EXHIBIT B-6 Procurement Agreement (version 010411)

INWARD ONLY LINES

Subject to the Terms and Conditions of the SPECIAL PRICE AGREEMENT by and between FISPA and MEMBER named herein and FISPA’s CONTRACT SERVICE AGREEMENT AND ALL ADDENDUMS with BellSouth Telecommunications Inc. (DBA AT&T Southeast) setting forth the terms and conditions of BellSouth’s provisions of services to Member, the Member listed below elects to procure the following services:

Send electronic PDF order to or fax to 704-844-2728

FISPA PROVIDED AUTHORIZATION NUMBER:

Member Billing Name: FISPA-BL %

Member name

Member Billing Address:

CITY, STATE, ZIP:

Phone Number: Fax Number:

Email address to send order status:

CREDIT CARD INFORMATION TO PAY FISPA SERVICE FEE

CRCD Number: Exp Date:

Name on CRCD: Security Code:

Type of Card: VISA MC AX DISC Use CRCD on file with FISPA

DESCRIPTION AND LOCATION OF REQUESTED SERVICEFISPA one-time

Please use a separate form for each ckt orderedService Fee $25

New

Correction to previous request (same authorization number)

Installation Address:

To complete this order Member must submit both pages to FISPA, along with the Service Fee and pass FISPA and AT&T SE Credit Requirements.

After receipt of order confirmation, should the order for this service be canceled prior to the completed installation, the ISP Member shall pay all reasonable costs incurred by BellSouth and FISPA’s one time service fee. Such reasonable costs shall not exceed standard installation charges. Cancellation of this order must be in writing to BellSouth.For and in consideration of processing this order I acknowledge that I have signed or otherwise authorized under FISPA’s then current Special Price Agreement and that I am a current on all FISPA invoices and a current member in good standing.

Authorized Member Signature: ______Date: ______

FISPA Signature: ______Contract ID:

Exhibit B-6 page 2

FISPA Provided Authorization Number:

Member Billing Name: FISPA-BL %

Client Name where svc to be installed:

Installation Address:

City, State, Zip:

Bldg/Suite:

Existing Club Bill Acct Number:

(If do not have one, must contact Acct Team PRIOR to submitting)

Technical Contact: Technical Contact Tele #:

Secondary Contact number:

Department Identifier:

(Required for all ckts, 26 characters free form field)

Jack or Wiring required: No*Yes

If required what type of Jack:

Desired Due Date: Access Hours-install site

*If no, line will be installed on NID at normal demarc in customer premise. Please ensure you have discussed this with your client. Wire and Jack in a single tenant building approx. $89 + tax or in a multi-tenant building approx. $162 + tax.

Special Remarks to be placed on every order-Member Please complete:

Attn: Installer any request for inside wiring work beyond what is on initial order MUST be approved by (NSP), before any additional work is completed.

Remarks/Special Instructions: