Nortel Networks Passport 4400 - Manual (Page 20)

Introduction Passport 4400 Hardware Installation Manual
1-10
AFFIDAVIT FOR CONNECTION OF CUSTOMER PREMISES EQUIPMENT TO 1.544 MBPS AND/OR
SUBRATE DIGITAL SERVICES
For the work to be performed in the certified territory of ___________________(Telco Name),
State of____________________, county of________________________________,
I,_____________________(name), _____________________________________(business
address)________________________(telephone number) being duly sworn, state:
I have responsibility for the operation and maintenance of the terminal equipment to be
connected to ________________________________________________1.544 Mbps and/or
_____________________Subrate digital services. The terminal equipment to be connected
complies with Part 68 of the FCC rules except for the encoded analog content and billing
protection specifications with respect to analog content and billing protection:
( ) I attest that all operations associated with the establishment, maintenance, and adjustment of
the digital CPE with respect to encoded analog content and encoded billing protection
information continuously complies with Part 68 of the FCC Rules and Regulations.
( ) The digital CPE does not transmit digital signal containing encoded analog content or billing
information which is intended to be decoded within the telecommunications network.
( ) The encoded analog content and billing protection is factory set and is not under the control
of the customer.
I attest that the operator(s)/maintainer(s) of the digital CPE responsible for the establishment,
maintenance, and adjustment of the encoded analog content and billing information has (have)
been trained to perform these functions by successfully having completed one of the following
(check appropriate blocks):
( )_____a. A training course provided by the manufacturer/grantee of the equipment used to
encode analog signals; or
( )_____b. A training course provided by the customer or authorized representative using
training materials and instructions provided by the manufacturer/grantee of the equipment used
to encode analog signals; or
( )_____c. An independent training course (e.g., trade school or technical institution) recognized
by the manufacturer/grantee of the equipment used to encode analog signal; or
( )_____d. In lieu of the preceding training requirements, the operation(s)/maintainer(s) is (are)
under the control of a supervisor trained in accordance with _____(circle one) above.
I agree to provide____________________(telco’s name) with proper documentation to
demonstrate compliance with the information as provided in the preceding paragraph, if so
requested.
____________________(signature)
____________________(title)
____________________(date)
Subscribed and Sworn to before me this _____day of_________,(year)
______________________________
Notary Public
My commission expires: