CONTACT AND BILLING INFORMATION by tgl10640

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									                                     Advanced Integrated Technologies
                                     9855 West 78th Street, Suite 300
                                                                                                                       Customer Service Agreement – Residential
                                     Eden Prairie, MN 55344
                                     800-300-5408 phone . 800-731-5601 fax                                                                PARTNER NAME:
                                     www.goait.com . customerservice@goait.com                                                            PARTNER NUMBER:

CONTACT AND BILLING INFORMATION

CUSTOMER NAME:                                                           MAIN PHONE:                                              EMAIL ADDRESS:

INSTALLATION ADDRESS (no PO boxes):                                                                   CITY:                                   STATE:                 ZIP:

BILLING NAME AND ADDRESS (If different):                                                              CITY:                                   STATE:                 ZIP:

CREDIT CARD TYPE:                               CREDIT CARD NUMBER:                                                                                           EXP. DATE:

    AUTOMATIC CREDIT CARD PAYMENT                      CREDIT CARD FOR BACKUP ONLY               LOCAL PHONE COMPANY:

OUTBOUND SERVICE

INTERSTATE RATE:                                INTRASTATE RATE:                                       PIC INTRALATA ONLY              PIC INTERLATA ONLY              PIC INTER/INTRALATA

LINE NUMBER       1.                                         2.                                            3.                                            4.

TOLL-FREE SERVICE

**INTERSTATE RATE:                           **INTRASTATE RATE:                           **65 cent payphone surcharge applies to all calls originating from a payphone

TOLL-FREE NUMBER:                                                 DIRECTORY ASSISTANCE* (Y/N)                           POINT TO NUMBER:

* A $25 monthly fee, a $25 setup fee and a $25 cancellation 8xx fee applies to each toll-free number listed in Directory Assistance
CALLING CARDS

**RATE PER MINUTE:                         # OF CALLING CARDS:                             **65 cent payphone surcharge applies to all calls originating from a payphone

AGREEMENT TERMS AND SIGNATURE
This Agreement is made by and between the undersigned Customer and Advanced Integrated Technologies (AITech). Customer appoints AITech as its agent in dealings with any party
necessary to implement and maintain long distance services to the Customer. This change will entail a charge for each phone line, identified on Customer’s local phone bill as a “PIC” charge,
and will result in a change in Customer’s long distance carrier. Customer acknowledges that AITech, the underlying carrier and AITech’s authorized dealer assume no liability for calls not
completed due to circumstances beyond its control. Unless prohibited under applicable law AITech makes no warranties expressed or implied, except as stated in this agreement. Customer
accepts the rates shown above. Customer accepts a $1.95 monthly charge on each invoice with new charges less than $10.00. AITech will provide Customer with 30 days advance notification
of rate and fee modifications via an invoice note or at www.goait.com. AITech will notify Customer of interstate rate modifications. If account goes more than 60 days past due, the past due
amounts may be charged on the credit card provided above. If service is interrupted due to account delinquency, a $10.00 reconnection fee will be applied to the account when service is
restored. An authorization will be run on credit card to verify that credit card number is valid. Customer agrees to pay a late fee on the unpaid balance, at a rate of 1.5% per month, if
payment is not made by the due date. This agreement may be canceled by either party by giving written notice to the other party. Customer is responsible for notifying the local phone
company of its cancellation of AITech services and is liable for the payment of all usage charges it incurs for the services requested above prior to the actual cancellation of AITech services by
the LEC or AITech. If AITech refers Customer account to a third party for collection due to a dispute or uncollected balance, Customer agrees to pay all related costs, including interest, fees,
court costs, and attorney’s fees. Customer accepts the terms and conditions imposed by AITech for the use of its services and agrees that a fax signature is binding.


CUSTOMER SIGNATURE:                                                                     PRINT NAME:                                                                DATE:

								
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