HomeMy WebLinkAbout2021 - Comcast Disconnect II - signedDisconnect Request Form
Attention: SAGE
Direct Dial: 866-950-3231
E-Mail: WST_SAGESupport@comcast.com
A.Please accept this letter as an authorized written request to disconnect Business Class Services for:
Company Name
Address
City State Zip
Account # CPNI#
B.Fill out in full
Permanent
Disconnect
Stop Service Date:_________________________________________
Reason: _________________________________________________
Check all that apply:
Voice Disconnect Internet Disconnect Video Disconnect Smart Office Disconnect
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
Pursuant to Comcast's records, Early Termination Fee liability: $0
Pursuant to the General Terms and Conditions (GTC) of my company's Comcast Business Class Service Order Agreement.
My company may be liable for 75% 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. To
view the GTC go to http://business.comcast.com/terms-conditions/index.asp
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.
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).
City of Auburn, Washington
3355 s 120th Place, Suite #520, Tukwila, WA 98168
Auburn Washingon 98168
Service No longer needed at location
Colin Schmalz 253-804-5023
25 W Main St, Auburn, WA 98001
934545412
7/8/2021
7/8/2021
X
Colin Schmalz (Jan 14, 2022 12:49 PST)
Colin Schmalz
VDR Form2020
Final Audit Report 2022-01-14
Created:2022-01-14
By:Melissa Bailey (mbailey@auburnwa.gov)
Status:Signed
Transaction ID:CBJCHBCAABAA5NsaWk0QtTqMhXD9YuUkkppQODKJ199M
"VDR Form2020" History
Document created by Melissa Bailey (mbailey@auburnwa.gov)
2022-01-14 - 8:48:00 PM GMT- IP address: 38.94.96.2
Document emailed to Colin Schmalz (cschmalz@auburnwa.gov) for signature
2022-01-14 - 8:48:42 PM GMT
Email viewed by Colin Schmalz (cschmalz@auburnwa.gov)
2022-01-14 - 8:49:42 PM GMT- IP address: 38.94.96.2
Document e-signed by Colin Schmalz (cschmalz@auburnwa.gov)
Signature Date: 2022-01-14 - 8:49:53 PM GMT - Time Source: server- IP address: 38.94.96.2
Agreement completed.
2022-01-14 - 8:49:53 PM GMT