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HomeMy WebLinkAbout2021 - Lake Tapps Cancellation DocuSignDisconnect Request Form To:Attention: Direct Dial:Fax: E-Mail: A. Please accept this letter as an authorized written request to disconnect Business Class Services for: Company Name Address City State Zip Account #MACD# Ticket # B.Select one: Stop Service Date: New Address: City:State:Zip: Stop Service Date: Would you recommend our product/service to others in your industry? X Disconnect Reason: Check all that apply: Voice Disconnect Internet Disconnect Video Disconnect Smart Office Disconnect Cloud Solutions Disconnect Voice Port Out I will be porting my number(s) to: C.Approval Authorized Signature Date of Request Print Name Contact Telephone Number Final 'Bill To' Address D. Important Information regarding your company's Business Class Account EARLY TERMINATION FEE AND NOTICE OF TERMINATION If my company decides to reconnect its Business Class account, it will be assigned a new email address and Static IP (if applicable) and/or telephone number(s), as applicable. Pursuant to the General Terms and Conditions (GTC) of my company's Comcast Business Class Service Order Agreement. My company may be liable for 100% of the balance remaining if services are disconnected or terminated during the initial term (Early Termination Fee). My company will also be billed for any Comcast Equipment that is not returned to a Comcast Service Center (like cable modem and television set-top boxes). If my company is terminating Services as indicated above, this document will serve as my company’s 30 day notice of termination (as required by the GTC). My company will be responsible for outstanding amounts due for the Services through the actual date of termination. Permanent Disconnect Pursuant to Comcast's records, Early Termination Fee liability: If my company is taking (porting) its telephone number(s) to another provider, it must contact the new provider to set up service. The new provider will contact Comcast to terminate the company's Business Class Voice Service (to ensure there will be no loss of service during the transfer). Transfer Existing Service Start Service Date: DocuSign Envelope ID: 27B7CE89-8D84-4A12-A561-6FFC468F3F30 1-720-268-8852 8498340390231043 LAKE TAPPS TRAFFIC CAM_ 7/14/2021 CR975985971 9601 East Panorama Circle Comcast_BusinessVDR@cable.comcast.com Disconnect Processing 98092 Comcast Business Services Centennial WA Technical issues Melissa_Bailey CO 1-800-391-3000 80112 0.00 X 1180 LAKE TAPPS PKWY SE AUBURN Comcast Business Next steps for disconnecting service 1 | Complete the disconnect form emailed via DocuSign. Making returns is free and easy. The UPS Store® will pack and ship it for you. Just bring your equipment to The UPS Store and they’ll take care of the rest – at no cost to you. A store associate will scan the equipment serial number so we can make sure your account is properly updated. Find a UPS Store location near you. • For support on how to submit an e-signature, please reference DocuSign support. • If the reason for disconnection is not listed within the form, choose the most relevant option. • The disconnect notification period will begin on the date the form is signed via e-signature. Until then, the account will remain active and continue to be billed. For details on the service termination policy and disconnect period, reference the Comcast Business Terms & Conditions. 2 | Return your device(s) associated with your service, including modem, phone or cable box. © 2020 Comcast. All rights reserved. SLS91042_3.20 Contact us 24/7. We’re here to help. 3 | Questions? DocuSign Envelope ID: 27B7CE89-8D84-4A12-A561-6FFC468F3F30