Service Agreement

and Service Order

This Business Class Service Agreement and Service Order, including all attached Work Orders and additional Terms and Conditions that are
incorporated herein by this reference ("Service Agreement"), is between customer identified below ("Customer") and Time Warner Cable ("TWC" or
"Operator") and is effective as of the date last signed below.
Time Warner Cable Information
Time Warner Cable Business Services Website: http://www.twc.com/nationalaccounts
13820 Sunrise Valley
Herndon, VA 20171 Customer Support: 1-877-892-4519
Drive,
Customer Information
Customer Name (Exact Legal Name): Federal Tax ID No (9 digits):
EL REY MOTEL 954533465
Business Street Address (Service Address):* Suite: City: State: Zip Code:
454 E FOOTHILL BLVD RIALTO, CA 92376
Customer’s Phone # Extension: Fax #:
(909) 875-0134
Customer Contact Name: Telephone #: E-mail:
MARVIN LAL (909) 875-0134 MARVINAV78@YAHOO.COM
Billing Address: Suite: City: State: Zip Code:

Billing Contact Name: Telephone #: E-mail:

MARVIN LAL (909) 875-0134 MARVINAV78@YAHOO.COM

Existing Customer Account #: 9098750134734 Check One:

Single Play Double Play Triple Play
X New Customer Customer Code: X
For BCP Only

TWC Channel Mgr Contact Name: Telephone #: E-mail:

Cloud Solutions Adminstrator Name: Customer’s Phone # Extension: E-mail:

(909) 875-0134 Email

Customer Owned Domain SharePoint Host Name

* This address will be used for Emergency 9-1-1 services

Services

Type **
Order
Install Fee/ Monthly Total Monthly
Products Ordered Term (Months) Quantity Set up Fee Fee Recurring
BCP M2M 2 $29.99 $59.98
60 MEG M2M 1 $59.99 $59.99
VOICE MAIL M2M 1 $0.00 $0.00
25 CALLING FEATURES M2M 1 $0.00 $0.00
UNLIMITED NATIONWIDE LONG DISTANCE M2M 1 $0.00 $0.00
BUSINESS WIFI M2M 1 $4.99 $4.99

Total Install Fees*** $0.00 Total Monthly*** $124.96

** Order Type: N—New | A—Add | C—Change | M—Move ****Prices do not include taxes and may include additional fees.

AGREEMENT
THIS TIME WARNER CABLE BUSINESS CLASS SERVICES AGREEMENT IS SUBJECT TO THE TIME WARNER CABLE BUSINESS CLASS SERVICES AGREEMENT TERMS AND
CONDITIONS AVAILABLE AT http://www.twcbc.com/corporate/service_agreement.html, A COPY OF WHICH WILL BE PROVIDED TO CUSTOMER UPON REQUEST. SUCH TERMS
AND CONDITIONS ARE INCORPORATED HEREIN BY THIS REFERENCE. BY EXECUTING THIS TIME WARNER CABLE BUSINESS CLASS SERVICES AGREEMENT WHERE
INDICATED BELOW, CUSTOMER ACKNOWLEDGES THAT (1) CUSTOMER ACCEPTS AND AGREES TO BE BOUND BY ALL SUCH TERMS AND CONDITIONS, INCLUDING
SECTION 21 THEREOF, WHICH PROVIDES THAT THE PARTIES DESIRE TO RESOLVE DISPUTES RELATING TO THE TIME WARNER CABLE BUSINESS CLASS SERVICES
AGREEMENT THROUGH ARBITRATION; AND (2) BY AGREEING TO ARBITRATION, CUSTOMER IS GIVING UP VARIOUS RIGHTS, INCLUDING THE RIGHT TO TRIAL BY JURY.

By signing and accepting below you are acknowledging that you have read and agree to the terms and conditions outlined in this document.

