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- :: _c= '. : .~G 334-791-5349 .•.......•...... , ~•... A HOUSE www.mybright~ou$e;C<l]l(B WID #: 8307266 INSTALL TECH/00B# 7161-001 POINTS 2S 3103-605-007 03 AR/UG: -:. A. . . . . . . A £11-<.69241 OPR TIME DATE PMS13 12:12 9/16/0 32440 .00 33.00 BUSINESS OF 866-876-1872 -000-0000 CHANGE PR AD 1 0 ! 0 EXPANDED ACCT.# 00501043413703 AGREEMENTIWORK ORDER CURRENT PR AD o 0 o 0 , :~./r~4TCR cC'A;:R.UNNER : T~ IPLE -:: .. :::--03 brfght~o~ house ;:-.~ •. ~ "'!!!!", -----s~.:~c---_ .00 O/OO/OC .00 1_81'PMI' 3~o - ~~6o Vd •••I/e.;- @./"""-JIe .•. ,...r. Co,." 1(),,2111/!?~005g 03 00 -= - IN-HOME TERMINALS RECOVERED NEED MORE WOAK o Needs lap o Requires ConSlr. AsSiStance o BurydrOp BlOCK NO. BlJLDING NO. 51 Technician Signatllfe:: , RESOLU1lON COOES I II] I r -£&.j • •• CE7E:...~ = ~-S =NO ='fES =,., Cl'! -..: TAP IN.HOUE TERMINALS INSTAUED 99. 67 S. 81 108. 49 .00 .00 ~-oo- 108.49 CASH RECEIPT ~AYMEI'iT -10-12P OLD ACCOUNT#: !i)~02/0S SLOT •.. -. .•.. ~'-' •••. J.,. .. r JOB INCOMPLET~ iOCh.. - - --_, _', __ Tech. ' __ Data: _ . __ OJH i1me ---::;:- , '_ _ o No Money 0 Not Home :toepfflacy notice. 0 Cancel 0 Reschedule Pe, Cust""'"' ~ ~ &. o..~ 0Other 0Minor Present BUSINESS PHONE LANDLORD No. SALESMAN NO. . - :c.-=-: =), '-i2E AND MAILBOX "SEF ',;1~ABLE --~ : --~-~ RATE :. - ..... __v TAX = =::-='':' ~E Al'10UNT : 5-~~~ATIONCHARGES :==~"~T GHARPES =;=::A~ REQUEST CHARGES - .~ ~EADANa 1NfTlAJ.. BELOW: -~ ._--~ ~ • - ~ .•• frame I expected. EXPANDED ACCT.II 00501043413703 AGREEMENTIWORK ORDER / /b:;ght@ h~~w~~ ~ .• 434137-03 CHANDLER • VIRG 334-791-5349 BUSINESS OF 866-876-1872 • -000-0000 .. www.mybrighl(1oU$El>CCOOJ W/O #: 8307266 INSTALL TECH/JOB# 7161-001 POINTS 2S 3103-60S-J07 03 A HOUSE 4968 32440 aPR TIME PM513 12:12 DATE 9/16/0 AR/UG:-> A... .... A BI-\69241 3{.o ..- '/0 b 1) Vd•••J/t/ @'r"'''-(J!e"Ir.Co'''' I{);l? fj;f1<1? oo:r~ l-----SERVICE---- 426 NAVIGATOR 428 ROADRUNNER A419 IN TRIPLE CURRENT PR AD o 0 o 0 CHANGE PR AD 1 0 1 0 .00 33.00 .00 LST PMT . 00 O/OO/OC Technician Signature: 99. 67 8. 81 108.49 .00 .00 .00 108.49 TOTALS: ~IONTHLY RATE MONTHLY TAX PRO-RATE AMOUNT INSTALLATION CHARGES ~-+-- _ __ DEF'DSl. <,J-{ARflE5 SPECIAL REaUEST CHARGES COD AMOUNT OLD HOUSE, # ON HSE AND MAILBOX *SERVICABLE 11/03/08 ~IONDAY -10-12P OLD ACCOUNTII: RESOLUTION CODES IN-HOME TERMINALS RECOVERED o Needslap o Requires Constr. AsSlSlance o Bury drop BLOCKNO. BliLDING NO. JO 03 51 6 NEED MORE WORK START . ; .• . ~COMPLEnON .. hSl~G~N~A~L~L~EA~KA~G~E~OETECTED~~bi~~~~=~~=~= ~GIB GROUNDED Text CH GNOIBLK TAP • 60 79 89 11. US DS SNR ItHiOME TERMINALS INSTALLED JOB INCOMPl!;li. CASH RECEiPT l'AYMENT DIG CBLE. RR. PH NEW ~ NO eTM II RESCHEDULED FROM 10/02/08 SLOT QUALITY ASSURANCE. PLEASE READ AND INmAL BELOW: ___ Yes, the representative arrived within the tim~ frame I expected. Tech. Tech. 1/--- Date: ---- ___ Ves, the representallve demonstrated all (tQuipmf;!nt. DJ1-llime----=------ ___ Yes, I received my information packet including the privacy notice. 0 No Money 0 Not Home o Cancel 0 Aeschedule Per Customer Yes, picture quality is table on all outlets. 0 Olhor 0Minor Present SPECIAL lNSTRlXlTlONS BUSINESS PHONE LANDLORD NO. SALESMAN NO. I i I I I L THE CUSTOMER. UNDERSTAND THAT I AM RESPONSIBLE FOR PAYMENT OF ALL APPLICABLE I SERVICES AND PRODUCTS PAOVlDED BY BRIGHT HOUSE NETWORKS. I ACKNOWLEDGE THAT I HAVE I CAREFUUY READ THE FRONT AND BACK OF THIS FORM, AND THAT IF I AM A DIGITAL PHONE I CllSTOMEA I EXPRESSLY ACKNONlEDGE THAT I HAVE READ AND UNDERSTAND BHN'$ E911 NOTICE ON THE BACK OFTHI$ FORM. I FURTHER ACKNOWLEDGE THAT I HAVE BEEN PROVIDED THE CAELE I MODEM SUBSCRIPTtON AGREEMENT ANOOR DIGITAL PHONE SUBSCRIPTION AGREEMENT AND THAT I I AGREE TO THE APPUCABLE TERMS OF SERVICE. i CUSTOMER SIGNATURE -------------------- II SSN#'-- VALID DRIVER'S LICENSE -------- i J UNDERSTAND THAT A COLLECTION CHARGE WILL BE ADDED TO MY ACCOUNT. ~NATlJRE 1 REV. 11105 , O'l3'f/37-D3