P.O. Box 40, 825 Innovation Ave. Milltown, WI
T. (715) 825-2171 / firstname.lastname@example.org
What type of services are you interested in?:
What residential services are you requesting?:
Applicant: First and Last Name:
Applicant Email Address::
Applicant Cell Phone: :
Applicant Home Phone: :
City:: Postal Code: :
CPNI Identification Password (Customer Proprietary Network Information)::
Enter CPNI Identification Password Again.::
What is your mother's maiden name?::
What is the name of your first pet?::
Are you working with a Lakeland Representative? If yes, please select the individual::
Will You have a Co-Applicant?:
Co-Applicant:: Co-Applicant Birth Date::
Co-Applicant Cell Phone: : Co-Applicant Home Phone: :
Co-Applicant Email Address::
Is the billing address the same as the service address?:
Billing Address: :
Billing City: : Billing State: : Billing Postal Code: :
Video Activation Fee- $49.99
We will call you to collect the prepayment once we receive your application.Select ACH and Ebill to receive a $24.99 bill credit.
Are you interested in the following? (Select ACH and Paperless Billing to receive a $24.99 bill credit)::
Paperless Billing Email:
Smart Support: Included on the 50/25 Mbps internet package and above:
Optional Add Ons:
Wi-Fi Password: Confirm Wi-Fi Password:
How did you hear about us?:
Do you have interest in any other services?:
Please note that you have until midnight on to cancel your service order with no fees or penalties. Should you choose to cancel, please e-mail email@example.com or call (715)825-2171.
Note: If the Service Address you identified is not connected to Lakeland Communications’ fiber, you are required to purchase a modem from Lakeland Communications in order to receive Broadband services.
Individuals applying for internet service must be at least 18 years of age and applying for service in his or her name. Unless the customer requests a specific activation date, all accounts will be activated per Lakeland’s schedule. Billing for the account starts on the activation date. The initial activation charge does not include any wiring, jacks, labor, ethernet cables or miscellaneous equipment. Any technical assistance at the customer premise after the initial activation is subject to regular Lakeland Communication’s tariffed charges.
Lakeland provides service 24/7, but the service is provided “as is”. Lakeland services may be interrupted for several reasons, including but not limited to malfunctions, maintenance, and improvement or as required to protect network resources in the event of malfunctions or misuse. Advance notification of any such interruption of service may not be provided. In case of an unexpected outage, Lakeland will work to correct the problem as soon as possible. In no event, will Lakeland be responsible or liable for damages or loss of profits due to use or the inability to use Lakeland’s services. I agree that any outage of the system will only be refunded if that outage is for a period of more than 24 consecutive hours. The refund would be calculated on a percentage of the monthly package fee for the number of days out of service. Certain Internet content may contain language or pictures which some individuals may find offensive, inflammatory or of an adult nature. Lakeland does not endorse such materials and disclaims any and all liability for their content.
AT THE SOLE DISCRETION OF LAKELAND, VIOLATIONS OF ANY OF THE ABOVE REGULATIONS/POLICIES MAY RESULT IN TERMINATION OF SERVICE.
If a service call is required after activation of working service, a dispatch fee along with professional tech service & materials fee will be charged if the problem is determined to be the customers: Home visit/consultation billed at a $50.00 dispatch fee plus $90.00 per hour professional tech service & materials. I understand these charges:
The package fee is billed one month in advance. Modem, activation, package fee and any labor may be due before service is installed. Speeds listed are not guaranteed. We highly recommend that the customer use a surge protector on all electronic devices to protect against power surges and lightning. Lakeland will not warranty a device (such as a modem, router etc.) that has been hit by lightning unless warranty is purchased per device. You may otherwise be able to pursue coverage of the device with the manufacturer of the surge protection that you were using at the time the damage occurred. Any work, wiring or maintenance done at the customer premise will be billed at: $90.00 per hour, material and wiring charges, along with a $50.00 dispatch fee. Pricing may increase with programming fees.
