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Main Acct W: Sub- location tr: <br /> 4MCLeOd <br /> . <br /> Business Name: <br /> Customer Agreement and Checklist <br /> The Agreement consists of the documents below: YES NO NA <br /> 1 Customer has verified billing address is correct on the Customer Information Form. I 11 11 1 <br /> 2 Customer has verified physical address is correct on the Customer Information Form. II 11 1 <br /> 3 Customer has verified phone numbers are correct on the LOA. f ( 1 I 1 1 <br /> 4 Customer has verified Local Exchange Service is correct on the LOA. l 11 IL 1 <br /> 5 Customer has verified IntraLATA Service is correct on the LOA. 11 J1 1 <br /> 6 Customer has verified InteaLATA Service is correct on the LOA. 1 11 1 <br /> 7 Customer has agreed to PIC freeze on lines. 11 1 1 11 <br /> 8 Customer has requested and agreed to have wire maintenance on lines. 11 r 1 L I <br /> 9 Customer has verified the directory listing information is correct. L 1 i1 L J <br /> 10 Customer has verified the agreement tern is correct on the Addendum. r 11 1 ET <br /> 11 Customer has verified pricing and conditions are correct on the Addendum. r 11 1 1 1 <br /> 12 Customer has received and read General Terms and Conditions with the Checklist. [ 11 1 r 1 <br /> 13 Customer has verified set -up for voicemail. L 1 t 11 1 <br /> (Where Available) <br /> 14 Customer has verified set -up for Internet service. 1 ( [ 11 t <br /> (Where Available) <br /> 15 Customer acknowledges that charges from previous service providers 1 11 If 1 <br /> are their own responsibility. <br /> NON- DISCLOSURE: Customer agrees not to disclose the terms and conditions of this Agreement to any outside third party without the written permission of McLeodUSA. <br /> Broach of this condition may forfeit all teens and conditions outlined in the agreement. <br /> I hereby authorize McLeodUSA to make inquiries concerning my credit worthiness and hereby authorize financial institutions, vendors, and others to disclose <br /> credit information to McLeodUSA. <br /> Do not sign unless a box has been completed for each item. <br /> Business Name McLeodUSA Telecommunications Services, Inc. <br /> Representative McLeodUSA Representative <br /> Title Print Name <br /> C °nature X Branch Manager Signature <br /> r ate Print Name <br /> White-Service Delivery Yellow- Customer CAc 7n6Ps9 <br />