12 Month Subscriber Agreement Landlord Letter of Permission Letter of Agency Lifeline New Application No Truck Roll Service Expansion Apply to Edu-Net Lifeline Re-Certification 12 Month Subscriber Agreement Agreement for 1G Internet Service GENERAL TERMS AND CONDITIONS The following Terms and Conditions apply to all services offered by Burlington Telecom (“BT”), unless otherwise specifically noted. These Terms and Conditions, the Service Agreement, the Acceptable Use Policy (if applicable), the Privacy Agreement and applicable state tariffs bind the Customer and constitute a contractual arrangement upon acceptance and use of BT’s service.1. SERVICEAll applicants must be 18 years of age or older. Anyone under age 18 must have a parent or legal guardian sign the application.Every account must have one or more responsible party assigned to place orders and make changes to the account. No addition, termination or changes will be made to the account without the direct consent of the responsible party.BT reserves the right to require proof of identity before providing service.Package pricing excludes required taxes and surcharges, which are assessed to the applicable portion of the Customer’s bill.2. SUBSCRIPTION REQUIREMENTSFor Customers requesting telephone service with BT, a signed Letter of Authorization (“LOA”) must be on file before service will be provided.The LOA gives legal authorization to BT:i. To act as Customers agent to make any and all inquires necessary for the purpose of obtaining customer service records information.ii. To act as Customers agent for the purpose of taking any and all actions required (including the removal of any account protection/freezes) to become Customers LOCAL SERVICE PROVIDER and to implement other services described herein for all of the Customers physical service and billing locations including changing Customers long distance carrier(s).a. Customer also authorizes BT to review the Customers account information, assess current services and assist in making modifications to Customers account throughout the duration of the agreement.b. Customer gives BT authorization to notify all appropriate parties, including Customers local and long distance carrier of Customers choice of carriers and to make the necessary changes for the Customers current and future services without further permission.c. Customer directs the chosen long distance carrier for toll charges within Vermont and outside Vermont domestically and internationally, if not BT, to comply with BT’s current applicable access tariff’s, or release Customer from any unfilled contractual obligations for service.d. BT may obtain any records from Customers local intra-lata long distance and/or long distance telephone company necessary to provide these services.e. Customer also agrees to indemnify BT, its employees, and agents from any liability resulting from any credit injury, or client privacy issue, or liability to any third party for pre-existing obligations Customer may have regarding local long distance services.For Internet service, BT highly recommends all Customers install anti-virus software, anti-spyware software, and personal firewall to protect the Customers system. BT shall not be responsible for any loss of service resulting from customer negligence, including loss of service from viruses, spyware, and other malware.3. ACCESS TO PREMISESBT will not enter onto a Customer premise without the presence of an adult 18 years of age or older.Customer grants to BT or any duly authorized agent an irrevocable license to enter upon Customers premises at reasonable hours with reasonable notice to install, maintain and remove any equipment necessary for BT’s provision for service to Customer or other Customers. In purchasing service from BT, Customer hereby assumes full responsibility for securing permission from Customers landlord for theinstallation of all applicable wiring and equipment. BT is released from liability arising from any failure to secure such permission.4. USE LIMITATIONSCustomer acknowledges that programming is for non-commercial entertainment viewing in Customer’s private premises only. Customer may not reproduce, rebroadcast or otherwise re-transmit and/or exhibit the programming received from BT in exchange for an admission fee or for any other charge or consideration or in furtherance of a commercial enterprise. Customer agrees that the programming provided over the cable system will not be viewed in areas open to the public. Customer may not order or request Pay-Per-View programming or Video on Demand for receipt, exhibition or taping in a commercial establishment. Customer may neither exhibit nor assist in the exhibition of Pay-Per-View or Video on Demand programming in a commercial establishment. Customer may not move the set top box to another location or use it at any time at an address other than Customer’s home or location where service was installed by BT.Customers with Internet service through BT also agree to follow the policies set forth in the Acceptable Use Policy (“AUP”).If the Customer fails to abide by these restrictions, the Customer will be liable for any and all claims made against BT. The Customer agrees to indemnify and hold harmless BT from any damage to BT as a result of Customer’s breach of this Agreement, use or reliance upon in furtherance of commercial or professional enterprise.5. PAYMENTThe Customer is responsible for payment of all charges for service furnished to or usedby the Customer, or the Customer’s agents, employees or customers. The Customer is also