Terms and Conditions Applicable to Services
TERMS AND CONDITIONS OF SERVICE
These Terms and Conditions of Service set forth the terms and conditions by which Lakeland Communications Group, LLC (“Lakeland Communications”) will provide voice, video and/or broadband services (“Services”) requested by applicant(s) (individually and collectively the “Customer”). Each Customer shall individually have all the rights and obligations of a Customer under this Agreement. Lakeland Communications and Customer agree to be bound by this Agreement. This “Agreement” includes: (i) these Terms and Conditions of Service; (ii) any application for Services (“Application”); (iii) Lakeland Communications’ Policies, if applicable, set forth at www.lakeland.ws/legal; and (iv) the following documents, if applicable: (a) for Telephone Services (local) – Lakeland Communications’ Tariff for local telephone service on file with the Public Service Commission of Wisconsin set forth at www.lakeland.ws/legal; (b) for Telephone Services (toll) – Lakeland Communications’ General Terms and Conditions for toll services set at www.lakeland.ws/legal; (c) for video and broadband Services – Lakeland Communications’ General Terms and Conditions for Video and Broadband Service set forth at www.lakeland.ws/legal; all of which are incorporated herein, and any and all of which may be amended from time to time by Lakeland Communications in its sole discretion. To the extent that there is any conflict between the terms and conditions of these Terms and Conditions of Service and any of the documents listed in (iv) above, the terms and conditions set forth in the documents listed in (iv) above shall control.
Services. Lakeland Communications shall provide the Services to Customer at the Service Address identified on the Application, or such other address in Lakeland Communications’ service territory as Customer may request and Lakeland Communications’ approves (the “Premises”). Customer may not resell or redistribute Services to others. Neither Customer nor any user (whether or not use was authorized) of the Services (“User”) may use the Services for any unlawful or improper purpose or in such a way that interferes with Lakeland Communications’ network, business operations, employees or other customers. Customer acknowledges and agrees that Lakeland Communications has no control over and is not responsible for any content transmitted to Customer through the Services. Customer agrees to use the Services in a manner consistent with all applicable local, state, federal and international laws and regulations (“Applicable Law”). Internet Services are provided "up to" the transmission speed identified for the particular broadband Service, but may be lower for a variety of reasons including: the performance of Customer-owned equipment/devices; the type of connection between Customer-owned equipment/devices and the Equipment (defined below); the number of users simultaneously using the Customer’s LAN network; high demand on destination websites; and Customer location. Customer understands and agrees that Lakeland Communications does not warrant or guarantee any particular amount of bandwidth on the Lakeland Communications network or that any speed or throughput of Customer's connection to the Lakeland Communications network will be available to Customer. Use of broadband Services by Customer or any User must comply with Lakeland Communications’ “Acceptable Use Policy” available at www.lakeland.ws/legal, which is incorporated herein, and which may be amended from time to time by Lakeland Communications in its sole discretion.
Equipment; System. Any in Premises equipment provided by Lakeland Communications (“Equipment”) and the system of wires, cables, fiber and additional Premises equipment owned by Lakeland Communications used to provide the Services (the “System”), shall remain Lakeland Communications’ sole property. Title to the Equipment and System shall remain with Lakeland Communications at all times and Customer shall have no rights or interest therein. Under no circumstances may Customer move or relocate the Equipment or System for use at another location. Customer shall keep the Equipment and System in good condition. If Customer fails to return in good condition any Equipment within seven (7) days of the date of termination of Services by either scheduling an appointment for Lakeland Communications to retrieve the Equipment (which shall be billed at Lakeland Communications’ current hourly rates) or by Customer returning the Equipment to Lakeland Communications’ office, Customer will be responsible for the Equipment replacement charges. The replacement charges for unreturned or damaged Equipment are the then-current replacement costs of the same or like equipment. Customer must notify Lakeland Communications promptly of any Equipment or System failure or malfunction. Lakeland Communications shall repair or replace Equipment and the System, except that Customer shall be responsible for all costs incurred by Lakeland Communications to repair or replace the Equipment or System if such repair or replacement is caused by Customer’s or any User’s negligent or willful conduct. Customer agrees that no other person besides Lakeland Communications or its contractors shall repair or replace the Equipment or System.
Access. Customer hereby grants, without fee, to Lakeland Communications all easements and rights-of-way on, under, above, and across the Premises necessary to install, maintain, inspect, remove, repair and replace the Equipment and System. Customer further grants to Lakeland Communications, its employees and contractors the right to enter the Premises for the same purposes. Upon termination of this Agreement, Lakeland Communications shall have the right but not the obligation to remove the System. In the event that Customer is not the owner of the Premises, Customer warrants that Customer has the consent of the owner of the Premises to grant Lakeland Communications the reasonable access provided herein.