Authorized Customer Signature: Authorized Time Warner Cable Signature:

Printed Name: Printed Name:

Title: Title:

Date Signed: Date Signed:

Ver. 2013 09 27
 Business Class Customer Service Order
Business Class PRI/SIP Services Detail- Attachment B
Customer Name: EL REY MOTEL

Additional Required Information for PRI/SIP Caller ID (15 Char Max - Alpha only) Trunk Inbound Call Blocking -->
PRI Channels (23, 16,12 or 8) --> Trunk Outbound Call Blocking -->
Qty of DIDs (Ported / Native) --> Inbound Call Block*: (COL) Collect, (TP) Third Party, (CTP) Collect and Third Party
MOU Pkg (# of minutes) --> Outbound Call Block*: (900) 900 Numbers, (Int) International, (900INT) 900 and International
Is PRI over FIBER or DOCSIS? --> *Customer’s election of call blocking can minimize potential exposure to fraud or unnecessary charges.

1 For BC PRI/SIP list the lead number of the PRI group and the associated E-911 Address on the first line below.

Telephone E-911 Location Additional or

Service Location Street Service Location City, State
Number(s) / PRI (Floor/Suite) (If CP Foreign
Address ZIP
Group Lead TN1 applicable) Listing? (Y/N)2

If customer is porting more than 20 #'s, you may submit a list using the "PRI-SIP-PORT LIST" tab. Put "Please see attached list of TNs" on first line below.

«LEAD PHONE_NUMBER»
«Floor_Suite»

Toll Free Service DIRECTORY LISTING Information

Toll Free Number: Ring to Number: Listed Phone # Yellow Page Category

********** < if customer does not require a listing, please indicate that here>

Notes:

AGREEMENT
THIS TIME WARNER CABLE BUSINESS CLASS SERVICES AGREEMENT IS SUBJECT TO THE TIME WARNER CABLE BUSINESS CLASS SERVICES AGREEMENT TERMS AND CONDITIONS AVAILABLE AT
http://www.twcbc.com/corporate/service_agreement.html, A COPY OF WHICH WILL BE PROVIDED TO CUSTOMER UPON REQUEST. SUCH TERMS AND CONDITIONS ARE INCORPORATED HEREIN BY THIS
REFERENCE. BY EXECUTING THIS TIME WARNER CABLE BUSINESS CLASS SERVICES AGREEMENT WHERE INDICATED BELOW, CUSTOMER ACKNOWLEDGES THAT (1) CUSTOMER ACCEPTS AND AGREES TO BE BOUND
BY ALL SUCH TERMS AND CONDITIONS, INCLUDING SECTION 21 THEREOF, WHICH PROVIDES THAT THE PARTIES DESIRE TO RESOLVE DISPUTES RELATING TO THE TIME WARNER CABLE BUSINESS CLASS SERVICES
AGREEMENT THROUGH ARBITRATION; AND (2) BY AGREEING TO ARBITRATION, CUSTOMER IS GIVING UP VARIOUS RIGHTS, INCLUDING THE RIGHT TO TRIAL BY JURY.

By signing and accepting below you are acknowledging that you have read and agree to the terms and conditions outlined in this document.

Authorized Customer Signature: Authorized Time Warner Cable Signature:

Printed Name: Printed Name:

Title: Title:

Date Signed: Date Signed:

Ver. 2013 09 27
 Business Class Customer Service Order
Busines Class PRI Services Detail- Attachment B
Customer Name: EL REY MOTEL

PORTED Telephone # list

*********** Use this page only if total TNs to be ported is over 20. **************
1 For BC PRI list the lead number of the PRI group and the associated E-911 Address on the first line below.

Telephone E-911 Location Additional or

Service Location Street Service Location City, State
Number(s) / PRI (Floor/Suite) (If CP Foreign
Address ZIP
Group Lead TN1 applicable) Listing? (Y/N)2

Qty

1 «LEAD PHONE_NUMBER» «Floor_Suite»

2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
 Business Class Customer Service Order
Busines Class PRI Services Detail- Attachment B
Customer Name: EL REY MOTEL

PORTED Telephone # list

*********** Use this page only if total TNs to be ported is over 20. **************
1 For BC PRI list the lead number of the PRI group and the associated E-911 Address on the first line below.

