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04/28/1989 1 Public Telephone Authorization Card , ,/ To ensure continuation of your AT &T "Dial 0+" long distance service on your local PLEASE NOTE: y j pq telephone company public telephones, please sign and return this Authorization * You may designate only one "Dial 0 +" long distance comp for ea o f y our public telephone Card as soon as possible. Doing so will ensure that all long distance calls will numbers. Selecting more than one long distance company for a telephone may invalidate your choice. continue to be handled by AT &T when they are dialed with a "0" plus the area code * There may be a charge by your local telephone company per line for any change you make if you change and telephone number and will enable AT &T to handle all necessary arrangements your choice following your first selection. for your "Dial 0 +" service with your local telephone company. Please sign and date this card for the Bell Telephone Company Public Phones at your location. Please l ist the Bell Telephone Company Public Phone number(s) on the back of this card. Please sign here: You. �L;��qo Please print or type name, company name, address, city, state and zip code below: X 417 1 7,r�i�f;�7 Monroe County, 500 Whitehead St. , Key ��'!✓ X g9 � y AUTHORIZED SIGNATURE DATE West, Florida 33040 Phone number where you can be reached during business hours. (SEAL) O 305 - 294 -4641 - ext. 505 Atte •DANNY L. KOLHAGE, Clerk / , . : : , e , . . . . . . . 4 ..., 4 . e (1 Prk OVER 2 AT &T Individual Commission Agreement AT &T This Agreement is entered into between AT &T Communications, Inc. , acting on behalf of the Interstate Division of the American Telephone and Telegraph Company and the AT &T Communications interexchange companies (hereinafter "AT &T ") and 0 Monroe County ("Agent') Company name WHEREAS Agent is responsible for the placement of public telephones on the premises listed in Attachment A hereto and has arranged for the placement on such premises of public telephones owned and operated by a local exchange company ( "LEC "), the parties agree as follows: 1. Agent represents and warrants that it is authorized to make decisions concerning public telephone service at the locations listed in Attachment A, including the right to select the primary interexchange carrier ( "PIC ") foraperator assisted ( "0 + ") interLATA calls placed from those locations. 2. Agent hereby selects AT &T as the "0 +" PIC for the LEC public telephones at the locations listed in Attachment A, and it appoints AT &T as its Agent for the purpose of submitting Agent's selection of AT &T as its PIC for such telephones. Agent also agrees that it will promptly sign and return any ballot received from a LEC in connection with "equal access" for that LEC's public telephones and to name AT &T as Agent's "0 +" PIC on the ballot. Nothing in this Agreement requires Agent to route "1 +" interLATA calls to AT &T from the telephones covered by this Agreement. 3. Agent must inform AT &T of the telephone line numbers for each of the LEC public telephones at the locations listed in Attachment A ( "locations ") and all changes or additions to those numbers. Agent may direct the appropriate LEC to provide AT &T with such information, but AT &T is not obligated to pay the commissions described in paragraph 5 below unless and until it has been provided with correct line numbers for the LEC public telephones. 4. Agent will use its best efforts to retain the placement of the LEC public telephones at the locations listed in Attachment A during the term of this Agreement. If the number of LEC public telephones covered by this Agreement decreases substantially, AT &T has the right to terminate this Agreement. 5. AT &T agrees to pay Agent a commission as described in Attachment B on the billed revenues for non- sent paid (i.e., collect, credit card and billed to third number) AT &T calls placed from the LEC public telephones at the locations listed in Attachment A, provided that: a. Agent complies with all of the requirements in paragraphs 1 -4 above. b. Agent will indemnify and hold AT &T harmless against any claim by any third party for commissions relating to the LEC public telephones covered by this Agreement. c. Agent will provide AT &T or its designee with reasonable access to Agent's records relating to this Agreement. 6. This Agreement will begin upon the signing of this Agreement by both parties and will be in effect for the period described in Attachment B. AT &T's obligation to pay commissions pursuant to paragraph 5 above will begin on the date that any LEC first implements Agent's selection of AT &T as Agent's "0 +" PIC from that LEC's covered telephones. AT &T may terminate this Agreement with respect to any or all of the locations listed in Attachment A by sending written notice to Agent if the Federal Communications Commission, a State Public Utilities Commission or a court of competent jurisdiction issues an order or ruling which contains terms or conditions that materially and adversely affect this Agreement, its profitability to AT &T, or the ability of AT &T or Agent to perform its (over please) obligations as set forth herein. In addition, if applicable rules and regulations change, so that Agent is not permitted to select the interexchange carrier for all "0 +" dialed interLATA calls from the covered telephones, Agent's duty to route all such calls to AT &T will end, and AT &T may terminate this Agreement by sending written notice to Agent. Termination of this Agreement under this paragraph will not give Agent any right to seek damages from AT &T as long as AT &T complies with its obligations to Agent up to the date of termination. 7. Except in cases involving willful or wanton conduct, AT &T's liability to Agent is limited to its obligations to pay commissions as described above. AT &T SHALL NOT BE LIABLE FOR ANY INDIRECT, SPECIAL, INCIDENTAL, CONSEQUENTIAL OR PUNITIVE LOSS OR DAMAGE OF ANY KIND, INCLUDING LOST PROFITS (WHETHER OR NOT AT &T HAD BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSS OR DAMAGE), BY REASON OF ANY ACT OR OMISSION IN ITS PERFORMANCE UNDER THIS AGREEMENT. 8. Any technical or business information or data disclosed or furnished to Agent by AT &T ( "information "), including all information relating to AT &T calls, remains the property of AT &T. When in tangible form, this information must be returned upon request. All such information must be kept confidential by Agent and used only in Agent's performance under this Agreement, unless the information was previously known to Agent without any obligation of confidentiality or is made public by AT &T. 9. This Agreement and any attachments hereto constitute the entire understanding between the parties. They supersede all prior understandings, oral or written representations, statements, negotiations, proposals and undertakings with respect to the subject matter hereof. All amendments to this Agreement must be in writing, must refer specifically to this Agreement and must be signed by authorized representatives of the parties. AT &T Communications, Inc. O Monroe County Company Na� .4` .4.6 . By By (Authorized Signature) (Authorized Signature) Date Date Print /Type name: Q Print /Type name: Michael Puto Mayor Title: Title: 500 Whitehead Street Company address Key West, Florida 33040 City State Zip Code DAi T0 1 305 - 294 -4641 Company telephone number AND LEGAL 3UFFIC/ENCi ('r 0 50- 6000 -749 sr , j / 1 , gI ,I Federal Tax 1DD(To issue commission checks) /{/ A(o / rm.''s."