Dte Service Agreement

12 South First Street

BUSINESS SIMPLE SOLUTIONS

P.O. Box 246

SERVICE AGREEMENT

Dubois, WY 82513

Dubois / Crowheart Areas: 455-2341

Baggs Areas: 383-2150

FOR OFFICE USE

Y O U R L O C A L A D V A N T A G E

TELEPHONE NUMBER: ______________________

ADDT’L #’s THIS ACCOUNT: _____________________________

INSTALL DATE: ____________________________

_____________________________________________________

CSR: _____________________________________

_____________________________________________________

ACCOUNT NUMBER: _______________________

_____________________________________________________

SUBSCRIBER INFORMATION

___________________________________________________________________________________________________

Billing Name

____________________________________________________________________________________________________________________________

Billing Telephone #

Billing Address

City

State

Zip

____________________________________________________________________________________________________________________________

Physical Address

City

State

Zip

____________________________________________________________________________________________________________________________

Exchange Number

Contact Name

CBR Telephone Number

SIMPLE SOLUTIONS OPTIONS

Rates and discounts only available if business subscribes simultaneously to basic local exchange service

BASIC LOCAL SERVICE Current monthly Rate as filed $____________/mo

CALLING FEATURES ___________________________________________________________________________________

ADSL [

] 3. Mbps $40/mo [

] 6. Mbps $50/mo [

] 10. Mbps $60mo [

] 15. Mbps $75mo

[

] 20. Mbps $130/mo

(Fiber Customers Only)

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SERVICE AGREEMENT

1 Year Term 5% off

2 Year Term 10% off

3 Year Term 15% off

DSL monthly rate_____

DSL monthly rate_____

DSL monthly rate_____

INSTALLATION CHARGE Applies to all terms of contract for Simple Solutions Plan early termination fee $300

(see attached Terms and Conditions)

EQUIPMENT

(Price does not include installation)

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modem/router ____________________________

other_________________________________________________

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SECURE IT

BASIC $2.95/mo

LIVE $4.95/mo

PLUS $6.95/mo

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ONLINE BACKUP

5GB $2.95/mo

50GB $7.95/mo

250GB $14.95/mo

EMAIL ADDRESS

Additional email addresses

Username________________________ Password_____________________

Username - up to 20 characters

Username________________________ Password_____________________

lowercase letter and/or numbers

Username________________________ Password_____________________

Username________________________ Password_____________________

Username________________________ Password_____________________

Password - 8 - 16 characters combining letters & numbers

TERMS AND CONDITIONS

SUBSCRIBER is responsible for payment of all charges for the Services as will appear on the monthly phone bill. Failure to pay these charges may result in termination of service for

non-payment.

SUBSCRIBER selecting one or more options offered in the Simple Solutions for Business hereby agrees to the terms and conditions as defined by additional literature (attached).

SUBSCRIBERS selecting 1, 2 or 3 year service agreement are subject to early termination fees as defined by the additional literature (attached).

Simple Solutions for Business is available to business customers only. Some services not available in all areas. Prices exclude taxes, surcharges and other fees. Internet connection

speeds may vary doe to websites accessed, customer location, Internet congestion, customer equipment.

SUBSCRIBER ACKNOWLEDGES READING AND AGREES TO ALL THE TERMS AND CONDITIONS OF THIS AGREEMENT, WHICH TERMS AND CONDITIONS ARE PART OF

AND HEREBY INCORPORATED INTO THIS AGREEMENT BY THIS REFERENCE In the event of unauthorized signature by an agent of a corporate or other business subscriber, the

undersigned agrees to be individually liable for amounts not paid when due.

Authorized Customer Signature

Date

Authorized Customer Signature

Date

X______________________________________________

X________________________________________________

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