Verilink PRISM 3001 (34-00186) Product Manual - Manual (Page 58)

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 completing one of the following: Check
appropriate ones(s).
❏ A. Training course provided by the manufacturer/grantee of the equipment used to encode
analog signals; or
❏ B. 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. Independent training course (e.g., trade school or technical institution) recognized by the
manufacturer/grantee of the equipment used to encode analog signals; or
❏ D. In lieu of the proceeding training requirements, the operator(s) maintainer(s) is(are) under
the control of a supervisor trained in accordance with _________above.
I agree to provide _______________________________________ with proper documentation to
(Telco’s Name)
demonstrate compliance with the information as provided in the proceeding paragraph, if so
requested.
________________________________________________ (Signature)
________________________________________________ (Title)
________________________________________________ (Date)
Subscribed and Sworn to before me this ______day of ________________________, 19____.
________________________________________________
Notary Public
My Commission expires: ____________________________________