?NkP i (SEAL) • � Attu DANN L. KOLHAGE, Chem, 0016 12- � i�,r,G.e, Clerk Instruction Sheet Please complete the shaded areas on inserts 1 -4. 1 Public Telephone Authorization Card • Please fill in name and address. Q List all local telephone company public phone numbers. O Sign by an authorized representive and date. o Indicate phone number during business hours. • You may also be receiving a Ballot from your local telephone company requesting your selection of a Primary Long Distance Company. To be sure that your phones route the "0 +" interLATA calls to AT &T, check (✓ ) AT &T on the ballot and return promptly. 2 AT &T Individual Commission Agreement o Fill in your company name. • Fill in your company name, sign by an authorized representative, and date. o Print name of authorized signature, title, company address and phone number. Q Indicate your Federal Tax ID number so that commission checks can be issued. 3 Attachment A: Local Telephone Company Public Phones • Please copy this form before filling it out if you have multiple locations. • To ensure you receive your full commission, it is important that you write down each of your local telephone company public phone numbers. Q Fill in company name, (as it appears in local telephone company records) company address, city, state, zip, type of company and authorized contact person. Q Fill in name of local telephone company. Q List all local telephone company public phone numbers at this address. Q Indicate set type of public phone(s). Q Sign by an authorized representative, date, and indicate phone number during business hours. Attachment B: AT &T Individual Commission Plan • This form details the AT &T Individual Commission Plan and needs to be returned with your signed contract. 4 Exhibit - AT &T And Private Pay Stations • Please copy this form before filling it out if you have multiple locations. • Only complete this form if you have AT&T Public Phones and /or Private Pay Stations that have AT &T as the "0+ " long distance carrier. • This form must be completed and signed for each public phone location. Q Fill in company name, company address, city, state, zip, type of company and authorized contact person. Q List all AT &T Public Phones and /or Private Pay Phone telephone numbers. Q Sign by an authorized representative, date, and indicate phone number during business hours. 0021 12 -88 • AT & ti Attachment A: Local Telephone Company Public Phones To ensure you receive your full commission, it is important that you write down each of your local telephone company public phone numbers. (Complete one Attachment A form for each business address. You may have to copy this form before filling it out if you have multiple locations.) 0 Monroe County 0 .5.0U/7 3ELIi COMPANY NAME LOCAL TELEPHONE COMPANY 500 Whitehead Street XX NEW ACCOUNT COMPANY ADDRESS Key West, Florida 33040 ADDITIONAL LINE(S) CITY STATE ZIP CODE TYPE OF COMPANY DISCONNECT LINE(S) George Harper 305 - 296 -0348 AUTHORIZED CONTACT PERSON o Local Telephone Company 0 Set Type: Q Local Telephone Company Q Set Type: Public Phone Number Coin or Coinless Public Phone Number Coin or Coinless SEE ATTACHED- LISTS BI% %� ✓��� / /,. ACCEPTED BY: AT &T O AUTHORIZED SIGNATURE AUTHORIZED SIGNATURE Michael Puto TYPE OR PRINT NAME TYPE OR PRINT NAME y • • 4/a?8' -8.9 ,_ , • DATE DATE • 305 - 294 -4641 ext. 505 APPROVED AS TO FORM PHONE NUMBER DURING BUSINESS HOURS =� (SEAL) AND LEGAL SUFFICIENCY. - A1'T 0017 -88 DANNY K LHAGE Clerk Atte el. � ,y At rney "s Office Jerk - - _ _ _ _. . 