Telephone E-911 Location Additional or

Service Location Street Service Location City, State
Number(s) / PRI (Floor/Suite) (If CP Foreign
Address ZIP
Group Lead TN1 applicable) Listing? (Y/N)2

Qty
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
 Business Class Phone & Business Class Trunk Service
Notice and Acknowledgement Regarding E911

Customer understands and acknowledges that the Time Warner Cable Business Class Phone & Business
Class Trunk (SIP or PRI) voice-enabled customer premise equipment is electrically powered and, in the
event of a power outage or Time Warner Cable network failure, Enhanced 9-1-1 (“E911”) services may not
be available.

The Time Warner Cable Business Class Services Agreement prohibits moving your Time Warner Cable
voice-enabled customer premise equipment to a new service address. Customer understands and
acknowledges that if this equipment is moved to another location, E911 services may not operate properly
and emergency operators may be unable to accurately identify the caller's address in an emergency. The
E911 location specified on the Time Warner Cable Business Class Service Order will be provided to
emergency operators for emergency calls made from the telephone numbers associated with this
Service Order. To move your service to another location, you must call Time Warner Cable.

Customer agrees to specifically advise every end user of the Time Warner Cable Business Class Phone or
Trunk service, prominently and using the language provided above, of the circumstances under which
E911 service may not be available through Time Warner Cable Business Class Phone or Trunk service
and to distribute Safety Stickers, to be supplied by Time Warner Cable, to all end users of the Time Warner
Cable Business Class Phone or Trunk service and instruct each end user to place a Safety Sticker on or
near any telephone or other equipment used in conjunction with the service.

Customer must ensure that all alarm, security, medical and/or other monitoring systems and services are
tested to validate proper operation after Business Class Phone orTrunk service is installed.

By signing my name below, I acknowledge that I have read and understand this E911 Notice and
Agreement and agree to the obligations described above.

(Authorized Customer Signature) (Date Signed)

Time Warner Cable Business Class is a trademark of Time Warner Inc. Used under license. © 2009 Time Warner Cable. All rights reserved.
 BUSINESS CLASS PHONE SERVICE LETTER OF AGENCY

Company Name: EL REY MOTEL

Billing Address: 454 E FOOTHILL BLVD RIALTO,, CA 92376

By checking the following items, I designate Time Warner Cable to be the service provider for the telephone number(s) listed on
the attached Service Order.

X I choose Time Warner Cable to provide local telephone service for the telephone number(s)
(check) listed on the attached Service Order.

X I choose Time Warner Cable to provide domestic and international long distance service for
(check) for the telephone number(s) listed on the attached Service Order.

I am at least 18 years of age and I am authorized to designate the provider for the services and telephone number(s) identified
above. I understand that I may choose only one provider for each telephone service and number identified herein. By signing
my name below, I acknowledge that I have read and understand these statements and authorize Time Warner Cable to act as
my agent for these provider designations.

(Authorized Customer Signature) (Date Signed)

(Printed Name) (Title)

Note: To complete you order, you must confirm your selection of Time Warner Cable as your service provide by initialing the
boxes next to each statement. Should you have any questions, please call you time Warner Cable Business Class account
representative.
 Business Class Phone
Customer Service Record
Query Authorization
Customer consents to Time Warner Cable’s access to and use of information regarding the Customer’s local, long distance and
international communications services, customer service reports, and credit and billing history, with respect to the billing telephone
number(s) and all the associated working telephone numbers listed below and on the attached additional pages, if any for the
purpose of calculating pricing plans and proposals. This document does not constitute authorization for Time Warner Cable to
provide service to the customer. Customer appoints Time Warner Cable to act as its agent to the extent necessary to acquire the
information described herein from the entities indicated below:

