Verizon - Blanket Agency Agreement


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PSP company name

,

DBA


	with principal offices at:

Address

Street address





City		State		ZIP code

				-


	(hereinafter referred to as "Vendor") is a vendor of telecommunications equipment and services. Vendor, acting as an agent for various customers, may submit to Verizon (hereinafter referred to as "Telephone Company") on behalf of its customers, inquiries about the telephone service or equipment of those customers and orders or requests for Telephone Company service. In consideration of Telephone Company's agreement not to require Vendor to submit written agency authorizations from its customers, Vendor makes the following representations, agreements and commitments:

•	Vendor agrees that it will not submit to Telephone Company any service requests or inquiries unless Vendor has a current, written authorization allowing it to do so from the customer for whom the request is being made. Vendor agrees it will retain all such authorizations in its files and will provide copies of same to Telephone Company within three days of receipt of a written request from Telephone Company.

•	By its submission of an inquiry or service request, Vendor represents to Telephone Company that it is in possession of a current written authorization permitting it to do so.

•	In the event that a Telephone Company customer challenges action taken by Telephone Company as a result of the above mentioned inquiries or service requests, Vendor will provide evidence of proper customer authorization and will defend Telephone Company from and against all claims, suits, or actions and will indemnify and hold Telephone Company harmless from any and all damages (including tariff charges not collected by Telephone Company), losses, costs, and other expenses (including attorney's fees) resulting from said challenge.

•	In the event that a Telephone Company customer challenges billing which resulted from service requests submitted to Telephone Company by Vendor, Vendor will defend Telephone Company from and against all claims, suits, or actions and will indemnify and hold Telephone Company harmless for any damages, losses, costs or expenses (including attorney's fees) resulting from said challenge.

•	Vendor agrees that Telephone Company shall have the right to terminate this Blanket Agreement at any time, with or without cause, and require separate letters of agency for each customer.

•	Vendor warrants and represents that the signature on this Agreement is of an official of Vendor and is authorized to legally bind Vendor to the above stated representations and commitments.

Name of vendor company




	Signature of official		Date

Name of official

Title of official


	This form requires a signature and cannot be submitted electronically. Please fill out the above form and click on the "next" button below. This will allow you to see the results of your entries exactly as they will appear when printed. After your review, simply print this completed form from your browser and fax or mail it to NPCC at the address below. Please keep a copy for your records. Please fax or mail to: Verizon NPCC 110 E. Monroe St. MC: ILLLBMH Bloomington, IL 61701 Fax: 1-800-483-4534 Phone: 1-800-483-2678 E-mail us using our electronic form.

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