1 , . . .0 I 1 2 ij * *mmm* * *t14ss - P p pp WN r Seit IS FO+O1,4617 N 1 A r --. \ ma 1 N 0 wOON 0w V VF t IS l a il W V WS a V V N VOON VtAt:A i r N el r rl+ m r 000000ooee000000 ka n+ 00000 H 9 pp 4 111 T N Ni'8O I p N p N S N I ..G O Q 0 O o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 N r w w w w w w w w w w w w w w w W A 0 0 r eeeeeeeeeeeeeeee st yi a O ♦ 0 {}I W �+ N yy{{ y • 0 I+N in NI0{ M I N 1 OtOfIQiINaSOVVS�IWONa Q N r M ab O 00 y0yy0y10Myi w O«ee «000000 e O «pe i i e` 1 N �I�IN�i11�1R�1`Qi RR O a rpr�aa a A •• aaaaaaaaa 13331311333E 11111111R /1/1111////1 Int k k k N N k N r e F 0 y 4 N N S rrrrrrrrrrr °o g ( 4 4 t ° f i s 11 1 . 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S S S S 7 4 � 7Y <n1 =; ��lR 1 g It 1 N 2..„1 N$ N 11 4 III 4 . 41/"'N `Q • 4 • Attachment B: AT &T Individual Commission Plan This form details the AT &T Individual Commission Plan and needs to be returned with your signed contract. 1. The commission rate payable to Agent for each location listed in Attachment A and the term of this Agreement are set forth below: m Total Number Of Public Telephones O AT &T Non -Se ission Rate nt At A Location Routing "0 +" Paid Revenues From InterLATA Calls To AT &T LEC Public Phones The initial term of this Agreement is a period of two (2) years from the date Agent first begins earning commissions on any telephone listed in Attachment A pursuant to the terms of paragraph 6 of the Agreement. This Agreement shall be automatically renewed for additional one year terms unless either party gives thirty (30) days' notice of its intention not to renew. 2. AT &T Non -Sent Paid Revenues will be calculated based on a monthly period beginning on the 16th day of each calendar month and ending on the 15th day of the following month. } AT &T 0019 12 -88 s. ill .. APPOINTMENT OF AGENT , The undersigned does hereby appoint AT &T my agent, to act in my name and stead, to handle all arrangements with local telephone companies (LEC's) to select AT &T as the "0 +" carrier for all current and any ) y future LEC public telephones installed at all locations under my control throughout the United States. It is understood that only one "0 +" long distance company may be selected for a LEC one li ne public telephone, and that the selection of more than one "0+" long distance company for a LEC public telephone may invalidate any choice. It is f p further understood that there may a charge by the local telephone company(s) for each public tele h g p yc) fo ne it there p one com here is a change an e in choice of "0+" long companies g lon distance com anies followin the initial selection. Monroe County . (Company) 500 Whitehead Street / (Address) ���/// (Signature) Key West, Florida 33040 Michael•Puto, Mayor of Monroe County (City, State) • (Name and Title) 305 - 294 -4641 • (Business Telephone Number) (Date) APPROVED AS TO FORM (SEAL) A LEGAL S CY. Attest: , ,, "71' AC- tiegkilL Clerk 3 .. A:04. meat A. IA:wal velephone Company Public Phones' . : 4', To ensure you receive your full commission, it is important that you write down each of your local telephone company public phone numbers. (Complete one Attachment A form for each business address. You may have to cop) this form 4 ) before filling it out if you have multiple locations.) / 0 M, wRDE CDUNTI / 0 Souriy6fw ��LL COMPANY NAM E LOCAL TELEPHONE COMPANY 5* CJH/rE HEAD ST XX NEW ACCOUNT COMPANY ADDRISS C� . 