Colorado Valley Fiber Speed Change 6/2019 First Name (Legal) * Last Name * Date of Birth * Email * (All correspondence including your service agreement, installation scheduler, and billing information will be sent to this email address.) Phone Number * Service Address * City * State (2 character abbreviation) * Zip Code * Your High Speed Broadband Community Fiberhood Phase Do you rent or own the property where you are looking for service? * Rent Own Landlord's name * Landlord's phone number * Is your billing address different from your service address? * Yes No Billing Street Address * Billing City * Billing State * AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Billing Zip Code * How did you hear about Colorado Valley Internet? * Billboard Community Event Connection Magazine Direct Mail/Post Card Email Employee Facebook Newspaper Ad Radio Ad Referred by a friend/neighbor Service Truck Web Advertisement Web Search Yard Sign Friend/neighbor * Employee name * Pick your internet option! Are you interested in.. * Adding New Service Upgrade your existing Choose your service type Bundle (Phone + Internet, requires 36 Month Contract) Individual (Internet only) Please choose your preferred term commitment. Note the monthly pricing is reduced for longer term commitments and the installation fees are waived. * 36 Mo Contract $0.00 Install Fee 24 Mo Contract $0.00 Install Fee 12 Mo Contract $199 Install Fee Month To Month $399.00 Install Fee Please choose your preferred term commitment. Note the monthly pricing is reduced for longer term commitments and the installation fees are waived. * 36 Mo Contract $0.00 Install Fee INTERNET MONTHLY CHARGES * PackageMonthly 100/100 Mbps $159.99 50/50 Mbps $149.99 50/20 Mbps $139.99 50/10 Mbps $129.99 40/40 Mbps $119.99 40/10 Mbps $109.99 20/20 Mbps $99.99 20/10 Mbps $89.99 10/2 Mbps $79.99 *Note - Early termination of contracts will result in an Early Termination Fee of 75% of the remaining contract. INTERNET MONTHLY CHARGES * PackageMonthly 100/100 Mbps $149.99 50/50 Mbps $139.99 50/20 Mbps $129.99 50/10 Mbps $119.99 40/40 Mbps $109.99 40/10 Mbps $99.99 20/20 Mbps $89.99 20/10 Mbps $79.99 10/2 Mbps $69.99 *Note - Early termination of contracts will result in an Early Termination Fee of 75% of the remaining contract. INTERNET MONTHLY CHARGES * PackageMonthly 100/100 Mbps $139.99 50/50 Mbps $129.99 50/20 Mbps $119.99 50/10 Mbps $109.99 40/40 Mbps $99.99 40/10 Mbps $89.99 20/20 Mbps $79.99 20/10 Mbps $69.99 10/2 Mbps $59.99 *Note - Early termination of contracts will result in an Early Termination Fee of 75% of the remaining contract. INTERNET MONTHLY CHARGES * PackageMonthly 100/100 Mbps $169.99 50/50 Mbps $159.99 50/20 Mbps $149.99 50/10 Mbps $139.99 40/40 Mbps $129.99 40/10 Mbps $119.99 20/20 Mbps $109.99 20/10 Mbps $99.99 10/2 Mbps $89.99 *Note - Early termination of contracts will result in an Early Termination Fee of 75% of the remaining contract. VOICE & INTERNET BUNDLE - Minimum 36 month Contract Required * PackageMonthlyDown/Up SpeedsUnlimited Local, SLC, ARC, 911Unlimited LD + Features CVC Complete* $107.9920/10 Mbps✔✔ CVC Complete Plus* $147.9950/10 Mbps✔✔ CVC Basic $87.9920/10 Mbps✔ CVC Basic Plus $127.9950/10 Mbps✔ *Includes Caller ID, Call Waiting ID, Voice Mail Basic, Call Forwarding Busy and Call Forwarding No Answer. Calling Features and/or Long Distance may be added to basic Plans at their regular prices. Additional Internet Options Monthly charges unless otherwise indicated Speed Up $3.99 per 1 Mbps (some restrictions apply) Speed will be * Static IP Address $6.50 per address Quantity needed? * UPS ( one time charge ) $54.95 Router Service Options * Wireless Router Service $2.00 Managed Wi-Fi $9.99 (includes 2 devices) No Thank You Will this service also be used for gaming and/or security cameras? * Yes No VOICE SERVICE MONTHLY CHARGES Telephone Service Monthly Charges Total BLS does not include all surcharges and taxes Telephone Service Monthly Charges - Residential Basic Local Service Total BLS does not include all surcharges and taxes VOICE ACTIVATION CHARGES Simple Reconnection (no service trip) $29.10 New Line (to outside only) $60.90 Install jacks while at premise (check if yes) $24.30 Number of jacks requested * Do you wish to port your number(s)? 