Temporary Wireless Internet Temporary Wireless Solution Customer Agreement Form First Name * Last Name * Email * Phone Number * Service Address * City * State * ALAKARAZCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMHMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Postal Code * Temporary Wireless Service * Yes, I request temporary wireless internet service at my residence. Agreement Terms & Conditions * I understand that by opting for the temporary wireless internet service provided by Mid Century, I will be transitioned to the Mid Century Fiber Service upon the completion of fiber installation at my residence. The temporary wireless service offers speeds up to 25 Mbps with unlimited data usage. This Agreement (“Agreement”) is made effective between Mid Century Fiber, located at 285 Mid Century Lane, Fairview, IL (“Provider”), and the undersigned Customer for the provision of wireless internet service at the specified address. I agree to pay Provider for (i) all use of my services, (ii) installation and applicable service charges, (iii) equipment, and (iv) all applicable local, state, and federal fees and taxes. Charges for the services that I receive have been provided to me. Other charges are set forth on a separate price list that I have received and/or can be provided on request. I will be billed monthly in advance for recurring monthly charges. If I participate in a promotional offer that requires a minimum time commitment and I terminate early, I agree that I am responsible for any termination fees that were described to me at the commencement of such promotional or discounted price. I authorize Mid Century to make an investigation of my credit history if needed. All charges are payable on the due date specified, or as otherwise indicated, on my bill. I agree that late charges may be assessed if my account is past due. My failure to deliver payment by the due date is a breach of this Agreement. The current late fees can be provided upon request and, if applicable, will not exceed the maximum late fees as set forth by applicable law. Mid Century reserves the right to change the late fees at any time. I certify that I am 18 years old or older and I am the property owner or I have permission from the property owner to have services installed. I authorize Mid Century to make any preparations to the premises necessary for the installation, maintenance, or removal of equipment. Mid Century shall not be liable for any effect of normal services installation and workmanship, such as holes in walls, etc., which may remain after installation or removal of the Mid Century equipment, except for damage caused by negligence on the part of Mid Century. The Mid Century equipment is and at all times shall remain the sole and exclusive personal property of Mid Century, and I agree that I do not become an owner of any Mid Century equipment by virtue of payments provided for in this Agreement or the Tariff(s) or the attachment of any portion of Mid Century equipment to my residence or otherwise. Upon termination of any services, subject to any applicable laws or regulations, Mid Century may, but shall not be obligated to, retrieve any associated Mid Century equipment not returned. All equipment must be returned within seven days after cancellation of service to avoid charges. I understand that Mid Century does not guarantee the functionality of the service at the specified address. I agree that data services are best effort delivery, and that Mid Century does not guarantee the maximum throughput rate will be achieved at all times. I also understand that the actual throughput rate I may experience at any time will vary based on numerous factors, such as the condition of wiring at my location, condition or age of device being used, computer configurations, Internet and network congestion, the time of day at which I use the service, and the website servers I access, usage of the service inconsistent with the Terms of Service, among other factors. I agree to accept and abide by Mid Century’s Terms of Service and network management policies, available at https://midcentury.com/corporate-legal-regulatory/. Terms are subject to change. Technical support for the temporary wireless internet service is available during regular business hours. For 24/7 assistance, our technical support team can submit a trouble ticket on your behalf. Customer Proprietary Network Information (CPNI) is personal information stored and collected by Mid Century for billing and provisioning services. Examples of protected information include call detail, services and features subscribed to, and carrier selected. Examples of non-protected information, because it is of public record, include name, address, and phone number (if published). Mid Century will do everything possible to protect the privacy of your CPNI information. The Federal Communications Commission (FCC) requires Mid Century to perform a customer authentication process anytime you call for protected information about your account or if you come into the office. The following procedures have been put into place by Mid Century to comply with these requirements and will take effect immediately. If you come to the office for information, please bring a copy of your complete bill with you. If you do not have your bill, you will need to provide a valid photo ID before we can share information on your account. If you are calling the office, you need to provide your Personal Identification Number (PIN) to allow us to share information about your account. You will assign a PIN to your account when signing up for services. Please note, this PIN can be no more than 10 characters. Only the person(s) whose name is on the account will be able to access account information with this PIN. To add another person to your account, please indicate that on the form when signing up for services and provide the name(s) of the person(s) you wish to add. I am the owner or an authorized signer of the Mid Century account referenced above. By typing or signing my name and clicking Submit, I acknowledge that this action carries the same legal weight as my written signature. Signature * signature keyboard Clear Captcha Submit If you are human, leave this field blank.
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