Assumption Of Liability Authorization Form - Agency To Agency
ADVERTISEMENT
1Assumption of Liability Authorization
Agency to Agency Liability
rev. 04.02.2007
Agency A (“Assignor”) hereby agrees to assign liability for certain mobile telephone number(s) (single number
identified below, multiple numbers identified in the attached spreadsheet titled “Attachment A”) to Agency B
(“Assignee”), and Assignee hereby agrees to assume liability for said mobile telephone number(s) from Assignor.
The following conditions apply to this Assumption of Liability:
Assignee must submit to Government Contract eligibility verification and submit a purchase order to
Verizon Wireless, if not previously in existence.
Assignor’s account on each of the applicable mobile telephone numbers to be transferred must be current.
Liability for billing and all other rights in each mobile telephone number will not transfer from Assignor to
Assignee until processing by Verizon Wireless is complete. (Normal processing time is 3-5 business days).
Assignor remains liable for all charges associated with each mobile telephone number until assumption of
liability is completed.
Once the Assumption of Liability described herein is completed, Assignor shall have no further
responsibility for any obligations associated with the assigned mobile telephone numbers.
Once the Assumption of Liability described herein is completed, Assignee shall be solely responsible for all
obligations associated with the assumed mobile telephone numbers subject to the terms and conditions of
its existing agreement with Verizon Wireless.
Signatures on this document must be from an authorized government representative or contracting officer.
Acknowledged and agreed:
AGENCY A (ASSIGNOR)
Agency Name:
Signed:
Date:
Agency Address:
Name:
City:
State:
Zip:
Title:
Fed Tax ID:
Contact Number:
AA
Account Number of Wireless Number to be assigned:
Wireless Number to be assigned:
Note: Multiple numbers should be provided on spreadsheet titled
Attachment A
Agency B (ASSIGNEE)
Agency Name:
Signed:
Date:
Agency Address:
Name:
City:
State:
Zip:
Title:
Fed Tax ID:
Contact Number:
Account Number(s):
Fax the completed form to: 800 290 1468
ADVERTISEMENT
0 votes
Related Articles
Related forms
Forms Dor 82130aa - Agency Authorization Form, Agency Authorization Continuation Form - 2004
Business
Form Wld-34-a - Report Of Beer Sales Form Breweries To Wyoming Wholesalers - Wyoming Liquor Division
Financial
Related Categories
Parent category: Business