472215_20_000031986_5-23-2012_10-47-24_PM.pdf

Certification of Officer to Authorize an Agent to File Data Reported on Behalf of Reporting Carrier
I certify that (Name of Agent) _________________________________________________ is authorized to submit the information reported on behalf of
the reporting carrier. I also certify that I am an officer of the reporting carrier; my responsibilities include ensuring the accuracy of the data
provided to the Authorized Agent; and, to the best of my knwoledge, the actual data provided to the Authorized Agent is accurate.
Name of Reporting Carrier:
Signature of Authorized Officer:
Printed name of Authorized Officer:
Title or position of Authorized Officer:
Telephone number of authorized officer:
Persons willfully making false statements on this form can be punished by fine or forfeiture under the Communications Act of 1934, 47 U.S.C.
§§ 502, 503(b), or fine or imprisonment under Title 18 of the United States Code, 18 U.S.C. § 1001.
Study Area Code of Reporting Carrier Filing Due Date for this form
(mm/dd/yyyy)
Date:
472215 6/18/2012
CAMBRIDGE TEL CO
Kristie Kanady
Billing Manager
208-257-3314
5/23/2012
Kristie Kanady
TO BE COMPLETED BY THE REPORTING CARRIER, IF AN AGENT IS FILING DATA ON THE CARRIER'S BEHALF:
Name of Authorized Agent :National Exchange Carriers Association, Inc.
National Exchange Carriers Association, Inc.
Digitally signed by Kristie Kanady DN:cn=Kristie
Kanady,email=[e-mail],O=cambridge tel
co,l=Cambridge ID 83610, Date:5/23/2012