The undersigned member of Jackson County Rural Electric Membership Corporation, Inc. ("Cooperative"), hereby applies for Residential Broadband Internet Services provided by Jackson County REMC. By signing this document, the undersigned agrees to the terms of Terms and Conditions of Services Agreement, Acceptable Use Policy, and any other Rules and Regulations now in effect or which may be hereafter amended, adopted or repealed. If the electric membership is a joint membership, only one (1) member signature is required.
Service Location Address
Billing Address (If different from service location address)
Do you rent/lease or own the Service Location?
(If you rent, the landlord or property owner must complete the Landlord/Tennent approval form.)
Broadband Services Plans and Optional Services
Signing this agreement does not guarantee the actual installation date but will initiate the scheduling of the pre-drop survey. The installation date for broadband service at your residence is dependent upon your location and the Jackson County REMC build-out schedule.
By signing below, I am authorizing Jackson County REMC to install fiber optic lines, equipment and devices at the service location indicated and if necessary, to penetrate the structure of the residence to install the equipment for the service drop. In addition, I am agreeing to receive internet service from Jackson County REMC.
The location of all existing underground improvements as determined during the Pre-Drop Survey are based upon (in addition to an 811 inspection) aboveground evidence and upon information provided by you. These improvements may include but are not limited to telecommunications cables, waterlines and pipes, electrical lines and conduits, dog fences, drains, downspouts and septic tank and its laterals. JACKSON COUNTY REMC will not be responsible for any damages to any underground improvements on your real estate occurring during the fiber-optic cable installation which were not revealed by an 811 inspection or not disclosed on the attached Pre-Drop Survey. You agree that you will be responsible for and shall defend and indemnify and hold harmless JACKSON COUNTY REMC, and its employees, affiliates, suppliers, agents and contractors and shall reimburse us for any damages, losses or expenses (including without limitation, reasonable attorney’s fees and costs) incurred in connection with any claims, suits, judgements and causes of action arising out of any damages caused to an underground facilities or improvements on your real estate not revealed by an 811 inspection conducted pursuant to I.C., 8-1-26 or by the pre-drop survey.
Once broadband internet service is installed, it is your responsibility to take appropriate precautions to secure your own network by installing and maintaining anti-virus and anti-malware software. Jackson County REMC does not assume any responsibility and you are solely responsible for any content stored, accessed, or transmitted using Jackson County REMC broadband internet services.
BY EXECUTING BY SIGNING BELOW, YOU ARE AGREEING TO RECEIVE INTERNET SERVICE FROM JACKSON COUNTY REMC. FAILURE TO PURCHASE SERVICE WILL RESULT IN JACKSON COUNTY REMC BILLING ME FOR THE FULL COST OF THE FIBER SERVICE DROP. YOU ALSO UNDERSTAND AND AGREE WITH ALL TERMS AND CONDITIONS CONTAINED AND ACKNOWLEDGE THAT THE TERMS AND CONDITIONS AND THE ACCEPTABLE USE POLICY CAN BE FOUND ON WWW.JACKSONREMC.COM OR AVAILABLE UPON REQUEST.