33x90 ADDITIONAL LINE(S) CITY y STATE ZIP CODE e 4D VERNMI4/T DISCONNECT LINE(S) TYPE OF COMPANY // // GEdRGE HAiWie 3''S -.19G -o392 AUTHORIZED CONTACT PERSON O Local Telephone Company 0 Set Type: 0 Local Telephone Company 0 Set Type: Public Phone Number Coin or Coinless Public Phone Number Coin or Coinless gas V — / //ce Cain/ 3os -- pe% - / /OS co /AJ 39 - ,M - /1/3 30.E on - / /D6. " 30s - .,e94/ - .,e9 / - ///4/ 11 3es" - 0,194 - 90203 „ J 5- W79 / //s 3D.3 .296 - 93G11 " 3os d99 ///4 ..1.6' s 0194 - ?WI " 305' 0?9V - 906.3 30s -0292/- 9c$7,2_ 30S - d94 - //Do 30.E - 0294 - /11/ 3Ds aC - / /Dl JAC - .294 - / //. " J.0, OG - //D a_ 303 0.$6 - Ill g 30s - QM - / /D3 ,, 3 5 -99 - ///9 ,, 30S -,,,e9�- //0i/ - - BY: ACCEPTED BY: AT &T 0 Ar1dA. -- ��LL.f AUTHORIZED SIGNATURE A ORIZ D SIG jr• D 7 Afr Al TYPE OR PRINT N ME s�L/r0 TYPE OR PRINT NAME k dl I uy Dempsey 628.-S9 s' -. g49 SRCC Manager DATE DATE PHONE NUMBER DURING BUSINESS HOURS AT&T 0017 12.88 : � m ent A. cA ' e ` tepbo n e o b lic 'P ho n es ." To ensure you receive your full commission, it is important that you write down each of your local telephone company public phone numbers. (Complete one Arturhme•nt .4 fnr,n for each business address. You Max have to cope this f o•m Z b(�li,re filling it out if you have multiple locations.) o A hAIR,6r CouivIy f 0 SearHEf,t/ Zezz. COMPANY NAME // LOCAL TELEPHONE COMPANY PLAAVT/e 15 / � D VT, CENTF/e XX NEW ACCOUNT COMPANY ADDRESS ,/ 7LA A ,V / / AL- . 33070 ADDITIONAL LINE(S) CITY STATE ZIP CODE eduNrY Go vbrA eA/T DISCONNECT LINE(S) TYPE OF COMPANY "AMR 2 GEdRGE H 1de 3c -- 29t - D 39 AUTHORIZED CONTACT PERSON 0 Local Telephone Company 0 Set Type: CO Local Telephone Company 0 Set Type: Public Phone Number Coin or Coinless Public Phone Number Coin or Coinless 3os -8s� - 9y /e, c a/,/ - - 30s - 8 02 - 9'/W - - 30s - Ose2 - 9WW4 - - 3as - 85'2 - 9 3 ' 3 '3 - - • BY: ACCE 'TED BY: ATE, 0 AI'IL - _ . �".C.A.: %—..,/ AUTHORIZED SIGNATURE A 'HOR ZED Stye R / / A1141/ AEt. /faro Nancy Dempsey TYPE OR PRINT NAME TYPE OR PRINT NAME .9 Si . � -,� S� -f9 � F;CC Manager DATE DATE Jas - 0?9 - '/C V/ ext. Sos PHONE NUMBER DURING BUSINESS HOURS __— AT &T 0017 12-88 3 . It a meat A : ' i o ia ' ` ep mpany Public hones y ;, 4 To ensure you receive your full commission, it is important that UK, 03 you write down each of your local telephone company public phone numbers. (Complete one Attachment A form for each business address li,u ntas• have to cops • this farm before filling it out if sou hate multiple locutions./ 0 A A/R D E cola/7 AA'g . C, y. S ;4e /Ff p ,Colo x,v lez z. COMPANY NAME // LOCAL TELEPHONE COMPANY • SS 776 t1 // VE, tAs Hay. xx NEW ACCOUNT COMPANY ADDRESS PLANTA770N 4y IC. 3307D ADDITIONAL LINE(S) CITY STATE ZIP CODE eda4/7 Go vERNrl tNT DISCONNECT LINE(S) TYPE OF COMPANY '' // 6EdRGE HA,®Ze 30 D.551 AUTHORIZED CONTACT PERSON 0 Local Telephone Company 0 Set Type: 0 Local Telephone Company 0 Set Type: Public Phone Number Coin or Coinless Public Phone Number Coin or Coinless 305" 1SOZ - 9D3D CD/A/ - - BY: ACCEPTED BY: A T 0 AUTHORIZED SIGNATURE AUTHORIZED E S IRE / dr /4/CNAEL PaTp TYPE OR PRINT NAME TYPE OR PRINT NAME (\ of 1Cy Dempsey - ,,I8 - Sr? _0; 2_ Fq ERGO Manager DATE DATE 34 - a91 - 4 '// exf. say — PHONE NUMBER DURING BUSINESS HOURS AT&T ow 12-88 • 3 T ��, to men A. n 'ele 4 A" a 'Ow -,;,-y- ' ti .h r To ensure you receive your full commission, it is important that Goc V you write down each of your local telephone company public phone numbers. (Complete one Attachment A J for each business address. You mar have 10 copy this form before ore filling it out if you have multiple locations.) p ill I ' I ill ' //s / . p SOur,61 21°44 COMPANY NAME Dis j o2 LOCAL TELEPHONE COMPANY 3/0 4 VERStAS AV/. XX NEW ACCOUNT • COMPANY ADDRESS A/AMilMA/ /` / L 3 ADDITIONAL LINE(S) CITY STATE ZIP CODE CI UN7 / GO VERa/ltA/T DISCONNECT