Local Exchange Carrier Inter-LATA Toll Carriers Intra-LATA Toll Carriers

Customer Information
Account Name Account Number Federal Tax ID Number
EL REY MOTEL 9098750134734 954533465
Contact
MARVIN LAL
Billing Info Service Address Info
Billing Address Service Address
454 E FOOTHILL BLVD
City State ZIP City State ZIP
RIALTO, CA 92376
Account Executive Info
Account Executive Phone Fax

Current Carrier Info

Current LEC Current IXC
AT&T AT&T

Telephone Number Information

Note - Ported TNs listed below must match the Ported TNs on the BCP and/or PRI Services Detail Page
Phone Line Type Ported Telephone Number
BTN 9098750134
WTN
WTN
WTN
WTN
WTN
WTN
WTN
WTN
WTN
THIS AUTHORIZATION SHALL REMAIN IN EFFECT UNTIL MODIFIED OR REVOKED IN WRITING

EL REY MOTEL
(Customer Name)

(Authorized Customer Signature) (Date Signed)

(Printed Name) (Title)

Business Class Phone Services Detail EL REY MOTEL
The Letter of Agency, The Toll Free Service Letter of Agency, the E911 Notice and Agreement and the CSRQA (if applicable) are required for this service.

Calling Plan
Caller ID Information

Local & LD

Local Only
Phone Number

Unlimited

Unlimited

Hunting
(If same for all lines, only complete line 1)

In State
(Enter NATIVE if not

Private

Global
Listed
Line #
Ported)
15 Character Maximum
1 X (909) 875-0134 X 1 E L R E Y M O T E L
2
3
4
5
6
7
8
9
10
11
12

Mobilty Package, If ordered on Sv Order page 1 Custom Ring, if ordered on Sv Order page 1
Assign to Number Assign to Number Custom Ring Number Assign to Number

Voice Mail, if ordered on Sv Order page 1 Call Blocking Options*

Single, Shared, Group (Pick one) Assign to Number Inbound and/or Outbound Assign to Number

Remote Call Forwarding, if ordered on Sv Order page 1 Toll Free Service Toll Free Rate: $0.06/min
Number to be Forwarded: Forward to Number Toll Free Number: Number Ring to:

Directory Listing Information

Listing Information Yellow Page Header
Addiitonal
Straight

Foreign

Lines Name Type of Business for Listing Category

Inbound Call Block*: (COL) Collect, (TP) Third Party, (CTP) Collect and Third Party
Outbound Call Block*: (900) 900 Numbers, (Int) International, (900INT) 900 and International
*Customer’s election of call blocking can minimize potential exposure to fraud or unnecessary charges.
A telephone/key system vendor may be required at time of BCP installation

AGREEMENT
THIS TIME WARNER CABLE BUSINESS CLASS SERVICES AGREEMENT IS SUBJECT TO THE TIME WARNER CABLE BUSINESS CLASS SERVICES AGREEMENT TERMS AND
CONDITIONS AVAILABLE AT http://www.twcbc.com/corporate/service_agreement.html, A COPY OF WHICH WILL BE PROVIDED TO CUSTOMER UPON REQUEST. SUCH TERMS AND
CONDITIONS ARE INCORPORATED HEREIN BY THIS REFERENCE. BY EXECUTING THIS TIME WARNER CABLE BUSINESS CLASS SERVICES AGREEMENT WHERE INDICATED
BELOW, CUSTOMER ACKNOWLEDGES THAT (1) CUSTOMER ACCEPTS AND AGREES TO BE BOUND BY ALL SUCH TERMS AND CONDITIONS, INCLUDING SECTION 21 THEREOF,
WHICH PROVIDES THAT THE PARTIES DESIRE TO RESOLVE DISPUTES RELATING TO THE TIME WARNER CABLE BUSINESS CLASS SERVICES AGREEMENT THROUGH
ARBITRATION; AND (2) BY AGREEING TO ARBITRATION, CUSTOMER IS GIVING UP VARIOUS RIGHTS, INCLUDING THE RIGHT TO TRIAL BY JURY.

By signing and accepting below you are acknowledging that you have read and agree to the terms and conditions outlined in this document.

Authorized Customer Signature: Authorized Time Warner Cable Signature:

Printed Name: Printed Name:

Title: Title:

Date Signed: Date Signed:

Ver. 2013 09 27
 Service Delivery Questionnaire
Dedicated Ethernet Access Services (Fiber & Ethernet over DOCSIS)
Customer / Company NAME EL REY MOTEL
Check Service Ordered Below:
DIA EPL (pt-2-pt) EVPL (pt-2-mpt) E-LAN (mpt-2-mpt) PRI ISDN Service EoDOCSIS

Configuration Require /30 IP To Be Assigned to WAN Interface of Customer Router

# of IP Addresses Requested List Other Here

/30=1 29=5 /28=13 /27=29 /26=61 /25=125 /24=253 Other

Note: If BGP Required Please engage TWC Sales Engineer
PRI ISDN Service Configuration & Equipment Information
Phone Vendor Name: Tel: E-mail:

PRI ISDN Configuration PBX/Phone System Model Software Version

Switch Type / CO Emulation
NI2 5ESS DMS100 Verify Channels Required: # of Digits Sent by Carrier:

Other 23 16 12 8 3 4 7 10
Clock Source:
Voice Gateway/TWC Switch Footage from PBX to TWC NID:

PBX? # Spare PRI Ports TWC Equipment Mounting: Existing Number of PRIs?
Rackmount Wallmount
Recommended Type of Cut-Over: Backup Power Source:
Hot Cut Migration New None UPS Generator None

Primary Site Address CPE UNI Handoff Type

Copper Optical MMF
Optical SMF
Customer Site Demarcation Information
Wall Mounting AC DC Yes No Yes No
Drywall Plywood Dedicated Power? Rack Space? Backup Power?
Building Contact Info
Phone Vendor Name: Tel: E-mail:

Technical Contact ( Main or Site Based)

Building Contact Name: Tel: E-mail:

Demarc Information:

Z Location Address (If Applicable) CPE UNI Handoff Type

Copper Optical MMF
Optical SMF
Customer Site Demarcation Information
Wall Mounting AC DC Yes No Yes No
Drywall Plywood Dedicated Power? Rack Space? Backup Power?
Building Contact Info
Phone Vendor Name: Tel: E-mail:

Technical Contact ( Main or Site Based)

Technical Contact Name: Tel: E-mail:

Demarc Information:
 1- TWC SIP Trunks Service
Customer Name

Customer Technical Contact Name

Customer Technical Contact Phone

Address of SIP Trunk location

Total number of call paths

Transport? Fiber or DOCSIS

How many call digits are processed by the PBX?

TWC contact name

TWC contact e-mail
TWC contact telephone #
Date

2- SIP Trunks Equipment

PBX manufacturer
PBX model
PBX software version
Backup power supply

Can you support G.711 codec?

Are you using a PBX vendor? If so, please provide contact information.

Describe additional telephony equipment connected to the IP PBX and used

for TWC SIP Trunks
VoIP Telephone
ATA
Point Of Sales (POS)
Alarm System
FAX Machine
Other

Does the location have an AC 110V receptacle available in close proximity3- Site Conditions
of ESG location?

Is the site temperature always between 32F and 104F?

Is there appropriate space for Innomedia or is a special build required? The
ESG has an approximate size of a cable modem, and requires a rack shelf

4- PBX/SBC Connection
Will the ESG connect directly to the PBX or a LAN switch? If connected into
the PBX, skip the next question.

