Name:
Service Address:
Phone Number:
Equipment List: See Addendum A
I, Customer Name, (“Subscriber”) acknowledge receipt of the equipment as indicated on Addendum A, for use in receiving services from PanOptic, Inc., d/b/a ZIP Broadband, Inc.
The equipment shall remain the property of ZIP Broadbandand Subscriber shall not attempt to repair or tamper with the equipment.
ZIP Broadbandhas the right to periodically audit Subscriber’s equipment upon reasonable notice.
The Subscriber will provide two weeks’ notice to ZIP Broadbandof his/her intent to vacate the premises or to terminate services if possible so that ZIP Broadbandwill have sufficient time to disconnect the services and retrieve the equipment.
Subscriber will be financially liable if any equipment is withheld, destroyed, damaged, or stolen while in the Subscriber’s possession, including the Network Interface Device attached to the Subscriber’s home. Rates for the equipment will be at the retail rate as published from time to time on ZIP Broadband’s rate card.
If services are terminated due to non-payment, Subscriber agrees to allow ZIP Broadband to recover the equipment.
I have read and agreed to the above terms, as supplemented by my residential services agreement
__________________________________
Date and Subscriber’s Name
ADDENDUM A: EQUIPMENT LIST
DEVICE SERIAL NUMBER
