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Confirmation of Service Order <br />Egchange Dedicated Communications Services - <br />Base Rate, Fractional DSl, DSl and D53 Services <br />Service Type: ? <br />? Base Rate Point-to-Point <br />Base Rate Muitipoint ? Fractional DS1-128 ? DS1 <br />? Fractional DS1-256 ? DS3 <br />? Fractional DS1-384 <br />Order Type: X] New ? Renewal ? Conversion ? Upgrade ? Upgrade ? Winback <br />(Faster speed; ex: (Same Service/Longer <br />DSO to DS1) Term; ex: 3yr to 5 yr) <br />Existing Contract #: Existing Circuit ID: <br />Term Plan (months): ? 12 ? 36 X] 60 Requested Installation Date: <br />Monthiy Charges: 156.00 Non Recurring Charges: 0.00 <br />Circuit Quantity: 1 # Multipoint Locations: <br />Service Location #1: Service Location #2: <br />Your signature acknowledges that you understand and accept the terms and conditions on Pages 1 and 2 <br />and that you are authorized to make the commitments under this Order <br />CUSTOMER <br />Authorized Customer Signa ure <br />t"iK T." AVS ia1,_A24aw^ <br />Print Name and Title <br />A1 ov-. <br />Date <br />ClTY OF NORTH OLMSTED - 296 R94 3269 <br />Company Name <br />Biiling Address <br />City, State and Zip Code <br />Customer Contact <br />AMERITECH <br />Authorized Ameritech Signature <br />Print Name and Title <br />Date <br />AMERITECH CONTACT INFORMATION <br />HARLEY ROSS H685120 <br />Ameritech Sales Representative Name Sales Code <br />DCT INC. <br />Company <br />27877CLEMENS RD. <br />Street Address <br />WESTLAICE OH 44945 <br />City State and Zip Code <br />440 892 0300 <br />Customer Contact Phone Number Phone Number <br />440 892 2850 <br />Existing Billing Account Number (if appiicable) Fax Number <br />As used herein, Ameritech means Illinois Bell Te[ephone Company in Illinois; Indiana Bell Telephone Company Incorpcrrated in Indiana; Michigan Bell Telephone <br />Company in.Michigan; The Ohio Be11 Telephone Cornpany in Ohio; nnd Wisconsin Bell Inc. in Visconsi <br />March 2002 Page 2 of 2 <br />