responsible for payment of charges for all other third person use of service to which the Customer subscribes. The Customer is responsible for all charges to the account even if the charges are incurred by fraud or without the Customer’s knowledge. The Customer is solely responsible for controlling access to, and the use ofthe equipment and facilities.All charges due from the Customer are payable to BT. Credit cards, personal checks, certifiedChecks and cash will be considered as acceptable forms of payment. Charges may be billed to the Customer’s credit card, debit card or bank account, as applicable, each month. BT is not responsible for any charges or expenses resulting from charges billed by BT.The Customer is billed from the date services are installed and activated to the date the services are disconnected. Therefore, the first bill a Customer receives or the first bill after an additional service has been installed or activated will include partial month charges in addition to his/her advanced monthly charges. This charge will be from the date of installation and activation to the last day of the current billing month. BT’s billing cycle is from the 20th – 21st of the following month. When a customer is disconnected, an amount from the date of disconnection to the last day of the billing month billed in advance will be subtracted from the Customer’s bill.Any objections to billed charges must be reported to BT within forty-five (45) days after receipt of bill. Objections may be filed in person at BT’s Business Office, by telephone or by mail. Any adjustments or additional charges are shown separately on each bill. BT shall make no refund of overpayment by the Customer unless the claim of such overpayment, together with proper evidence, is submitted within two (2) years of the date of alleged payment.6. INTERRUPTION OF SERVICEBT will attempt to provide continuous and uninterrupted service. When BT schedules a service interruption for maintenance or repairs, BT will notify the Customer of the cause and expected duration of the interruption at least twenty-four (24) hours in advance, when possible. However, BT may designate a regular maintenance window during which maintenance may be conducted without notifying customers for each event. Such regular maintenance windows will be communicated to Customers.Credit allowances for interruptions of cable and telephone service which are not due to BT’s testing or maintenance of equipment, to the negligence or other wrongful act or omission of the Customer, or to the failure of equipment provided by the Customer or the Customer’s agents, employees, or Customers, are subject to the general liability provisions set forth herein. It shall be the obligation of the Customer to notify BT immediately of any interruption in service for which a credit allowance is desired by the Customer unless there is a system-wide disruption or the Customer’s disruption is otherwise known or should have been known by BT. Before giving such notice, the Customer shall ascertain that the trouble is not within his or her control, or is not in wiring or equipment, if any, furnished by the Customer. Interruptions caused by Customer equipment or inside wiring that was not run by BT are not deemed an interruption of service.For purposes of credit computation, every month shall be considered to have thirty (30) days and every day twenty four (24) hours. No credit shall be allowed for an interruption of continuous duration of less than twenty-four hours. For disruption greater than twenty-four (24) hours, an allowance equal to 1/30 of the regular monthly recurring charges shall be made for each twenty-four (24) hours the service remains disrupted; except that the total allowance may not exceed the regular monthly recurring charges for service.An interruption is measured from the time the Customer notifies BT, personally, by telephone or in writing, or otherwise the interruption is known or should have been known to BT, until the trouble is cleared. Once BT receives notification of the interruption in service, the credit shall be automatic. Each interruption is considered separately for the purposes of establishing credit allowance. Interruptions reported afterthe fact shall not be eligible for a credit.7. RETURNED CHECKSBT reserves the right to assess a charge of $25.00 fee, whenever a check presented for payment of service is not accepted by the institution upon which it is written.8. LATE FEES AND DISCONNECTIONService is provided and billed in advance on a monthly basis with the exception of toll calls, Video on Demand and Pay-Per View, which are billed in arrears. Bills are due and payable upon receipt. A late fee equal to 1.5% may apply to any unpaid or past due balance. The late fee begins to accrue no sooner than the 30th day after the billing date. In the event that BT incurs fees or expenses, including attorney’s fees, collecting or attempting to collect, any charges owed to BT, BT may charge the Customer, and the Customer will pay these fees or expenses.BT reserves the right to suspend the Customer’s use of such services as Video on Demand and long distance for Customers, upon prior written notice, when there is an unpaid balance for service that is more than forty-five (45) days overdue. Service may be disconnected by BT, upon prior written notice to the Customer and in accordance with applicable law, when there is an unpaid balance for service that ismore than sixty (60) days overdue. If service has been canceled for nonpayment and the Customer wishes it continued, service