LAN connection Which switch port will the ESG connected to?
What is bandwidth of the Ethernet port?
10Mbps, 100Mbps or 1Gps (1000Mbps)

Duplex? "Full" or "Auto"

5- Signaling and Media

IP Address for PBX or SBC
To setup LAN configuration for signaling of voice traffic to the ESG

Please provide IP Address for the TWC Enterprise SIP Gateway

What is the SIP registration method for your PBX?

"Static" or "Dynamic"

Registration Username
Credentials for
dynamic SIP
registration Password

TWC expects a single IP subnet for PBX/SBC and associated phones or fax
machines. If the media (RTP) is connected differently, please provide IP
Address and subnet

6- CODEC
Check all protocols supported by your PBX for DTMF:

Check all protocols supported by your PBX for Fax:

7- Non-Compliant PBX
Is the PBX model or manufacturer part of the TWC approved PBX list?
Only in case of the PBX manufacturer or model or software version is not
part of the TWC list of compatible of IP PBX. Do you know if the PBX is
compatible with any "SIP Connect" standard?
List all methods defined by SIPConnect 1.0/1.1 and are not supported by
PBX. More information could be found at the SIP Forum website
http://www.sipforum.org/content/view/274/228/
8- Final Comments
1- TWC SIP Trunks Service

Primary contact for the TWC SIP

Trunks installation representing
the customer

Max 60 for Fiber, max. 23 for

DOCSIS
DOCSIS
Digits could be stripped from 10
10 (default) up to 1 digit

2- SIP Trunks Equipment

TWC is supporting only G.711,

other codecs like G.729 are not
supported

Describe any additional contacts

(Name/Phone) working on IP
PBX or LAN configuration

Please provide details on device

type and planned use
3- Site Conditions

Temperature outside the 32-104

degree (Fahrenheit) range will
impact operations of the ESG
 Dimension of the ESG
(Innomedia ESBC9378) are 2.5
in (H) x 7.8 in (W) x 6.0 in (D)
4- PBX/SBC Connection
Recommended direct PBX
connection

Recommended 100 Mpbs

Recommended Full Duplex
If 'Auto-Negotiate' is selected,
TWC cannot guarantee call
quality
5- Signaling and Media
IP: xxx.xxx.xxx.xxx
Subnet: 255.255.xxx.xxx
TWC could provide IP address if
ESG IP: xxx.xxx.xxx.xxx customer cannot setup LAN
Static Static' is default, dynamic
registration will add security

TWC will provide username and

password before service turn-up

Other IP: The Real-time Transport Protocol

(RTP) is carrying the media
stream of voice calls end-to-end
Other Subnet:
6- CODEC
Which codecs are you planning
to use?
Which codecs are you planning
to use?
7- Non-Compliant PBX

If not compatible provide a

sample of call trace of a call
received by the PBX
Only if PBX is NOT compatible to
SIP Connect Standards
8- Final Comments
 Business Class Customer Service Order

Attachment C
Metro Ethernet Solutions/Dedicated Access Service

DEDICATED INTERNET ACCESS SERVICES

Monthly
Product/Service Bandwidth Recurring Install NRC
Location Address City State Zip Fees
(Mbps)

TOTAL $0.00 $0.00

POINT TO POINT ETHERNET SERVICES

Monthly
Bandwidth
Location Description Location Address City State Zip Recurring Install NRC
(Mbps)
Fees
A - LOCATION
Z- LOCATION
TOTAL $0.00 $0.00

POINT TO MULTI-POINT ETHERNET SERVICES

Monthly
Bandwidth
Location Description Recurring Install NRC
(Mbps) Location Address City State Zip Fees
AGGREGATION SITE
REMOTE CIRCUIT SITE
REMOTE CIRCUIT SITE
REMOTE CIRCUIT SITE
REMOTE CIRCUIT SITE
REMOTE CIRCUIT SITE
REMOTE CIRCUIT SITE
REMOTE CIRCUIT SITE
REMOTE CIRCUIT SITE
REMOTE CIRCUIT SITE
REMOTE CIRCUIT SITE
TOTAL $0.00 $0.00

Additional Terms

Electronic Signature Disclosure

By signing and accepting below you are acknowledging that you have read and agree to the terms and condition outlined in this document..