LINE(S) TYPE OF COMPANY ,, // CE)RGE HAV'i 34 Z - 038 . AUTHORIZED CONTACT' PERSON o Local Telephone Company 0 Set Type: 0 Local Telephone Company 0 Set Type: Public Phone Number Coin or Coinless Public Phone Number Coin or Coinless 3s - 71/3 - 99t 7 Ca/A/ - - BY: ACCEPTED BY: AT 0 II�. , /i�.J1—:.../ AUTHORIZED SIGNATURE AUTHORIZED SIG /�' / d Al IC H AEI. ,ur0 k\ 2 lcy nemp,ey TYPE OR PRINT NAME TYPE OR PRINT NAME S RCC Manager DATE DATE 30c - 191 - VC V/ ext. Sas — PHONE NUMBER DURING BUSINESS HOURS AT&T 0017 /2-88 i s t. • 4 . i.:: , %� rr ZOI" R�.'4';t . K `.!' = P. ti� 11-; ..C" -s - � . _.? _ . 3 '- ' tt ac h ment • t tip ' d eplione 3mpany tic hot e s x t 7 Rl.d, LC •.t .{ `.. . ;.��. To ensure you receive your full commission, it is important that 60c. you write down each of your local telephone company public phone numbers. (Complete one Attachment A form for each business address. Km may have 10 copy this farm before filling it out if you have multiple locations.) o Ml1A/R6f CoaNTV/ AARATMA/ AVoRT' 0 Souri!/exv oefeZ COMPANY NAME LOCAL TELEPHONE COMPANY M NI 37 /.2- XX . NEW ACCOUNT COMPANY ADDRESS MARAT/MAI 1L • g34so ADDITIONAL LINE(S) CITY STATE ZIP CODE ee r GL vegivioA/r DISCONNECT LINE(S) TYPE OF COMP '' // 4edRGZ HAgpile 3,2C-..194 - D398 AUTHORIZED CONTACT PERSON 0 Local Telephone Company 0 Set Type: 0 Local Telephone Company 0 Set Type: Public Phone Number Coin or Coinless Public Phone Number Coin or Coinless 345 - 74/3 - 9145" co/A/ - - 3os - 71/3 - 99/3 - - . .3o5 - 7V3 - 9az 1, - - BY: ACCEPTED BY: AT& 0 A/.d_ ._4!:�..! -_ AUTHORIZED SIGNATURE AUTHORIZED SIGNA v / A l IC N AEG / f a r o i = ►cy Dempsey TYPE OR PRINT NAME TYPE OR PRINT NAME RCC Manager DATE DATE PHONE NUMBER DURING BUSINESS HOURS ,_ AT &T 0017 12-110 ''k , ttachment to elephonevom{pany b1ic:Phones 3 _� •.. • •• ,..,: -._.-, =. To ensure you receive your full commission, it is important that L ' you write down each of your local telephone company public phone numbers. (Complete one Attachment A form for each business address. You may have to copy this form before filling it out if you have multiple locations.) o MoiR6i e /T/ /A' y 4 ksr T/vrL . o .Sourxex v 2e L COMPANY NAME A/vogT LOCAL TELEPHONE COMPANY 31/9M 3. RoawEYET B BL ✓ 6, XX NEW ACCOUNT COMPANY ADD' S A L!/EST /'-L . 330i/D ADDITIONAL LINE(S) C7 CITY ��rr STATE ZIP CODE /� C ali rri oVEXN/4Ei /T DISCONNECT LINE(S) TYPE OF COMPANY ,, // GEdRGE Hkvy,e. 3i -2 - esy$ AUTHORIZED CONTACT PERSON 0 Local Telephone Company 0 Set Type: 0 Local Telephone Company 0 Set Type: Public Phone Number Coin or Coinless Public Phone Number Coin or Coinless 344-C .9V — 9091 coid - - 30S -0794 9//5 " _ _ ., 30S - oft - 9/L2- " - - 3aS - 2Z - 9/6D ' _ _ 335 29 - 937, - - 36S c299 - 937V - - 3o5 - o9G - 93W - - • BY: ACCEPTED BY: AT& 0 AUTHORIZED SIGNATURE AUT HO SIG E G�t M Ic H AEL Pure .x: ,cy Dempsey TYPE OR PRINT NAME TYPE OR PRINT NAME c ,CC Manager 4/7,2g g9 s i' -7? DATE DATE PHONE NUMBER DURING BUSINESS HOURS AT&T 0017 12.18 • , y -e • r , t t • ` f i .:I a limelnt : ca l ile„ none �ompany ' blic Phones 3 _ . •, To ensure you receive your full commission, it is important that COC 7 you write down each of your local telephone company public phone numbers. (Complete one Attachment A form for each business address. You may have w ropy this form before filling it out if you have multiple locations.) o /2ONRDc CottiVI I f Paz3z /e . p .SourlEA' / 3,z 4 COMPANY NAME BLDG LOCAL TELEPHONE COMPANY IllAbok eo,.c.G� 1'S D. [ � XX NEW ACCOUNT COMPANY ADD 4/ lileST / . 330 ADDITIONAL LINE(S) CITY STATE ZIP CODE ceUNT GDVR,vflbur DISCONNECT LINE(S) TYPE OF COMPANY / / G4eRG,E 4 iie gas-- J9t - 039S AUTHORIZED CONTACT PERSON O Local Telephone Company 0 Set Type: Q Local Telephone Company Q Set Type: Public Phone Number Coin or Coinless Public Phone Number Coin or Coinless 325 o?9C - 7SDO Co/A/ - - 303 0?99 - 999 't - - • BY: ACC ' ED BY: i : T 0 AUTHORIZED SIGNATURE A /� E sir ATURE / - dr /yI It fl AEL Paro TYPE OR PRINT NAME TYPE OR PRINT NAME I J al i t.y Del np5ey 7 71,- g9 S .)51-79 SRCC Manager DATE DATE 3as - of - vc V/ ext. Sos -- PHONE NUMBER DURING BUSINESS HOURS AT &T 0017 12-86 3 : 4`��= . Oielhment dale a hone company:P.ublic Phones To ensure you receive your full commission, it is important that c4c g you write down each of your local telephone company public phone numbers. (Complete one Attachment .4 form for each business address. You may have to copy this form be f arc filling it out if you have multiple locations.) o A hAIRM Cow/Ty/ 0 .at/ rifEA'A/ 2Ez4 COMPANY NAME �+ LOCAL TELEPHONE COMPANY AoN)?DE C.CUNry 6AMe4 XX NEW ACCOUNT COMPANY ADDR4 71 E/ / 1L . 33DVD ADDITIONAL LINE(S) CITY STATE ZIP CODE CDuA r y Go vERN� ENr DISCONNECT LINE(S) TYPE OF COMPANY ,, // 6 RG, HA /VIR 34S -- 4290 - 03 AUTHORIZED CONTACT PERSON © Local Telephone Company 0 Set Type: 0 Local 'Telephone Company 0 Set Type: Public Phone Number Coin or Coinless Public Phone Number Coin or Coinless 3t 5 - aft - 99- ? co/A/ - - 1 BY: ACCEPTED BY: A . T 0 d..._ _ i�u,i_ AUTHORIZED SIGNATURE AUTHORIZED ATURE M /C H AEI_ Puro Nancy Dompsey TYPE OR PRINT NAME TYPE OR PRINT NAME SRCC Manager 4 - SI -c fig DATE DATE ■5 - - a791 - 4 V/ ext. SoS — PHONE NUMBER DURING BUSINESS HOURS AT & T 0017 1248 3 . ,,:..,, Al cai ' elephone on anyt "blie 'hones To ensure you receive your full commission, it is important that C you write down each of your local telephone company public phone numbers. (Complete one Attachment A form far each business address. You may have to ropy this farm z before filling it out if you have multiple locations.) Q 14hAIRDZ Cot-IA/Ty/ p SellTiyERA/ .ELL COMPANY NAME p LOCAL TELEPHONE COMPANY lig c S ,&M // XX NEW ACCOUNT COMPANY ADDR S /4/ 1E,Sr /L. 3344 0 ADDITIONAL LINE(S) CITY �r STATE ZIP CODE 6144/7 46 VegAi the DISCONNECT LINE(S) TYPE OF COMPANY // // G64R HATER sac -a& - 0398 AUTHORIZED CONTACT PERSON 0 Local Telephone Company 0 Set Type: Q Local Telephone Company Q Set Type: Public Phone Number Coin or Coinless Public Phone Number Coin or Coinless 3i5 d99 - 9 9 Co /A/ - - BY: AC TED BY: AT O AUTHORIZED SIGNATURE AUTHORIZED SIGRE /4 HAEL Pam ��� TYPE OR PRINT NAME TYPE OR PRINT NAME Nancy i.iempsey .28- If s-= ,2 9- ?I' SRCC Manager CATE DATE 30s - a95/ - yG 9/ ex /. sas PHONE NUMBER DURING BUSINESS HOURS AT &T 0017 124E f At I cjiment B: AT &T Indivi al Commission Plan s. This form details the AT &T Individual Commission Plan and needs to be returned with your signed contract. 1. The commission rate payable to Agent for each location listed in Attachment A and the term of this Agreement are set forth below: Commission Rate Total Number Of Public Telephones On AT &T Non -Sent At A Location Routing "0 +" Paid Revenues From InterLATA Calls To AT &T LEC Public Phones s7A77.4 vs g% The initial term of this Agreement is a period of two (2) years from the date Agent first begins earning commissions on any telephone listed in Attachment A pursuant to the terms of paragraph 6 of the Agreement. This Agreement shall be automatically renewed for additional one year terms unless either party gives thirty (30) days' notice of its intention not to renew. 2. AT &T Non -Sent Paid Revenues will be calculated based on a monthly period beginning on the 16th day of each calendar month and ending on the 15th day of the following month. AT&T 0019 12 -88