shall be restored when all past due amounts in addition to a restoration fee of$25.00 are paid or when a reasonable payment plan has been agreed upon between the Company and the customer for full payment of amounts owed.9. REPAYMENT PLANAny Customer having difficulty paying for service should contact BT to work out a repayment plan.Any repayment plan entered into between the Customer and BT will apply to delinquent amounts. BT expects new current charges to be paid when due.10. DEPOSITSEach applicant for service may be required to establish credit. Any applicant whose credit has not been duly established may be required to make a deposit at the time of application to be held as a guarantee of payment of charges. In addition, an existing Customer may be required to make a deposit if their service has been disconnected in the past. BT shall pay interest on deposits pursuant to applicable rules and regulations.An installment plan is available for payment of deposits if payment in full would constitute a hardship. A deposit shall not exceed the estimated charges for two (2) months service, plus installation, and shall be returned: 1) when an application for service has been canceled prior to the establishment of service; or 2) at the end of twelve (12) consecutive months of a satisfactory credit history (i.e. no disconnections and no more than three disconnection notices); or 3) upon disconnection of service. BT shall apply the deposit against any outstanding balances due. If a credit balance exists after such application, BT shall refund the balance to the Customer. The fact that a security deposit has been made in no way relieves the Customer from the prompt payment of bills upon presentation.11. CANCELLATION BY THE CUSTOMERThe Term of this Agreement is twelve (12) months from the date of customer’s signature. The Term only applies to the following internet services: 150 Mb and 1 Gb. The Customer may have service canceled upon written or verbal notice to the Company. Cancellations by e-mail will not be accepted. BT requires at least a two (2) day notification prior to termination of service. The Customer shall pay for service furnished until the cancellation date. In addition, if the Customer terminates one of the following services, 150 Mb or 1Gb, prior to the expiration of the Term, the Customer shall owe BT the monthly recurring revenue for the remainder of the Term. 12. CHOICE OF LAWThis Agreement shall be construed in accordance with, governed by, and subject to thedomestic laws of the State of Vermont.13. COMPLAINTSIf the Customer has any questions, comments or complaints regarding service, the Customer should contact BT’s Customer Service Department by telephone at (802) 540-0007 between the hours of 8:00 a.m. – 6:00 p.m. Monday through Friday or at the address below.Burlington Telecom200 Church Street, Suite 101Burlington, VT 05401If the Customer is not satisfied with the manner in which the concern has been addressed after speaking with the Customer Service Department, the complaint should be submitted in writing to the General Manager at the address listed above. If after further inquiry to the General Manager at BT, the Customer is still not satisfied, complaints should be submitted in writing to the Consumer Affairs and Public Information Division of the Vermont Department of Public Service at the address below.Consumer Affairs and Public Information DivisionVermont Department of Public Service112 State Street, Drawer 20Montpelier, VT 05620-260114. EQUIPMENT AND WIRINGExcept for the inside wiring, which BT considers the Customer’s property, the equipment installed by BT or provided to the Customer by BT belongs to BT. BT may supply new or reconditioned equipment to the Customer. The Customer may not sell or give away BT’s equipment, and BT’s equipment must be used only in the Customer’s home. If the Customer ceases to be a BT customer, the Customer is responsible for returning BT’s equipment to BT or its designee. If the Customer moves, do not leave BT’s equipment in the vacant home or with anyone else.BT’s equipment must be returned to BT or one of its representatives in working order, normal wear and tear accepted. IF CUSTOMER FAILS TO RETURN EQUIPMENT IN A MANNER AS STATED ABOVE, CUSTOMER WILL BE CHARGED FOR THE COST OF REPLACING THE EQUIPMENT INVOLVED.Customer is responsible for preventing the loss of or damage to BT’s equipment within the home. Customer will be directly responsible for repair, replacement and other costs, damages, fees and charges if the equipment is not returned to BT in an undamaged condition. Information related to BT’s Wire Maintenance Plan is located on www.burlingtontelecom.net. The Customer may not attach any unauthorized device to BT’s equipment. If the Customer makes any unauthorized connection or modification to the equipment or any other part of BT’s network or equipment, the Customer will be in breach of this Agreement, and BT may terminate service and recover such damages, as provided by applicable law that may arise as a result of the breach.None of the equipment supplied by BT, nor any of BT’s cable placed outside the home or property in connection with the installation of the equipment and service, shall be deemed fixtures, or in any way part of Customer’s real property. The equipment supplied by BT may be removed by BT, at our option, at any time during or following the termination of Customer’s service, and Customer shall allow BT access to the home for such purposes.15. CHANGES IN SERVICES, CHANGES IN TERMS OR CONDITIONSBT reserves the right to substitute, add or delete specific programming and programming services and to create, dismantle and/or alter tiers of programming at any time. BT will notify Customer of any material change in this Agreement or services, or an increase in charges prior to the billing period in which the changes would go into effect. Notification of the change in charges may be in the form of a bill insert. Notification may also be posted to our website at www.burlingtontelecom.net. Payment of charges or continued use of services after you receive notice will constitute agreement by you to the changes.For telephone service, the Federal Communications Commission (“FCC”) sets the Federal Universal Service Fund (“USF”) Fee. BT will charge equal or less than this rate. The FCC announces the new rate on a quarterly basis. BT will post the new fee on our website at www.burlingtontelecom.net at least 7 days before the new rate goes into effect. The Customer may also contact our Customer Service Office at the number on the bill seven (7) days before the start of the quarter to find out what fee BT will assess during the next quarter. In the event the FCC has not announced the Federal Universal Service Fund Contribution factor seven (7) days before the start of the quarter, BT will post the new fee on the website as soon as reasonably possible. The Federal Universal Service Fund Fee is assessed on all interstate and international charges (including usage and non usage) each month.16. LIMITED WARRANTYBT warrants that the services will function substantially in accordance with the service descriptions. If the services fail to function in this manner and the failure is not due to: (a) the fault of Customer, or Customer’s agents or (b) a contingency identified in Paragraph 18 of this Agreement, then BT, at our expense, will repair the services so that they function substantially in accordance with the service descriptions.THIS LIMITED WARRANTY IS EXCLUSIVE AND INSTEAD OF ALL OTHERWARRANTIES FOR SERVICES PROVIDED BY BT, WHETHER EXPRESS, IMPLIED,WRITTEN OR ORAL, INCLUDING, BUT NOT LIMITED TO, WARRANTIES OFMERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE.17. LIMITATIONS OF LIABILITYThe Company’s liability for damages arising out of any failure of service shall not exceed an amount equivalent to the proportionate charge to the Customer for the period during which the faults in transmission occur.Except as expressly required by applicable law, BT will not be liable for delays, damages, or failures in performance due to BT’s routine maintenance and testing of the services that BT provides to Customer or to causes beyond BT’s reasonable control, including, but not limited to acts of a governmental body, civil commotion, acts of God, acts of third parties, fires, floods, strikes or other labor disputes, or inability to obtain necessary equipment or services.The Company is not liable for any act or omission of any entity, other than the employees or agents of the Company, furnishing facilities or services connected with or provided in conjunction with the Company’s services.The Customer agrees that all information provided on the Services, the Services themselves, and any Equipment are provided “AS IS” and on an “AS AVAILABLE” basis. The Customer agrees to indemnify and hold the Company harmless against claims for libel, slander or infringement of copyright from material transmitted over its facilities; against claims for infringement of patents arising from, combining with, or using in connection with facilities of the Company, apparatus and systems of the customer; against all other claims arising out of any act or omission of the customer in connection with facilities provided by the company; and against any and all losses from damage to the customer’s facilities or equipment attached or connected to facilities furnished by the Company.The Company disclaims any and all warranties, whether expressed or implied, including, but not limited to, the implied warranty of merchantability, fitness for a particular purpose, or any warranty that the services or any associated software or network transport will be uninterrupted or error free. In no event shall the Company be liable for any indirect, special, consequential or incidental damages, including without limitation, lost profits or loss of damage to data arising out of the use, partial use or inability to use the services, even if the Company has been advised of the possibility of such damages. The Company’s entire liability and the customer’s exclusive remedy under this Agreement, for any claim, whether in contract (including breach of warranty), or in tort (including negligence), shall be limited to the total amount paid by customers to the Company for those services upon which the liability is based.Provided the Customer makes a request for a refund within two (2) years of the date of alleged over-billing, a refund of charges for over-billing by the Company will be made for the full amount of excess charges when such amount can be determined. When the period during which over-billing occurred cannot be fixed or the exact amount of overbilling cannot be determined from the available records, the maximum refund will not exceed the estimated amount equal to such over-billing for a three (3) year period. When, in the judgment of the Company, the continued provision of service becomes unsafe, or where federal, state or local regulations place operational restriction(s) upon the Company because of unsafe or hazardous situation, or other unusual conditions including strikes or