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Name
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Last
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Service Address
(Required)
address of location where fiber is to be installed by JPUD.
Street Address
City
Consent to Terms of Installation Agreement
(Required)
By signing this agreement, you warrant that you are either the owner of the property (“Premises") or that you have the authority to give Jefferson County PUD ("JPUD") or its designated contractors ("Agents") access to the Premises. If you are not the owner of the Premises, you are responsible for obtaining any necessary approval from the owner to allow JPUD and its agents access to the Premises to perform the activities specified above. You are hereby granting JPUD and its agents the right to enter the Premises at which the fiber optic telecommunications services and/or equipment (“Service(s)”) will be connected at reasonable times, for purposes of installing, configuring, maintaining, inspecting, upgrading, replacing and removing the Service(s) and/or equipment used to receive any of the Service(s). Equipment and fiber optic cable installed at the Premises remains property of JPUD. Removal or damage of equipment will result in replacement charges to the resident not to exceed$300. Customer agrees to indemnify and hold harmless JPUD from any and all damages or claims resulting from installation of the equipment to customer's Premises. Customer further agrees to waive any claims to incidental or consequential damages and agrees that the liability of JPUD shall be limited to the cost of installation. The Customer shall protect, defend, indemnify, and hold harmless JPUD, its officers, officials, employees, agents, and volunteers from any and all claims, risks, injuries, damages, losses, suits, judgments, and attorney’s fees or other expenses of any kind arising out of or in any way connected with the performance of this agreement. Customer’s indemnity obligations hereunder do not extend to liability resulting from the gross negligence of JPUD, its agents, or employees.
I have read, understand, accept, and agree to the terms of this connection order agreement.
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