Default; Remedies. Customer shall be in “Default” of this Agreement if: (i) Customer or a User has tampered with or abused Equipment or the System; (ii) Customer or a User has violated Lakeland Communications’ Acceptable Use Policy; (iii) Customer fails to make payment within five (5) days after Lakeland Communications provides Customer with notice that payment is past due; or (iv) Customer breaches any of the other terms and conditions of this Agreement and said breach is not cured within twenty (20) days after Lakeland Communications provides Customer with notice of such breach. If Customer's account is in Default, Customer is subject to an interest charge of 1.5% per month, or the maximum allowable rate under state law, whichever is less, on any past-due balances. In addition, Lakeland Communications may impose a late charge of up to $50.00. Unless prohibited by Applicable Law, Lakeland Communications may without notice or demand, exercise all or any one or more of the following remedies in the event of a Default: (a) declare immediately due and payable all bills and all other sums due; (b) suspend some or all Services, in which case standard charges for the Services and Equipment shall continue to accrue until the account is canceled by Customer; and (c) terminate this Agreement. A reactivation fee of up to $100.00 may apply if Customer’s Service has been suspended.
Month-to-Month Services; Termination. Services are provided on a month-to-month basis (which shall commence on the installation date of the Equipment). Customer may terminate Services at any time upon notice to Lakeland Communications, which termination shall be effective on the next business day after receipt of such notice. Except as otherwise provided herein, Lakeland Communications may terminate this Agreement upon thirty (30) days’ notice to Customer. If Customer terminates (i.e., cancels) a Service, or Lakeland Communications terminates (i.e., disconnects) a Service as a result of a Default by Customer, Customer shall: (i) pay any termination fee as required under the Agreement, and (ii) with respect to video and broadband Services, not receive a refund for partial months of such Services.
Fees; Payment. The initial monthly fees for Services are as set forth on the Application. Lakeland Communications reserves the right, in its sole discretion, to increase the monthly fees for Services upon not less than thirty (30) days’ notice. Lakeland Communications shall bill Customer in advance for the recurring monthly fees associated with the Services and Equipment, and in arrears for the fees for all usage-based Services. Customer is responsible for payment of all charges on the bill including, without limitation, taxes, regulatory charges, regulatory cost recovery charges, surcharges and franchise fees, which are subject to change without notice. Customer shall make payments by the due date on the bill. Payments are late if not received by Lakeland Communications by the due date. UNLESS CUSTOMER GIVES NOTICE TO LAKELAND COMMUNICATIONS OF A GOOD FAITH BILLING DISPUTE WITHIN 60 DAYS AFTER PAYMENT OF A DISPUTED AMOUNT IS DUE, CUSTOMER WAIVES ANY RIGHT TO CHALLENGE THE DISPUTED AMOUNT. Lakeland Communications may charge Customer a fee of up to $50.00 with respect to any authorized demand by Lakeland Communications for payment of a bill from Customer’s designated financial institution which is rejected by the financial institution (e.g., NSF charge). Subject to Applicable Law, Customer agrees to reimburse Lakeland Communications for its costs, including reasonable attorneys’ fees, collection fees and similar expenses incurred by Lakeland Communications to collect payment. Lakeland Communications reserves the right to require Customer to pay an advanced payment and/or a deposit for the establishment or continuation of Services.
WARRANTIES. SERVICES ARE PROVIDED “AS IS” AND “AS AVAILABLE” WITH NO WARRANTIES AS TO CONTINUOUS AVAILABILITY OF THE SERVICES, ANY SPECIFIC FEATURES OF THE SERVICES (E.G. BROADBAND TRANSMISSION SPEEDS), OR THAT THE SERVICES WILL BE UNINTERRUPTED OR ERROR FREE. LAKELAND COMMUNICATIONS EXPRESSLY DISCLAIMS TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW ALL WARRANTIES OF ANY KIND, WHETHER EXPRESS, IMPLIED, OR STATUTORY INCLUDING, WITHOUT LIMITATION, THE WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE, TITLE, NON-INFRINGEMENT OF PROPRIETARY RIGHTS, OR ANY WARRANTY ARISING BY USAGE OR TRADE, COURSE OF DEALING OR COURSE OF PERFORMANCE. LAKELAND COMMUNICATIONS IS NOT RESPONSIBLE FOR CIRCUMSTANCES BEYOND ITS CONTROL INCLUDING, WITHOUT LIMITATION, ACTS OR OMISSIONS OF OTHERS OR ACTS OF GOD.