lockouts; service as provided in this Agreement may be temporarily suspended by the Company.The Company reserves the right to temporarily suspend service when repair, modification or improvement to the system is necessary. The Company is not liable for any defacement or damage to the subscriber’s premises resulting from the existence of the Company’s instruments, apparatus and associated wiring thereon, or from the installation or removal thereof, when such defacement or damage is not the result of negligence on the part of the Company.The subscriber’s facilities and equipment shall conform to all applicable laws, regulations or ordinances as may be effective and the conditions of this Agreement. The Company does not express, imply or warrant the adequacy, safety or other characteristics of subscriber owned or operated equipment by virtue of any inspection or rejection of facilities. The Company shall not be held liable in any way for subscriber owned and maintained equipment which causes or may cause a hazardous, unsafe or dangerous condition, or threatens the health of others, even if such facilities were inspected by the Company.18. LIABILITIES OF THE CUSTOMERThe Customer shall indemnify, defend and hold harmless BT (including the costs of litigation and reasonable attorney’s fees) against:(i) Claims for libel, slander, invasion of privacy, infringement of copyright or patents or unauthorized use of any trademark, trade name or service mark arising out of the material, data, information, or other content transmitted over BT’s services, facilities, or equipment; and(ii) All other claims (including, without limitation, claims for damage to any business or property, or injury to, or death of, any person) arising out of any act or omission of the Customer, or the Customer’s agents, employees, or customers, in connection with any service or facilities or equipment provided by BT.19. ASSIGNMENTWithout the Customer’s consent, BT may assign all or part of this Agreement including BT’s rights to receive monies under this Agreement. The Customer shall not assign, subcontract, sublet or transfer this Agreement, in whole or in part, without BT’s written consent. Any assignment, subletting, transfer, or subcontracting in violation of this paragraph shall be void.20. SEVERABILITYIf any of the terms or conditions in this Agreement is held to be invalid or unenforceable by a government body of competent jurisdiction, the holding shall not affect any other term or condition of this Agreement, and the Agreement shall be construed as if it did not contain the invalid or unenforceable term or condition.21. ENTIRE AGREEMENTThis Agreement supersedes all prior representations, understandings, or agreements on the subject matter of this Agreement. This Agreement may not be modified or waived except as described in this Agreement. With respect to all matters arising under this Agreement, this Agreement is a contract between the Customer and BT.Name* First Last Email* Date* Signature*ACCEPTANCE OF TERMS AND CONDITIONS By my signature above, I agree to all terms and conditions of this Agreement and accept the installation and/or service work to be satisfactory and in working condition. I further acknowledge that I have received, read and agree to all terms and conditions in the Subscriber Agreement and any other applicable policies. Acceptance of Service will constitute acceptance of the terms and conditions of this Agreement. This iframe contains the logic required to handle Ajax powered Gravity Forms. Landlord Letter of Permission For homeowners, landlords and property managers Property Owner InformationName* First Last Email* Phone*Address* Street Address City State / Province / Region ZIP / Postal Code As the Owner or Duly Authorized Manager of the property located at (enter street address below) I (we) hereby authorize Burlington Telecom, a department of the City of Burlington, to install communication cable and equipment and any internal wiring necessary to provide voice, internet and cable services to the property. This form provides permission for all units in a multi-dwelling. I also agree to the installation for additional properties I own listed below.Tenant InformationName* First Last Email Phone*Address* Street Address Owner Occupancy?*YesNoHousing Type*Single FamilyDuplexCondoMulti-UnitSpecial InstructionsSignature*For the purpose of this agreement it is understood that by signing this LETTER OF AUTHORIZATION in no way obligates the property owner to accept communication service from Burlington Telecom. It is further understood that no such inside wiring or installation will take place until a service order is initiated by the property owner or tenant thereof. By signing this agreement, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement. This is consent to be legally bound by this Agreement's terms and conditions.Need More?YesNoAdditional PropertiesAddress Street Address Housing TypeSingle FamilyDuplexCondoMulti-UnitAddress Street Address Housing TypeSingle FamilyDuplexCondoMulti-UnitAddress Street Address Housing TypeSingle FamilyDuplexCondoMulti-Unit This iframe contains the logic required to handle Ajax powered Gravity Forms. No Truck Roll Agreement for Self Installation GENERAL TERMS AND CONDITIONS Disconnection, Ownership of Equipment: It is understood that Burlington Telecom has the right to disconnect all services in the event that charges are not paid within sixty (60) days of the date billed by Burlington Telecom, or if a past due balance continues on the account. It is also understood that all