1 Number 2 Numbers 2+ Numbers Number to port (#1) * Number to port (#2) Special Calling Features -Monthly Charges (Please check all that apply) Automatic Callback $2.00 Automatic Redial $2.00 Call Forwarding $1.75 Call Forwarding-Busy $2.00 Call Forwarding-No Answer $2.00 Call Forwarding-Remote Access $2.00 Call Waiting $1.75 Direct Line/Manual Line $2.00 Distinctive Alert Call Waiting $2.50 Do Not Disturb $2.00 Do Not Disturb - Telemarketing $2.00 Selective Call Acceptance $2.00 Selective Call Forwarding $2.00 Selective Call Rejection $2.00 Speed Dialing 8 $2.00 Speed Dialing 30 $3.00 Three Way Calling $1.75 Residential Package Prices Two Features $2.50 Three Features $3.50 Four Feature $4.50 Five Feature $5.50 You will be automatically added to the following package. ADDITIONAL FEATURES & SERVICES MONTHLY RATES Anonymous Call Rejection No Thank You 50¢ with Calling Name and/or Number Feature $1.00 without Calling name and/or Number Feature Calling Name & Number Delivery $5.00 Calling Number Delivery $3.50 Voice Mail/Email $5.95 Call Waiting ID $3.00 (Must have Calling Name and/or Number Delivery) Basic Voicemail $4.95 (10 VMs @ 2mins each/5 day memory. Must have CF busy/CF No Answer) Enhanced Voicemail $8.95 (20 VMs @ 2mins each/10 day memory. Must have CF busy/CF No Answer) Find Me Ring $5.95 Colorado Valley Long Distance Rate Plans * Simple Rate .12¢ per minute Unlimited Long Distance $35.00 Monthly Simple Rate Premier $4.95 Monthly/.09¢ per minute No Thank You Minutes are anytime/anywhere in the continental U.S. Residential Monthly Toll Denial Charges * No Thank You Toll Denial $1.75 Toll Denial w/800 Access $1.75 Toll Denial w/PIN $2.00 If Toll Denial w/PIN Override is selected, PIN # will be (4 digits) * Long Distance Restrictions (Please check all that apply) 900 Block (No charge) Collect Block (No Charge) 3rd Party Block (No Charge) International Block (No Charge) Maintenance Protection Plan * No Thank You I agree to the $4.95 Monthly charge The Maintenance Protection Plan is an optional offering that provides protection from the costs associated with repairs to station wires and jacks. The plan is offered to residential customers only. DIRECTORY INFORMATION Would you like the telephone number published, non-published or unlisted? * Published Non-Published $1.00 per month charge Unlisted Do you wish to have Caller ID per line blocking? * Yes No Caller Name ID (how name will appear to called party) * Directory Listing Name(s) * Directory Listing Address (Optional) Additional Listings (if desired) (The fee for each additional listing is 50¢ per month per listing.) Community Name * La Grange Fayetteville Schulenburg Weimar Round Top Hallettsville Other Community Name (Community name is necessary for directory assistance inquiry. Customers residing in CVTC exchanges may prefer to be associated with the community of La Grange for directory assistance instead of their telephone exchange.) BILL PAY OPTIONS/ADDITIONAL INFORMATION Monthly Payment Method * Check/Cash (Bill via U.S. Mail) Credit Card (via cvctx.com or call 844-886-9799) Automatic Bank Draft (Authorization form required) Online Bill Pay via cvctx.com Accessibility Question * Please check here if you have a hearing or speech disability or condition and that this disability/limitation prevents or limits your ability to communicate over voice networks. No Thank You Comments/Questions Submit If you are human, leave this field blank.