TRANSPORT - SERVICE ORDER FORM10/31/2008 FRI 14:57 FAX 813 281 0125 Time Warner Telecom Q001/003
Transport - Service Order Form ?Jtelecom_
General Information
Status of Contract
a Master Services Agreement • MSA (Attached) OR a Effective Date of MSA on File:
Q Standard Terms and Conditions (Attached) OR Effective Dale of Ts and Cs on File:
GSA PON
Order Type
New
MSAii:
3/1/2003
TSP Auth p:
Customer Information
Customer Name: City Of Clearwater, Florida
Service Address: 100S Myrtle Avenue
City, State, Zip: Clearwater, FL 33756
If Carrier customer please provide the CIC or OCN code:
Account Number: 252181
Billing Address: 100 S Myrtle Avenue
City, State, Zip: Clearwater, FL 33756
Market: Tampa, FL
Requested Due Date:
Grand Total (Detailed Price Description Below) Monthly Recurring $311.80 Non-Recurring $250.00
Charges `MRC' Charges °NRC°
Customer and the individual signing below represent that such individual has the authority to bind Customer to this Agreement.
This Transport Service Order Form incorporates the Standard Terms and Conditions referenced above and the attached Service Level Agreement. Time Warner
Telecom will provide a firm due date to Customer upon receipt of a property completed and signed service order and any other documentation necessary to process
the service order. Customer and the individual signing below represent that such individual has the authority to bind Customer to this Agreement.
tw telecom holdings inc.
Signature:
Name (printed): Richard Santoro
Title: General Manager/ Vice President
Date:
Salesperson: Amanda Mahe
Customer: it Of Ciearw tQ, Flo
.00" A
rr
Signature: •
Name (printed): William B. Home II
Title: City Manager
Date: ?i 6 o r
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10/31/2008 FRI 14:57 FAX 813 281 0125 Time Warner Telecom Q002/003
Approved as to Form:
Signature:
Print Name: Leslie K. Dougal Sides
Title:
Date
w CEZ'?*&'
K ?- ? I// L? Attest:
ignature: 0,
,PIP nt Name: Cynthia. Goudeau
Title: City Clerk
- Date: t ! l S zoo
• Circuit Renewal / Disconnect
<Choose Renewal or Disconnect> Circuit ID:
<Choose Renewal or Disconnect> Circuit 10:
<Choose Renewal or Disconnect> Circuit ID:
<Choose Renewal or Disconnect> Circuit ID:
- if applicable
POINT to POI- Service Information
-- DSI/DS3
Transport Type
Region/Zone
Service Ca sct " " TWTC Mileage
Band Actual Circuit
Mileage
Line Codin
Framing /Format
TDM METRO DS1 _.- 0-3 0 B8ZS ESF
Percent of Interstate Use Interface Protection
0% Interstate NIA
Term
24 Months
POINT to POINT - Location Information
A Loc Z Loc
Company Name City Of Clearwater, Florida City Of Clearwater, Florida
Physical Address 706 N Missouri Avenue 100 S Myrtle Avenue
City Clearwater Clearwater
State FL FL
Zip Code 33755.4321 33755-5520
Service Type Type II Offnet Type l Onnet
CFA
Demarc/Rm/Floor 0
NPA/NXX
LOA Provider Name tw telecom tw telecom
Mux Handoff N/A N/A
Termination
If Jack What Type?
Inside Wiring
EEC Account #
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10/31/2008 FRI 14:57 FAX 813 281 0125 Time Warner Telecom
Q003/003
POINT to - Cootacts
Maintenance
Name Kathleen McMullen Kathleen McMullen
Phone 727-562-4858 727.562-4858
Email kathleen.mcmullen@m learwater.com kathleen.mcmullen*m clearwater.com
Schad. Maintenance
Name Kathleen McMullen Kathleen McMullen
Phone 727-562.4858 727-562-4858
Email kathleen.mcmuilen®m clearwater.com kathleen.mcmullen*m ciearwater.com
Test & Turn-Up
Name Kathleen McMullen Kathleen McMullen
Phone 727-562-4858 727.562.4858
Email kathleen.momullon@myclearwater.com kathleen.mcmullen0m clearwater.com
Oesi n
Name Kathleen McMullen Kathleen McMullen
Phone 727-562-4858 727.562-4858
Email kathleen.mcmullen@myclearwater.com kathleen.mcmullen@m learwater,com
Emergency
Name Kathleen McMullen Kathleen McMullen
Phone 727.562.4858 727.562.4858
Email kathleen.mcmullen 0 mclearwater.com kathleen.mcmuilan0m clearwater.com
Slte Off-Net only)
Name Kathleen McMullen
Phone 727-562-4858
Email kathleen.mcmullen0m learwater.com
Service Extension (Type I or 11): An additional charges incurred for requested demarc extensions will be assed on to customer. Please ovide details below.
POINT to POINT - Pricing and Charges
Pricing and Charges Unit Ot MRC - Unit MRC - Total NRC - Unit NRC - Total
Circuit 1 $ 311.80 $ 311.80 $ 250.00 $ 250.00
$ $
$ $
Other Charges $ $
Total Charges $ 311.80 $ 250.00
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