Account Number(Required) This Sandhill Master Service Agreement is hereby entered into by and between ("Sandhill") and the customer identified below ("Customer") for the designated services as of the date of execution by Sandhill. This Sandhill Master Service Agreement (“Designated Sandhill MSA”) incorporates the Business Services Terms and Conditions (“BT&Cs”) posted on Sandhill's website and modified from time to time. The Sandhill MSA, complete with Customer signature and initials, where requested, including acknowledgement of the incorporation of the BT&Cs, in addition to use of the services ordered, constitute the full service agreement (“Agreement”) between Sandhill and Customer. Sandhill agrees to provide, and Customer agrees to purchase, the services accordance with the Agreement. Customer understands that Sandhill may make periodic changes to the BT&Cs and that no such change shall modify the provisions of the Sandhill MSA. In case of a conflict between the terms of the Sandhill MSA, and the BT&Cs, the provisions of the Sandhill MSA shall apply. Customer InformationBusiness Name(Required) Contact Name(Required) First Last Contact Email(Required) Phone(Required)911 Address Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Estimated Install Date (mm/dd/yyyy)(Required) Month Day Year Term Begin Date (mm/dd/yyyy)(Required) Month Day Year Billing InformationBilling Contact(Required) Billing Email(Required) Billing Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Phone(Required)Federal Tax ID(Required) Minimum Terms (Months)(Required) Term End Date (mm/dd/yyyy)(Required) Month Day Year I hereby verify the information to be true and complete and agree to the terms and conditions. I understand that by typing my full name and pressing the Submit button, this form submission will be stamped with today’s date and authorized by me as if I had signed my signature.(Required)Acknowledgment 1: Customer has read and agrees to comply with the Sandhill Business Services Terms and Conditions (BT&Cs) (PDF). Customer acknowledges that, pursuant to the BT&Cs, under certain circumstances, additional charges will apply. I agree to the privacy policy.I hereby verify the information to be true and complete and agree to the terms and conditions. I understand that by typing my full name and pressing the Submit button, this form submission will be stamped with today’s date and authorized by me as if I had signed my signature.(Required)Acknowledgment 2: Customer has read and understands IP Voice 911 Limitations (PDF) as stated in this MSA and in the Sandhill Business Services Terms and Conditions (BT&Cs). I agree to the privacy policy.Authorized Customer Electronic Signature (Full Name)(Required) NameThis field is for validation purposes and should be left unchanged.