BULK ACTIVATION & CHANGE REQUEST FORM
Reset Form
To request activation of a Bulk Subscriber Account: (i) Retailer must fully and correctly complete (with all applicable signatures) this Bulk Activation Form (the “Activation Form”) and (ii) send it to DISH via
email to DISH at [email protected] or fax it to DISH at (303)723-3518 at least two (2) full business days prior to the Requested Activation Date specified below. Service is provided subject to
the terms and conditions of the Commercial Customer Agreement (the “Commercial Customer Agreement”), which is available on DISH's website at www.dish.com/commercial. Programming prices/rates
and packages are subject to change without notice at any time and from time to time in the sole and absolute discretion of DISH for any reason or no reason. All Bulk Programming rates are based on
programming being provided to 100% of the total Drops/Units at the Bulk Property, with a minimum prerequisite of ten (10) Drops/Units per Bulk Property.
PLEASE TYPE THE INFORMATION IN THE FORM BELOW, SIGN, AND EMAIL TO
[email protected] OR FAX TO (303) 723-3518.
Request Type
Requested Pre-Activation Date
Property Type
(Pre-activation may not exceed 30 days)
System Type
Total Drops/Units
Requested Full Activation Date
Must be 100% Drops/Units Minimum 10 Rooms/Units
Retailer Information:
Customer/Property Information:
Property Name
Retailer No.
Distributer Retailer Name (if Applicable)
Physical Address
Company Name
City
State
Phone
Zip Code
Fax
Mailing Address
City
Contact Name
State
Phone
Email
Zip Code
Fax
Email
Promotions
Property Account Number
HBO or HBO & Cinemax Commitment Offer Plan: To be considered for participation in the HBO
or HBO & Cinemax Commitment Offer Plan the Property MUST: (i) be a Qualifying Bulk Subscriber with
a minimum of ten (10) total Drops/Units. (ii) subscribe to Bulk Programming services totaling a
minimum of Four and 55/100 ($4.55) per Unit per month (exclusive of any applicable taxes or fees) and
(iii) enter into a three (3) year agreement. Participation is subject to DISH's approval which may be
withheld by DISH in its sole and absolute discretion for any reason or no reason. Rates set forth in the
Promotional Offer are subject to Chargeback pursuant to the terms and conditions set forth in the
Business Rules.
Hierarchy Account Number
Property Billing Information:
Business Name
NEW AMENITY INCENTIVE 60: To be considered for participation in the Amenity Incentive 60
Promotional Program, the Bulk Property MUST: (i) be a Qualifying Bulk Subscriber with a minimum of
fifty (50) total Drops/Units, (ii) subscribe to Bulk Programming services totaling a minimum of Nine and
50/100 Dollars ($9.50) per Unit per month (exclusive of any applicable taxes or fees) and (iii) enter into
a five (5) year agreement. Only new or reconditioned smartbox, ViP 211(k)(z), or ViP 222(k) receivers
are eligible for this Promotional Program and participation is subject to DISH's approval which may be
withheld by DISH in its sole and absolute discretion for any reason or no reason. Incentives are subject
to Chargeback pursuant to the terms and conditions set forth in the Business Rules.
Attention
Mailing Address
City
State
Phone
Zip Code
EXISTING AMENITY INCENTIVE 60: To be considered for participation in the existing Amenity
Incentive 60 Promotional Program, the Bulk Property MUST: (i) Not be under a current bulk promotional
commitment (ii)upgrade existing equipment to smartbox (iii) be a Qualifying Bulk Subscriber with a
minimum of fifty (50) total Drops/Units, (iv) subscribe to Bulk Programming services totaling a
minimum of Nine and 50/100 Dollars ($9.50) per Unit per month (exclusive of any applicable taxes or
fees) and (v) enter into a new five (5) year agreement. Only new or reconditioned smartbox are
eligible for this Promotional Program and participation is subject to DISH's approval which may be
withheld by DISH in its sole and absolute discretion for any reason or no reason. Incentives are subject
to Chargeback pursuant to the terms and conditions set forth in the Business Rules.