equipment installed upon the premises by Burlington Telecom or its agents, except for inside wiring, shall remain the property of Burlington Telecom and shall be returned by customer in good working order upon either disconnection of the services by Burlington Telecom or discontinuance of the service by the customer.Remedies: If the equipment supplied with the service described above is not returned on termination of the service(s), Burlington Telecom may charge the customer for the cost of replacement, repair, and other costs, damages, fees and charges for this equipment. Acceptance of Terms: By the signature below, the customer or agent for the customer agrees to all terms and conditions of this agreement, and accepts the installation and/or service work to be satisfactory and in working condition.THIS AGREEMENT (“Agreement”) DESCRIBES THE TERMS AND CONDITIONS REGARDING YOUR SERVICE WITH BURLINGTON TELECOM (“BT”). BY SIGNING THIS AGREEMENT YOU ARE HEREBY ACCEPTING THE TERMS AND CONDITIONS AS SET FORTH BELOW. IF YOU DO NOT ACCEPT THESE TERMS PLEASE NOTIFY US IMMEDIATELY AND WE WILL CANCEL YOUR SERVICE(S).1. SERVICEa. BT will provide the Service(s) (“Service”) identified on this document and perform its obligations hereunder, including installation of the Service, in a good and workman like manner. BT makes no other warranties, express or implied, including, but not limited to, the implied warranty of merchantability and fitness for a particular purpose or any warranty that the services or any associated software of network transport will be uninterrupted or error free.b. All applicants must be 18 years of age or older. Anyone under age 18 must have a parent or legal guardian sign the account application before service will be provided.c. Every account must have one or more responsible party assigned to place orders and make changes to the account. No addition, termination or changes, will be made to the account without the direct consent of the responsible party. BT reserves the right to require proof of identity before providing service.d. BT will not enter a premise without the presence of an adult 18 years old or older.2. CHANGE OF TERMSBT reserves the right to amend this Agreement from time to time upon advance written notice to the customer. Continued use of Service, upon written notice of these changes, will constitute acceptance of the changed terms.3. BILLING POLICES OF BURLINGTON TELECOMa. You are billed for service one month in advance on a month-to-month basis except toll calls, Video on Demand and Pay-Per-View, which are billed in arrears.b. You are billed from the date services are installed and activated to the date the services are disconnected. Therefore, the first bill you receive or the first bill after an additional service has been installed and activated will include partial month charges in addition to advanced monthly charges. This charge will be from the date of installation and activation to the last of the current month.When Service is disconnected, an amount from the date of disconnection to the last day of the month billed in advance will be subtracted from your bill.c. Any adjustments or additional charges are shown separately on each bill.d. A credit will be given to you if service has been interrupted for at least twenty-four (24) consecutive hours after notifying BT of the problem and after requesting this credit orally or in writing within ninety (90) days of the outage unless the outage is system-wide or the subscriber’s disruption is known or should have been known. The service interruption must be the fault of BT and not related tothe customer's television, computer or other equipment or customer owned wiring inside customer’s premise.e. BT will maintain a customer service department to handle any billing disputes which are submitted either by telephone or in writing. BT will not disconnect you solely for non-payment of the legitimately disputed portions of the bill within the regular due date period. PLEASE DO NOT WRITE ON YOUR BILL.All written billing, service or sales inquiries must be sent directly to BT's local business address which is listed on your bill.f. You agree to pay any local, state or federal taxes imposed on or levied on or with respect to the Service provided to you.4. NON-PAYMENT POLICES OF BURLINGTON TELECOMa. Payment is due upon receipt. If you are unable to pay your bill please contact our Business Office to set up a reasonable repayment plan.b. If payment in full is not received within thirty (30) days, a reminder will be placed on your bill in addition to a late fee of 1.5 % of the past due balance.c. If payment in full is not received within forty-five (45) days, some loss of service may result.d. If payment in full is not received within sixty (60) days, then (i) a late charge will be assessed to your account as well as a final notice message, requesting immediate payment in full will appear on your monthly statement and (ii) a formal notice of disconnection will be mailed to you requesting immediate payment in full of the delinquent account. If payment in full has not been received by our Business Office by the date specified on the disconnection notice, service will be disconnected.e. Accounts disconnected for non-payment will be reconnected only after the account has been paid in full as well as a payment of a reconnection charge is made.f. If payment in full is not received by our Business Office within thirty (30) days after being disconnected as a non-payment, your account will be turned over to a collection agency for legal action.g. In the event of non-payment you acknowledge that BT may use the services of a collection agency and/or attorney to collect sums due and agree to reimburse BT for any such collection fees incurred by BT as a result of such third party collection efforts to the extent such amounts reflect the reasonable costs of collecting sums due from you, minus the amounts of any late fees actually paid by you as a result of such collection efforts.5. CONTINGENCIESEXCEPT AS EXPRESSLY REQUIRED BY APPLICABLE LAW, WE WILL NOT BE LIABLE FOR ANY DELAYS, DAMAGES OR FAILURES IN PERFORMANCE DUE TO BT’S ROUTINE MAINTENANCE AND TESTING OF THE SERVICES THAT BT PROVIDES TO YOU OR TO CAUSES BEYOND BT’S REASONABLE CONTROL, INCLUDING, BUT NOT LIMITED TO ACTS OF A GOVERNMENTAL BODY, CIVIL COMMOTION, ACTS OF GOD, ACTS OF THIRD PARTIES, FIRES, FLOODS, STRIKES OR LABOR DISPUTES, OR INABILITY TO OBTAINNECESSARY EQUIPMENT OR SERVICES.6. LIMITATION OF LIABILITY IN NO EVENT SHALL BT BE LIABLE FOR ANY INDIRECT, SPECIAL, CONSEQUENTIAL OR INCIDENTAL DAMAGES, INCLUDING WITHOUT LIMITATION, LOST PROFITS OR LOSS OR DAMAGE TO DATA ARISING OUT OF THE USE, PARTIAL USE OR INABILITY TO USE THE SERVICES, EVEN IF BT HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. BT’S ENTIRE LIABILITY AND YOUR EXCLUSIVE REMEDY, FOR ANY CLAIM, WHETHER IN CONTRACT (INCLUDING BREACH OF WARRANTY), OR IN TORT (INCLUDING NEGLIGENCE), SHALL BE LIMITED TO THE TOTAL AMOUNT PAID BY CUSTOMERS TO BT FOR THOSE SERVICES UPON WHICH THE LIABILITY IS BASED.7. ADMINSTRATIVE FEESa. Deposit Policy: A deposit may be required as a precondition of initiating or continuing Service with BT. Deposits will be returned to you less any deduction for amount due after termination of service or after twelve consecutive months in which you have received no more than three disconnection notices and have not been disconnected.b. Returned Payment Fee: Checks returned for non-sufficient funds will be debited against your account and a fee will be charged against the account.8. DISCONNECTION POLICIESa. You may not assign this Agreement. In the event that you move from your present address, you agree to promptly notify BT’s business office and/or agent of BT if you desire the Service to be discontinued.9. EQUIPMENT AND WIRINGa. You are responsible for preventing the loss of or damage to BT’s equipment within your home. You will be directly responsible for repair, replacement and other costs, damages, fees and charges if you do not return BT’s equipment to us in an undamaged condition.b. Except for the inside wiring, which BT considers your property regardless of who installed it, the equipment installed by BT or provided to you by BT belongs to BT.c. If you cease to be a BT customer, you are responsible for returning BT’s equipment to BT or its designee. If you move, do not leave BT’s equipment in your vacant home or with anyone else. BT’s equipment must be returned to BT or one of its representative in working order, normal wear and tear accepted. IF YOU FAIL TO RETURN EQUIPMENT IN A MANNER AS STATED ABOVE, YOU WILL BE CHARGED FOR THE COST OF REPLACING THE EQUIPMENT INVOLVED.10. COMPLAINTSa. You agree to contact BT’s Customer Service Department at (802) 865-7529 (option 1) between the hours of 8:00 a.m. and 4:30 p.m. Monday through Friday or at the address below if you have any questions or concerns:Burlington Telecom200 Church Street, Suite 101Burlington, VT 05401b. All disputes, controversies, or differences that may arise between the parties out of or in any manner relating to or in connection with the Service or this Agreement, or the breach thereof, shall be submitted to and settled by the Vermont Department of Public Service or the Vermont Public Service Board.c. This Agreement shall be governed by and construed and enforced in accordance with the laws of the State of Vermont.11. ACCESS TO PREMISESYou hereby grant to BT or any duly authorized agent an irrevocable license to enter upon your premises at reasonable hours with reasonable notice to install, maintain and remove any equipment necessary for BT's provision of services to you or other customers. In purchasing Service from BT you hereby assume full responsibility for securing permission from your landlord for the installation of all applicable wiring and equipment. BT is released from all liability arising from any failure to secure such permission.12. SEVERABILITYIt is mutually agreed and understood that in the event any provision of this Agreement is ruled by a court or competent jurisdiction to be invalid, all remaining paragraphs and provisions shall remain in full force and effect as if the invalid provision was originally deleted herefrom. A suitable and equitable provision will be substituted for the invalid provision in order to carry out as far as may be valid orenforceable, the intent of the invalid provision.13. MISCELLANEOUSa. BT is not liable for any defacement or damage to your premises resulting from the existence of BT’s instruments, apparatus and associated wiring thereon, or from the installation or removal thereof, when such defacement or damage is not the result of negligence on the part of BT.b. This Agreement supersedes any and all prior Agreements between the parties regarding the subject matter described herein. No representation or warranty made by any agent or representative of BT shall be binding on BT unless expressly included in this Agreement. No amendment or modification of this Agreement or waiver of any term or provision hereunder shall be binding unless such amendments, modification, or waiver