Authorized Signature for Customer Authorized Signature for Time Warner Cable

Printed Name and Title Printed Name and Title

Date Signed Date Signed

 ETHERNET INTERSTATE/INTRASTATE DETERMINATION LETTER

In order to determine how to treat the [INSERT: Point to Point / Metro Ethernet HERE]
services we provide to you for taxation and fee assessment purposes,
we ask that you please check ONE of the boxes below as appropriate.

The traffic carried by Time Warner Cable in its provision of [INSERT: Point to Point / Metro Ethernet HERE]
services to [Insert Customer Name]
is at least 10% interstate in nature and, therefore, may be classified under FCC rules as jurisdictionally interstate.

The traffic carried by Time Warner Cable in its provision of [INSERT: Point to Point / Metro Ethernet HERE]
services to [Insert Customer Name]
is intrastate in nature and does not contain traffic that is at least 10% interstate.

Authorized Signature for Customer

Printed Name and Title

Date Signed
 Commercial Services End-User IP Address Space Justification
1.1       IP Address Allocation Justification Form
·  Please use the following forms for initial assignments as well as additional assignments.
· Road Runner requires written justification for any IP address block(s) requested so that it can demonstrate to ARIN that allocated IP
addresses are being used efficiently, per RFC 2050 (http://www.arin.net/library/rfc/rfc2050.txt).
· If e-mail is not available, submit them by fax to:
· If you have any questions about filling out the forms, please contact your sales representative at:
Please submit these forms to the following email address:

Organization Information and IP Request Form

1 Organization Name: EL REY MOTEL
2 Organization Street Address:

3 Organization City, State, Zip:

4 Organization Phone Number:

5 Technical Point of Contact (person’s name):

6 Technical Point of Contact E-mail Address:

7 Technical Point of Contact Phone Number:

8 Cable Router or Router Make/Model Number:

9 Assignment Request: New or Additional (Place "x" in appropriate box): New: Additional:
10 If Additional, what addresses have been assigned?

11 Number of IP Addresses Requested:

12 Number of IP Addresses Required Immediately:

13 Number of IP Addresses Required within 3 Months:

14 Number of IP Addresses Required within 6 Months:

Use this IP Justification Detail Form to justify each IP address requested in item 11 on IP Address Allocation Justifcation
Form 1.1

IP Justification Detail Form

Please note that individual workstations do not require globally unique IP addresses, and requests for such without proper
justification will be denied. Multiple workstations are supported via a combination of DHCP and NAT on the cable router.
Examples of justifiable host types are: firewalls, servers (web, mail, FTP, etc.), and devices under external control.

Type of Host Justification Quantity Notes

router, firewall, managed
1 Devices switches, managed tape 10
drives, VoIP switches
DNS servers, ISA Server,
2 Servers Certificate Server, mail 30
servers, ftp servers
Hosted Web applications
3 Web Servers 160

For joint development projects

4 Servers with partners 55

10

11

12

For additional IP addresses, please copy this IP Justification Detail Form as needed.
I verify that I am authorized to represent the organization named in Item 1 of the Organization Information and IP Request Form, and that
the information in both forms is true and correct.

I understand that IPv4 address space is limited and that users of the Internet are responsible for conserving address space and ensuring
that address space is utilized efficiently.

