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Business'
ACKNOWLEDGEMENT AND CONSENT TO TRANSFER PHONE NUMBER(S)
COX FLORIDA TELCOM L.P. ("COX') currently provides telephone services to City of
Crestview Police Dept ("Current Account Holder') pursuant to the Commercial Services
Agreement identified below, or if the Current Account Holder is a residential customer,
pursuant to Cox's standard residential terms and conditions. Current Account Holder and
City of Crestview ("New Account Holder') hereby acknowledge and consent to the transfer
of the following phone numbers from the Current Account Holder to the New Account Holder
effective as of August 15, 2012 (the "Transfer Date'):
Phone Number:
Phone Number:
Phone Number:
850-683-0896
If the Current Account Holder is a
Current Account Holder Properly
New Account Holder Property
commercial Cox customer, the Date of
Address:
Address:
Commercial Services Agreement for
Current Account Holder:
201 Stillwell Blvd, Crestview, 32539
198 N. Wilson St, Crestview, 32536
Acct: 103637-02
Acct: 71355-01
CONTINGENCY: The transfer of the phone number(s) listed above is contingent
upon:
1) If New Account Holder is considered by Cox to be a commercial customer,
New Account Holder must enter into a Commercial Services Agreement with COX,
or if New Account Holder has already entered into a valid Commercial Services
Agreement with Cox, such Commercial Services Agreement will apply to the
transfered phone number(s). If New Account Holder does not have an existing
Commerical Services Agreement with Cox and fails to enter into a Commercial
Services Agreement with COX on or prior to the earlier to occur of (a) the
Transfer Date and (b) fifteen days (15) following the last date upon which either
party has signed this form, New Account Holder hereby agrees that the transfer
of phone number(s) shall be subject to the standard Commercial Services
Agreement.
2) If New Account Holder is considered by Cox to be a residential customer, Cox's
standard terms and conditions for residential service shall apply to the
transferred phone number(s).
COX shall provide the use of such phone number(s) pursuant to the applicable
Cox terms and conditions.
Faxed to KMS (438-0295) - by
8/15/20127/28/2010
1
CO
Business'
This document when executed by the Current Account Holder and the New Account Holder shall
serve as an acknowledgment of and consent to the transfer of the phone numbers listed above
without the need for further documentation evidencing such transfer. Each person signing below
represents that he/she is authorized to sign this form on behalf of their company and acknowledges
that COX is relying on the validity and authority thereof. All Services shall be provided under the
applicable Cox terms and conditions. To the extent of any conflict between the terms and
conditions in this form and the applicable Cox terms and conditions, this form shall control.
CURRENT ACCOUNT HOLDER:
NEW ACCOUNT HOLDER
Print Corporate Name (if Current Account Holder is a
commercial Cox customer), or individual's name (if Current
Account Holder is a residential Cox customers):
�c ' �ji i ,�-� �-�
f
� , �l
Print Corporate Name:
/1-/-cf D ��Psrvi ea)Authozed
Signature:
Elizabeth M. Roy
zed Signature:
ce0
Print Signatory Name
Elizabeth M. Roy
Print Si atory Name
Elizabeth M. Roy
Title:
City Clerk
Title:
City Clerk
Date:
08/16/2012
Date:
08/16/2012
8/15/20127/28/2010