Membership Application and Agreement

                 WHEREAS, Mississippi One-Call System, Inc., (the Corporation), a Mississippi non-profit corporation, has been formed in an effort to reduce damage to underground facilities of its members and to establish a statewide notification center (the "Notification Center"):

                 WHEREAS, the undersigned represents that it has underground facilities located within the state of Mississippi and is otherwise eligible to be a Member of the Corporation; and

                 WHEREAS, the undersigned requests to be a Member of the Corporation and hereby tenders with this application the fee as specified by the Board of Directors of the Corporation.

                 NOW, THEREFORE, the undersigned hereby applies for admission as a Member of the Corporation and in connection therewith covenants and agrees when accepted as a Member, and it's assigns, as follows:

1.  To not share, sell or disseminate the One-Call ticket information with any other entity in any form or fashion.

 2.  To abide by and comply with such rules and regulations as the Board of Directors may adopt, from time to time, for utilization of the statewide Notification Center by members.

                 3.  To abide by and comply with the By-Laws of the Corporation;

                 4.  To pay promptly the fees prescribed by the Board of Directors of the Corporation.

Company Name
Name
Title
Billing Address
Address (cont.)
City
State
Zip Code
Telephone #
FAX #
E-mail

Entering your name here will serve as a digital signature exemplifying acceptance of this agreement by your company:

Signature 


Copyright © 2003 Mississippi One-Call System, Inc. All rights reserved.
Revised: 05/27/08 

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