Print Name:
(name of person filing this form)

For Road Runner Internal Use Only:

Gateway: CIDR:

Usable IPs: Mask:

Date Approved: Approved By:

 579743913.xlsx

Data Field Applicable Questionnaire

Product
Special Remarks ALL MRS Orders Are there any specific order processing instructions (e.g., for technical data collection, installation scheduling
and coordination, etc.)?
Request Network Solution Diagram ALL MRS Orders Please provide a network solution diagram

Site Router Admin Name ALL MRS Orders Who is the technical point of contact for this order? This POC will be listed for technical questions prior to,
during, and post service installation at the site; and will be provided a login ID and password for MRS
Customer Portal access.
Email ALL MRS Orders Technical POC email?

Phone (office) ALL MRS Orders Technical POC phone (primary)?

Phone (mobile) ALL MRS Orders Technical POC phone (mobile)?

LAN IP Address ALL MRS Orders Does the customer have a preferred private IP addressing scheme for their LAN (10.0.0.0, 172.16.0.0, or
192.168.0.0)? If customer has less than 250 users / devices connected to the LAN, recommend 192.168.1.1

LAN Subnet Mask ALL MRS Orders Based on the above, does the customer have a preferred private IP subnet mask (determines number of
available IP addresses)? If customer accepts recommendation of 192.168.1.1 above, recommend
255.255.255.0
WAN IP Address MRS for Does the customer have a preferred private IP addressing scheme for their WAN (10.0.0.0, 172.16.0.0, or
Ethernet 192.168.0.0)? If not, recommend 172.16.10.1 (for the first site / customer hub)

WAN Subnet Mask MRS for Based on the above, does the customer have a preferred private IP subnet mask for the WAN (determined
Ethernet based on number of WAN sites to be inteconnected)? If customer accepts recommendation of 172.16.10.X
above, recommend 255.255.255.248 (for 5 or fewer WAN sites) or 255.255.255.192 (for up to 60 connected
WAN sites)
WAN VLAN ID MRS for Does the customer already have a VLAN ID for their WAN? If not, recommend 200 as default (to be validated
Ethernet during engineering design)

Enable EIGRP MRS for Does the customer run / want to run EIGRP for dynamic routing? If no preference, leave blank
Ethernet

Enable OSPF MRS for Based on the answer above, recommend "Yes" for OSPF if the customer has no preference
Ethernet

Extended Access List MRS for Internet Does the customer have any specific firewall policies that need to be configured?

Extended Access List MRS for Internet Does the customer have any specific firewall policies that need to be configured?

Credentials (Anyconnect Access) MRS for Internet Does the customer have Remote Access VPN requirements? If "Yes", provide a list of userid's / passwords
for local (router) authentication

MRS for Internet 0

Page 18 of 20
 579743913.xlsx

Data Field Applicable Questionnaire

Product
VPN Pool for Anyconnect MRS for Internet Does the customer have a preferred private IP addressing scheme for the remote access VPN pool? If
customer has selected 192.168.1.1 above (for LAN IP), recommend 192.168.100.0

MRS for Internet Based on the above, does the customer have a preferred private IP subnet mask (determines number of
available IP addresses)? If customer accepts recommendation of 192.168.100.0 above, recommend
255.255.255.0
SSID Information Wireless For the "Wireless LAN" or "Secure Wi-Fi" add on feature, does the customer have a preferred (custom) SSID
name(s)? If not, recommend "Corp_Wi-Fi" as the default primary profile

0 Wireless Based on the above, does the customer have a preferred (custom) SSID password(s)?

Wireless LAN IP Address Wireless Does the customer want to configure a separate VLAN for wireless users (e.g., for a "Guest_Wi-Fi" SSID)? If
so, recommend 192.168.101.1

Wireless LAN Subnet Mask Wireless Based on the above, does the customer have a preferred wireless LAN IP subnet mask (determines number
of available IP addresses)? If customer accepts recommendation of 192.168.101.1 above, recommend
255.255.255.0

Page 19 of 20
To request your Time Warner Cable Bill Credit, visit the website below a minimum of 30 days after
your services install. Use the form to search for your order and click the "Request Rebate" button.
Rebates may take several bill cycles to be applied.

http://mytelecomorders.com