Verilink PRISM 3111 (34-00242) Product Manual User Manual

Page 104

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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 ____________________________________.

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