Acknowledgement & Release Form

The undersigned “Customer” of Eastex Telephone Cooperative, Inc. and/or its wholly-owned subsidiary, Eastex Celco, L.L.C. (collectively “Eastex”) hereby acknowledges that Customer has applied for and ordered telephone and/or broadband services (the “Services”) from Eastex and that, in order to provision the Services, Eastex must enter on to the Customer’s property described below (which includes any other property of Customer in the geographic area described necessary for the installation) (collectively the “Property”) to install communications facilities, which facilities may include underground conduit, innerduct, or other buried facilities, (the “Eastex Facilities”). If you as Customer do not own the Property, you warrant that you have obtained permission from any necessary party, including but not limited to the owner, landlord, or building manager, for Eastex’s activities on the Property and that you as Customer are fully and completely authorized to execute this Acknowledgement and Release as to the Property. Eastex will “flag” or “stake” the route for the Eastex Facilities on the Property and will utilize the Texas “One Call” service to determine whether Eastex’s placement of the Facilities will interfere with any other registered buried utility facilities on the Property. However, it is Customer’s responsibility to notify Eastex of and to accurately “flag” or “stake” any other buried facilities or equipment on the Property (the “Customer Facilities”), and through Customer’s signature below, the Customer hereby warrants and represents to Eastex that Customer has notified Eastex of and has “flagged” or “staked” any Customer Facilities as required.

Further, Customer acknowledges that Eastex’s installation activities on the Property are subject to, as applicable, the publically-filed tariff for the Services (the “Tariff”) and/or the terms and conditions applicable to the Services and published on Eastex’s website on our Terms of Use page and that the Tariff and/or the Terms and Conditions, as appropriate, limit Eastex’s liability for any damage to the Customer Facilities resulting from Eastex’s installation of the Eastex Facilities.

Finally, in consideration for Eastex’s commitment to provide the Services to the Property, customer hereby waives any claim for damage to the customer facilities to the extent not "flagged" or "staked" by customer as required herein, releases Eastex from any liability associated with such a claim, and agrees to indemnify, defend, and hold Eastex harmless from any claim or liability associated with damage to the customer facilities to the extent not "flagged" or "staked" by customer as required herein

This Acknowledgement and Release, together Customer’s application and order for the Services and the Tariff and/or Terms and Conditions, as applicable, set forth the entire agreement and understanding of Eastex and Customer as to Eastex’s installation activities on the Property. Notices regarding this Acknowledgement and Release may be sent to Customer at Eastex’s address on file for Customer and to Eastex at P.O. Box 150, Henderson, Texas 75653-0150.