MCN STAFF ONLY PLAT ID_________________________ Order MGR_______________________ MODEM #________________________ Due DATE_______________________

 

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:

By Mail MCN attn: DSL Orders P.O. Box 2445 Mendocino, CA 95460

By Fax Last page of signed contract and order form 707-937-0733

In Person MCN 10700 Ford Street Mendocino

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.

		Service Name	Download Speed	Upload Speed	IP	Introductory Monthly Price
Dynamic IP Service	1.___	MCN DSL Basic	Up to 1.5mbps	128kbps to 384 kbps	1	$29.95
	2.___	MCN Advanced DSL	1.5mbps to 3.0 mbps	384kbps to 512kbps	1	$39.95
	3.___	MCN Premium	1.5mbps to 6.0mbps	384kbps to 608kbps	1	$49.95

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

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