Cisco Systems MGX 8220 manual

AFFIDAVIT FOR CONNECTION OF CUSTOMER PREMISES EQUIPMENT TO 1.544 MBPS

AND/OR SUBRATE DIGITAL SERVICES

For the work to be performed in the certified territory of _________________(Telco Name)

State of ________________County of ___________________________

I.________________________(name),___________________________________(business address)

______________(telephone number) representing ______________________(name of customer), a customer located at

_____________________(address) _________(telephone number) being duly sworn: state:

I have the responsibility for the operation and maintenance of the terminal equipment to be connected to _________ 1.544

Mbps and/or _________ Subrate digital services. The terminal equipment to be connected complies with Para. 68 of the FCC

rules except for the encoded analog content and billing protection specifications. With respect to encoded analog content and billing protection.

()	I attest that all operations associated with the establishment, maintenance, and adjustment of the
	digital CPE with respect to encoded analog content and encoded billing protection information
	continuously complies with Part 68 of the FCC Rules and Regulations.
()	The digital CPE does not transmit digital signals containing encoded analog content or billing
	information which is intended to be decoded with the telecommunications network.
()	The encode analog content and billing protection is factory set and is not under the control of the
	customer.

I attest that the operator(s)/maintainer(s) of the digital CPE responsible for the establishment, maintenance, and adjustment of the encoded analog content and billing information has (have) been trained to perform these functions by successfully having completed one of the following (Check appropriate block).

() a. A training course provided by the manufacturer/grantee of the equipment used to encode analog signal(s); or

() b. A training course provided by the customer of authorized representative, using training materials and instructions provided by the manufacture/grantee of the used to encode analog signal(s); or

() c. An independent training course (e.g. trade school or technical institution) recognized by the manufacturer/grantee of the equipment used to encode analog signal(s); or

() d. In lieu of the proceeding training requirements, the operator(s)/maintainer(s) is (are) under the control of a supervisor trained in accordance with ________ (circle one) above.

I agree to provide _______________ (Telco’s name) with proper documentation to demonstrate compliance with the

information as provided in the preceding paragraphs, if so requested.

_________________(Signature)

________________(title)

__________(date)

Subscribed and Sworn to before me this ____ day of _____, 19__

_________________________

Notary Public

My commission expires:________________