is in writing and is signed by an authorized representative of BT. Name* First Last Email* Date* Signature*ACCEPTANCE OF TERMS AND CONDITIONS By my signature above, I agree to all terms and conditions of this Agreement and accept the installation and/or service work to be satisfactory and in working condition. I further acknowledge that I have received, read and agree to all terms and conditions in the Subscriber Agreement and any other applicable policies. Acceptance of Service will constitute acceptance of the terms and conditions of this Agreement. This iframe contains the logic required to handle Ajax powered Gravity Forms. Service Expansion I want BT in my neighborhood! Name* First Last Email* Phone*Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Comments/QuestionsThis form is solely for the purpose of gauging interest in potential Burlington Telecom service areas. The form in no way promises that service will be available. At this time any planned expansions will be solely for the Burlington proper area. All information is collected so that we can notify you if we are in your area and is not required. For any questions feel free to contact our Customer Service team at (802) 540-0007. This iframe contains the logic required to handle Ajax powered Gravity Forms. Letter of Agency Welcome to Burlington Telecom! We offer you the ability to keep your current telephonenumber(s) while changing your service provider to Burlington Telecom. By selecting BurlingtonTelecom for the telephone number(s) listed on this form, Burlington Telecom will be your onlyprovider for all your local, regional and long distance calls within the U.S. (excluding Alaska),Puerto Rico and Canada. To help make the transition of your telephone number(s) a smooth one, we will have to work withyour old service provider(s) to obtain accurate records for the transfer. The process will takeapproximately fifteen (15) business days to complete depending on your current serviceprovider(s). We will contact you if we should encounter any unusual delays. To confirm that you have expressly requested and authorized this transfer of your number(s),your old service provider(s) require this letter as proof. When you supply the informationrequested below and sign and date this letter, you give us the authority to start the process oftransferring your number(s) so that Burlington Telecom may provide its own service. Once thatprocess is complete, you will be able to use your old telephone number(s) with your new Burlington Telecom service. Billing Name* First Last Billing Address* Street Address City ZIP / Postal Code Phone Number to be Transferred*Additional Numbers?*YesNoAdditional Phone NumberAdditional Phone NumberCurrent Phone Provider*Current Phone Provider Account Number*If transferring more than three (3) numbers, please use multiple Letter of Agency forms. Please do not place any new service orders with your current service provider(s) on this accountas it relates to telephone service, as this may cause a delay or cancellation of your number transferrequest. This Letter of Agency once completed will result in the cancellation of your phoneservice with your current service provider. The Letter of Agency does not affect any otherservices therefore you will need to contact your current service provider to cancel any otherservices (if applicable). By signing below: 1. I authorize Burlington Telecom, or its designated agent, to transfer my current telephonenumber(s), which are listed above, so that Burlington Telecom may provide its voiceservices using that number. After this transfer occurs, I understand that BurlingtonTelecom will be my only provider for all my local, regional, and long distance callswithin the U.S. (excluding Alaska), Puerto Rico and Canada.2. I understand that only one provider may be designated as my primary interstate andintrastate interexchange carrier and primary local exchange carrier for any one telephonenumber.3. I also authorize Burlington Telecom, or its authorized agent, to obtain billinginformation, customer service records and other network information required to provideme with Burlington Telecom service using my current telephone numbers.4. I affirm that I am authorized to make changes to the telephone account associated withmy current number(s) and that I am over 18 years of age.5. I understand there are no charges to designate Burlington Telecom as my only providerfor local, regional and long distance calls, but charges may apply from my old telephoneprovider.Name* First Last Today's Date*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year20202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Signature*If you have any questions regarding whether the telephone change to Burlington Telecom hasoccurred, comments or complaints regarding service or this Letter of Agency, please contact ourcustomer service office at (802) 540-0007 or (866) 304-8434 between the hours of 8:00 a.m. –6:00 p.m. Mon-Fri, or 8:00am - 4:30pm on Saturday Burlington Telecom200 Church StreetBurlington, VT 05401 You also have the right to file a complaint with the Consumer Affairs and Public InformationDivision of the Vermont Department of Public Service at the address below; by calling their tollfree number: (800) 622-4496, or through the DPS web page:http://publicservice.vermont.gov/contact/file-complaint.html Consumer Affairs and Public Information DivisionVermont Department of Public Service112 State Street, Drawer 20Montpelier, VT 05620-2601 This iframe contains the logic required to handle Ajax powered Gravity Forms.