LIMITATION OF LIABILITY. LAKELAND COMMUNICATIONS SHALL IN NO EVENT BE LIABLE TO CUSTOMER OR ANY OTHER PERSON OR ENTITY IN CONTRACT, TORT (INCLUDING NEGLIGENCE) OR OTHERWISE, FOR ANY INDIRECT, INCIDENTAL, SPECIAL, RELIANCE OR CONSEQUENTIAL DAMAGES INCLUDING, WITHOUT LIMITATION, DAMAGES FOR LOSS OF DATA OR GOODWILL, LOST PROFITS OR OPPORTUNITY, BUSINESS INTERRUPTION, OR ANY OTHER COMMERCIAL OR ECONOMIC DAMAGES, AND ANY DAMAGES RELATED TO THE INSTALLATION, REPAIR, REPLACEMENT, INSPECTION, REMOVAL, USE OR FAILURE OF THE SERVICES, EQUIPMENT OR SYSTEM, EVEN IF LAKELAND COMMUNICATIONS HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. EXCEPT AS LIMITED BY APPLICABLE LAW, LAKELAND COMMUNICATIONS’ SOLE LIABILITY, IF ANY, FOR ANY CLAIM ARISING OUT OF OR IN CONNECTION WITH THIS AGREEMENT OR THE USE OR FAILURE OF THE SERVICES, EQUIPMENT OR SYSTEM, SHALL IN NO EVENT EXCEED AN AMOUNT EQUAL TO THE PROPORTIONATE CHARGE APPLICABLE TO THE PERIOD TO WHICH THE SERVICES, EQUIPMENT OR SYSTEM WERE AFFECTED. THESE LIMITATIONS, AS WELL AS THOSE SET FORTH IN THE DOCUMENTS THAT FORM THIS AGREEMENT, WILL APPLY REGARDLESS OF ANY FAILURE OF ESSENTIAL PURPOSE OF ANY LIMITED REMEDY AND TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW.
INDEMNIFICATION. CUSTOMER AGREES TO DEFEND, INDEMNIFY AND HOLD LAKELAND COMMUNICATIONS HARMLESS FROM AND AGAINST ALL CLAIMS, DAMAGES, LIABILITIES, COSTS AND EXPENSES (INCLUDING REASONABLE ATTORNEYS’ FEES) ARISING OUT OF, OR IN CONNECTION WITH: THE USE OF THE SERVICES, EQUIPMENT OR THE SYSTEM; THE CONTENT TRANSMITTED THROUGH THE SERVICES; OR ANY VIOLATION OF THIS AGREEMENT, APPLICABLE LAW, OR RIGHTS OF ANOTHER. THESE OBLIGATIONS WILL SURVIVE TERMINATION OF THIS AGREEMENT AND CUSTOMER’S USE OF THE SERVICES, EQUIPMENT OR SYSTEM.
GOVERNING LAW; JURISDICTION; VENUE. This Agreement will be governed by and construed under the laws of Wisconsin. THE PARTIES IRREVOCABLY CONSENT TO THE EXCLUSIVE JURISDICTION (INCLUDING PERSONAL JURISDICTION) AND VENUE OF THE FEDERAL DISTRICT COURT FOR THE WESTERN DISTRICT OF WISCONSIN AND THE CIRCUIT COURTS FOR POLK COUNTY, WISCONSIN.
Amendments. These Terms and Conditions of Service may be amended from time to time by Lakeland Communications in its sole discretion upon not less than thirty (30) days’ prior written notice. If Customer does not wish to be bound by such amendment, Customer may terminate any affected Service as provided herein. Customer’s use of a Service after the effective date of any amendment shall constitute Customer’s acceptance of and agreement to such amendment.
Notice. Customer may provide notice to Lakeland Communications: by calling Lakeland Communications at (715) 825-2171 by delivering written notice to a Lakeland Communications office; by depositing written notice in the U.S. Mail, postage prepaid, addressed to Lakeland Communications, Attn: Billing Department, PO Box 40, Milltown, WI 54858-0040; or by email to Lakeland Communications at firstname.lastname@example.org. Lakeland Communications may provide notice to Customer: by delivering written notice, or by depositing written notice in the U.S. Mail, postage prepaid, in either case, addressed to the Premises or the billing address on file with Lakeland Communications for the Customer.
Miscellaneous. Customer shall not assign this Agreement or any right or obligation hereunder without Lakeland Communications’ prior written consent. Lakeland Communications may assign this Agreement in whole or in part. If any provision of this Agreement is held invalid or unenforceable, the remainder of this Agreement will continue in full force and effect. Obligations under the Agreement that by their nature are intended to continue beyond the termination of the Agreement or any Service will survive the termination thereof. The Agreement represents the entire agreement between Lakeland Communications and Customer and supersedes any inconsistent or additional promises, representations, warranties or statements made to Customer by any employee or agent of Lakeland Communications.
I have read, understand and agree to all the above terms, conditions and prices.
Leave this empty:
Your legal name
Your email address
If you have questions about the contents of this document, you can email the document owner.
Document Name: Video Agreement
Agree & Sign