ATTACH Ee_Hawaiian Telcom Form.pdf

EXCAVATION NOTICE FOR TONING

� HOCC TICKET* NO.:

� MARK AREA

� AERIAL AREA HOCC TICKET DATE:

� CLEAR AREA

� INCOMPLETE REQUEST/INSUFFICIENT INFORMATION

EXCAVATION DESK - PH: 546-7746

1177 BISHOP ST., LOBBY RECEPTIONEST

DROP-OFF/PICK-UP HOURS: 8:00 AM - 4:00 PM RECEIVED:

DROP-OFF INSTRUCTIONS:

� FULLY COMPLETED AND SIGNED HT DROP-OFF FORM

� 3 SETS OF SITE PLANS (11x17 OR SIMILAR PREFERRED)

� STATE, C&C OR MILITARY TRENCHING PERMIT APPLICATION FORM.

� PLAN REVIEW WILL TAKE ABOUT 5 BUSINESS DAYS.

� YOU WILL BE CONTACTED WHEN PLAN IS READY FOR PICK-UP.

PLEASE COMPLETE THE FIRST BLOCK AND SIGN THE GENERAL AGREEMENT AT THE BOTTOM

CONTRACTOR/CUSTOMER: PHONE:

E-MAIL ADDRESS: MOBILE:

LOCATION:

DESCRIPTON:

CONTRACTOR/CUSTOMER INFO

CENTRAL OFFICE: MAP #

� FACILITIES CLEAR OF AREA FID #

� LOCATE FACILITIES: � � CABLES IN CONDUIT � CONDUIT � BURIED CABLES � OTHER

� AM

TONING COMPLETED BY: DATE , 2011 TIME � PM

TONING FACILITIES MARKED BY: � � PAINT � WOOD STAKES � OTHER

TONING ACKNOWLEDGEMENT DATE

REVIEWED BY: DATE

REMARKS:

Attachment Accepted By

DISTRIBUTION: Contractor Air Pressure Supervisor Engrg Suppt - Excavation Desk Title

(Contractor/Customer)

HT Use Only

Date Stamp Area

It is understood that the exact location of the facilities as shown on Attachment(s) _____ page(s) _____ through _____ of this agreement may differ from that shown on prints and maps or indicated by stakeouts. It is agreed that Hawaiian Telcom Incorporated shall not be liable for accuracy in locating the facilities and that the contractor must perform field verification by hand digging to also verify quantity and characteristics of underground facilities. The presence of an employee of the Hawaiian Telcom Incorporated on site shall not relieve the contractor of responsibility for field verification by hand digging, and shall not relieve the contractor from liability from any injury or damage resulting from contact with Hawaiian Telcom Incorporated facilities.

GENERAL AGREEMENT

(Issued by)

CALL HAWAII ONE CALL CENTER (HOCC)

1-866-423-7287

5 BUSINESS DAYS PRIOR TO EXCAVATION

*Check your HOCC ticket status at www.managetickets.org

AFTER HOURS TROUBLE OR REPAIR

PLEASE CALL "611" OR 643-6111

NOTE: The notice for toning is void 90 days after the date of approval. The applicant must reapply for toning if excavation has not been completed within this 90 day period.

NOTE: Excavations with duraction longer than 90 days may receive special handling. The notice for toning needs to be renewed with Hawaiian Telcom every 90 days for a record review. A weekly work schedule provided to Hawaiian Telcom may be required.

The contractor shall conduct his operations in such a manner as to avoid injury or damage to adjacent property and improvements and facilities in the street or along the line of work, including, but not being limited to, property of Hawaiian Telcom Incorporated.

Hawaiian Telcom Incorporated shall be held free and harmless from any and all claims, damages or liability from the contractor's activities.

HT USE ONLY - RECORDS

HT USE ONLY - DISPOSITION

(Contractor's Signature) (Date)