HomeMy WebLinkAboutContract 46409 CITY SECRETARY
CONTRACT No.
APPLICATION FOR SERVICE
Customer Name: City of Fort Worth Main Billing Tel. No: 817-337-8500
Address: 1000 Throckmorton St VSA No.(if applicable) [type VSA#here]
Fort Worth, TX 76102 Amendment No.(if applicable) [type VSA Amend#here]
Customer applies for and agrees to purchase from GTE Southwest Incorporated d/b/a Verizon Southwest ("Verizon") the services identified below
and as further described in Verizon's applicable tariffs (the "Services"), for a minimum period of_thirty-six (-36—) consecutive
months following execution of this Application and commencement of Services hereunder (the "Service Period"). The Services will be provided
subject to the terms and conditions of Verizon's applicable tariffs in effect during the Service Period (the "Tariffs"), which are incorporated by this
reference,and subject to the availability of suitable facilities.
If Customer terminates this Application or any Services prior to expiration of the Service Period, Customer will promptly pay to Verizon any
termination and cancellation charges specified in the Tariffs. The rates for the Services shall be as set forth in the Tariffs, which rates are
summarized below. Customer shall also pay all applicable charges, fees, taxes and tariff surcharges, including federal End User Common Line
Charges,charged pursuant to applicable law,regulations or Tariffs.
Service Monthly Non-recurring
Quantity_ __ _ _ Provided pursuant to(check one)_ ®StateTariff ❑ FCC Tariff Unit Rate _ Charles/Unit
... ....... .
3 i POTS I 35.00
2 1 POTS 23,50
_..._.._..._._.-._..._+............... __ ._...._ —_...._................_......._...........................................................__..._............................__........................................................._.......................__....__........._..........f._............_...........................__._......
.._-...._-..__.-. .._.._..__.__._.__..
_ _._.........._.....__._._.._._..— —_.....__._...__......_.....a.._......................_._................_...._........_.. ...........__........................_.........._.....__......._................_........................__...._........................_..........._ _ ...._._._....._._.._._............__._...._ __.._....._.............
......_ .....
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_._.__....._._......'.._...................__..__....-...._................._.__._. — ..........-..._..........................................................................._...........................................................__..................-._.._.____...._—...........................,_........-...._......................._._.._...__--
Note: Any mileage quantities listed in the table above shall be deemed initial estimates,and billing will be based on actual mileage. c
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The Services will be provided at the following Customer locations: o
3200 KELLER HASLET RD KELLER TX 76262 1900 TEXAN DR JUSTIN TX 76247 677 w
4705 RAY WHITE RD KELLER TX 76244 U_
OFFICIAL RECORD j o
CITY UCRETARV _>
The provision of any additional locations and/or quantities of Services will be subject to Verizon's applicable Tariffs. ddi W0rrq a�tXso e W
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required if suitable facilities are not available to provide the Service at any locations. Lw
Verizon may assign or transfer part or all of this Application to any of its affiliates. Upon reasonable prior written notice to Verizon and consistent with
applicable Tariff supersedure or other regulatory requirements, Customer may assign or transfer this Application to any company that is the
successor to substantially all of its assets. All other attempted assignments shall be void without the prior written consent of the other party.
This Application and the Tariffs constitute the entire agreement between Customer and Verizon regarding the Services, and supersede all prior oral
or written quotations, communications, understandings or agreements. In the event of a conflict between the Tariffs and this Application, the Tariffs
shall control. Customer represents that its execution of this Application is based solely on its independent assessment of the rights and obligations
set forth herein and not on any other oral or written quotations,communications,understandings or agreements.
Agreed and accepted-..-
City
ccepted::City of For ("Customer" AVPFMW AS TA YOMAtlgD L
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By Susan 0000 T
Name/ti Ci Nnnsge� - 0 ashia . Fser
Date �" , Senior Asa sfattr Att�ot[�Y
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