The undersigned confirms the participation of the below mentioned network in the <FULL NAME OF IXP> and that the Technical, Organizational, and Commercial requirements listed within this document are accepted and shall be adhered to.
Company Name: | _________________________________________ |
Company Address: | _________________________________________ |
_________________________________________ | |
_________________________________________ | |
Administrative Contact Name: | _________________________________________ |
E-mail: | _________________________________________ |
Telephone: | _________________________________________ |
Technical Contact Name: | _________________________________________ |
E-mail: | _________________________________________ |
Telephone: | _________________________________________ |
Authorized Representative Name: | _________________________________________ |
Position: | _________________________________________ |
Signature: | _________________________________________ |
Date (YYYY / MM / DD): | ___________________ / _________ / _________ |
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