the disclosing party desires to protect such information against unrestricted disclosure. Confidential Copyright © 2007 Qwest. All Rights Reserved. Page 1 of 3 v1.030107 Paul Simon - 209707[1].tif Page 3 MAY 07 2007 15:02 FIR OWEST 303 696 5650 TO 93033911784 P.03i07 HAY-07-07 HON 02:19 PH CITY FT COLLINS ICS DEPT FAX NO. 9702216329 P. 03 luformahon will not include information that to In the publlo domain through no breach of this Acknowledgment by the raeelving party or Is already known or is independently devclopod by the raceiving party. Customer may not assign this Acknowledgment or ony, of its lights or obligntlons hereunder without the prior wrillen consonl of Qwest which will not be unreasonably withhold. Customer may not assign ton resellrr or lelecommunleadons cnrrler under any circumstances and represents that it will not resell the 6ervigo. C mer Au impd 6ignalurc J' N 1 ad or Printed u;ete %.1/07 Copyright W 2007 owest. NI Rights Reseuvad. Page 2 of 9 v1.M0107 05/07/2007 3:07PM (GMT-06:00) Agreement Number: QWEST CIRCUIT INVENTORY BILLING TELE- PHONE NO. (BTN) ADDRESS/CIRCUIT ID CIRCUIT TYPE QTY. or Channel Terminations Surcharge Exemption Code, if applicable TBD 11 Old Town Square to 300 la orte T-1 2 E6 Customer hereby certifies that Service qualifies for exemption of the Private Line Surcharge in accordance with the Tariff. Written notification will be provided to Qwest at such time the exemption is no longer applicable due to changes or re -termination of any Service. Copyright © 2007 Qwest. All Rights Reserved. Page 3 of 3 v1.030107 Paul Simon - 209707[1] tlf Page 5 J MAY 07 2007 15:02 FR QWEST 303 B96 5650 TO 93033911784 P.05i07 MAY-07-07 MON 02:19 PM CITY FT COLLINS ICS DUT FAX NO. 9702216329 P. 05 FCC: Surcharge Exemption Certification Form Agreement (Revised September, 2003) Company Nanlct (aty or Ft Collins _ liillillgAddreAs: {tU. `Stl�_�QJ T ZcCQ"kaS, Co S-1=—Accx" k'303-1II�233% _.__.. I hereby ccl•tify drat the Privaiu Line Transpoil facilities shown below as surcharge exempt qualify I•or exem '0n ol'the Special Access Surcharge: Customer Sigualnrn: _ Print Nance:_- 'riale; rcull Number CKI. Auarrse Leratlens Account Number Exempt Code 0 of Channels Date _ CHI I CKL2 II Old7own square t Pt Collins 300 (`mporte, Ft Wllins 'r13D L'6 za 05J03/20 07 —_ —� •CIc I, 2 CKL f C:KL 2 ---- _.._._ -.-. CKI, 1 —I CKL --- CK1,2 CKI. I CKI,2 .CKI. I- T --- - ChL2 CKL 2 — lusirt edeas for New Service: e Igetore Cirenil Number ;utd Account Number fields Sample Fornt (9rruttNutnber -CKL AddrtssLocadons Account Exempt of Date - _— Number Coda Channels CKLI --- CKi, t 05/07/2007 3:07PM (GMT-06:00) CKL2 Instructions for Existing Service: • Fill in Circuit Number and account number field • Ignore address locations Sample Form Circuit Number CKL Address Locations Account Number Exempt Code # of Channels Date CKL1 CKL2 CKL1 CKL2 CPaul Simon - 209707[1 ].tif _Page 1 MAY 07 2007 15:01 FR OWEST 303 896 5650 TO 93033911784 P.01i07 Qwest- spuft of Sareirr Inter ions: BMG Contract Cover Sheet for *STANDARD Contracts Please compete the following information based on the contents or your contract Submit the corer sheet & contract for counter -signature. Please consult the "signature level authority" information posted on the BMGQ (Policy 107) for signature authority. htm•!/compliance n-uswest.mm/mlldWI07.Mml#26.3.2 Then fax the cover sheet & counter -signed contract to the Sales Office Administrator or Contract Manager for your office. The Sales Office Administrator will check the contract into BMG ]LINK contract Storage & retrieval. PLEASE NOTE: Be sure to include your C-matl address on the cover sheet. Your e-mail address ensure that you are sent Mn rn..w.r fna for Mre mnrrarf The rnnMM IM' i< rnreinvl by nrrM� F/Ifllr r[Y e// MieIS nL3l1?d IM(yW rhiS [[bla'aC[. 1reaNelMieb IPo JSr ct `S SALES MANAGER NAME: 'SALES * Document Type MANAGER SIGNATU & PATE: Contract 2 * 71 Corporate Entity QC 3 * Document Name Private line 4 * Customer Name City of Ft Collins 5 * Customer Sign Date (MM/DD/YYYY) 0610712007 6 * Qwest Accept Date (MM/DD/YYYY) 0510712007 7 * Contract Type (This Cover sheet only used for Standard Contracts Standard a * Contract Term Length (# of months) 9 * Contract Expiration Date SO * Channel GES it * Sales Of on (Channel, Segment, City -example, GSA-GES-Denver Denver 12 * Sales Rep eMail kulrich@gwest.com 13 * Sales Rep ID VW22 14 * Number of pages Induding this cover sheet 4 15 Account Number or 9-M: 16 Q.Central Opportunity ID: 17 Contract Number: 18 Monthly Commitment: n/a 19 Customer Signature Name: 20 Customer Signature Title: 21 Qwest Signature Name: Karen Ulrich 22 Qwest Signature CUID: kulrich 23 Automatic Renewal No 24 For Sales Administrators: Fdl in Content Ip number: Y Cotter Sheet and COMPLETE ORIGINAL Signed Hard Copy Contract must be sent to: Cl - 1801 California St, suite 900, Denver, to B0202 after BMG ILMK draCk i nd all you have wee . Thank *7hi5 covers//eet Is W Standard contracts onN. Non standard contract rover sheets are e-malled with the Non-standard contract from Offer Management Qwest mnJMentlol sebJect to CPNI rules 05/07/2007 3:07PM (GMT-06:00)