MCN DSL Order Form 1.22

Business Special Order Form

This is a binding contract. Please read it carefully.

To order DSL Service, please print and complete the form.
You will also need to complete a DSL Contract before MCN can order your DSL service.
You can download this order form as a PDF file MCN Order Form as PDF File
Please return both forms to MCN:

Your Name : ________________________________________________

Identify the BUSINESS Phone Number for Service

Please list the ten digit BUSINESS phone number, including area code for which you are requesting service:

____ ____ ____ - ____ ____ ____ - ____ ____ ____ ____

Choose A Level Of Service

Please choose only One of the three Levels of Service by initialing by that service.
MCN Basic DSL service is the most common selection.

Choose A Modem

____Single Port Modem ($44.95 plus tax)
____Four Port/Wireless Access Modem ($99.95 plus tax)

Current MCN DSL Service Provisions:

Following are the current DSL Service Provisions. These are subject to change as is noted in section IA of the MCN Contract.

• Price guaranteed for one year then goes to month to month pricing.  Current month to month prices: Basic: $45.95 | Advanced: $50.95 | Premium: $64.95.
  
• All MCN accounts are covered by the MCN Acceptable Use Policy.
• Introductory pricing requires a signed DSL Contract. One 12 month promotional period per customer unless customer orders concurrent service.
• Customer must maintain working AT&T phone line and AT&T local phone service or DSL service will not work. Customer should notify MCN if there are two-line phone jacks involved in their DSL order.
• MCN provided equipment for DSL service is available at $44.95 (single port) plus tax/shipping sale price. Multi-port Wireless modem available for $99.95 plus tax/shipping.
• Data transfer rates between customer NIC and DSL Central Office or remote terminal are influenced by several factors including line quality and loop length. 10% to 20% protocol overhead is considered normal. Actual rates above 80% of listed minimum transfer rate are considered acceptable.
• Customer must identify servers on DSL lines. Customer may be subject to further charges for excessive bandwidth if servers impact the MCN network
• MCN is not responsible for outages not reported by the customer.
• Customer is responsible for all aspects of the local area network and inside phone wiring at their site. DSL will not work if more than 5 jacks are used on the same phone line.
• Customer will be billed on DSL circuit due date unless customer notifies MCN of technical problems.

Subscriber:

By:__________________________________________________
                                                      signature


Name: ______________________________________________
                                                          print