Connection Request Form

YesNo
I am the building owner
The property is fenced
The building has a telecom closet or conduit inside
I authorize The Wired Road to share my information with Service Providers on the network. The Service Providers will make contact to quote service and estimate any costs associated with connecting to the network. If I agree to service then I also agree to allow a connection to the Network across the property to my building. If I am the property owner, I grant permission to The Wired Road's construction contractor(s), and other agents or assigns, to enter my property for the purpose of constructing and inspecting the connection and mounting the necessary hardware (the ONT or fiber modem). This permission is predicated on the condition that the construction contractor will restore my property as near to its original condition as is practicable, and that I will cooperate with such restoration. If I am not the property owner, I agree to help get the same permission from the property owner. No additional documentation of my authorization is necessary, no easement is established, and further work to maintain the connection will be addressed by separate agreement(s) if necessary. I agree that The Wired Road owns the connection and that I am liable for the return of the hardware to either the Service Provider or The Wired Road in the event I discontinue service.
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