Fax
Contact Name
AT120 Commitment Offer Plan: To be considered for participation in the AT120 Commitment
TOTAL PRICE PER DROP
Offer Plan the Bulk Property MUST: (i) be a Qualifying Bulk Subscriber with a minimum of ten (10) total
Drops/Units, (ii) enter into a three (3) year agreement. Participation is subject to DISH's approval
which may be withheld by DISH in its sole and absolute discretion for any reason or no reason. Rates
set forth in the Promotional Offer are subject to early termination fee One and 00/100 ($1.00) per
Drop/Unit per month for the number of whole months remaining on the Term Commitment, up to and
not in excess of Two Thousand Five Hundred and 00/100 Dollars ($2,500.00), pursuant to the terms
and conditions set forth in the Business Rules.
Property Representative Signature
Comments
Property Representative Title (i.e. Owner, Manager, etc.)
BY SIGNING IN THE APPROPRIATE SPACE DESIGNATED ON THIS ACTIVATION FORM AND SUBMITTING THIS FORM TO DISH, THE BULK PROPERTY AND THE RETAILER: (I) ACKNOWLEDGE AND AGREE
TO BE BOUND BY ALL OF THE TERMS AND CONDITIONS OF THIS ACTIVATION FORM, THE COMMERCIAL CUSTOMER AGREEMENT, AND THE BUSINESS RULES WHICH ARE INCORPORATED HEREIN BY
REFERENCE AND (II) DECLARE UNDER PENALTY OF PURJURY THAT THE INFORMATION CONTAINED IN THIS ACTIVATION FORM, INCLUDING WITHOUT LIMITATION THE REPORTED TOTAL NUMBER
OF DROPS/UNITS, IS TRUE AND CORRECT AND IN COMPLIANCE WITH THE TERMS AND CONDITIONS OF THE COMMERCIAL CUSTOMER SERVICE AGREEMENT AND THE BUSINESS RULES. Total Drops/
Units is defined in the Business Rules. Notwithstanding the foregoing, DISH reserves the right to determine from time to time, in its Sole Discretion, whether total Drops/Units with respect to each such
location should more appropriately be determined in a different manner.
6/16/2015
*“DISH Network” and “DISH” are trademarks of DISH Network L.L.C.
For purposes of this Activation Form, “DISH Network”, and
“DISH” shall mean DISH Network L.L.C.
Initial: Operator_____
Additional Bulk Services
Add
Electronic Programming Guide (EPG) Data Access Service [FTG Headend Locations Only]
DISH reserves the right to audit per the applicable agreement(s).
HD over Coax (Please type in approved equipment manufacturer)
DISH reserves the right to audit per the applicable agreement(s).
Manufacturer:
Remove
Price Per
Drop
Add
Remove
$0.25
Add
Remove
$0.00
Essentials
America's Top 120
America's Top 120 (FTG properties only, requires 3 year subscription, see page 1 for terms)
Add
Add
Add
Remove
Remove
Remove
Price Per
Drop
$1.90
$13.65
$6.00
Hospitality Plus (FTG properties only, must subscribe to Essentials or above)
Add
Remove
$0.50
America's Top 200
Add
Remove
$21.00
America's Top 250
Add
Remove
$30.50
Add HD (requires minimum subscription of America's Top 120)
Add
Remove
$1.00
Premier (Hospitality Only) *Cannot be used for L-Band Installations
Add
Remove
$3.40
Prime (MDU Only) *G4 or greater smartcard required
Add
Remove
$3.40
DishLATINO Clasico
Add
Remove
$3.75
University Pack (Available to Universities and Student Housing Properties only)
Add
Remove
Core Bulk Programming Packages (please check services ordered)
Add
Add-On Packages (requires subscription to one core package)
Remove
$3.05
Price Per
Drop
Add
Remove
Dish Movie Pack
Add
Remove
$5.15
Variety
Add
Remove
$0.63
Classic & Country
Add
Remove
$0.58
Education & Arts
Add
Remove
$0.57
Beyond Entertainment
Add
Remove
$0.34
History & More
Add
Remove
$0.69
News & Lifestyle
Add
Remove
$0.39
The Edge
Add
Remove
$0.88
The Escape
Add
Remove
$0.78
Golf
Add
Remove
$0.22
Comedy & Music
Add
Remove
$0.71
Action Pack
Add
Remove
$0.86
Discovery Pack
Add
Remove
$0.11
BET
Add
Remove
$0.16
CNBC
Add
Remove
$0.18
Expanded HD Package
Add
Remove
$0.40
Sirius Music
Add
Remove
$0.18
Pequeño Latino
Add
Remove
$0.17
CNN en Español
Add
Remove
$0.32
Local Networks In-Market
Add
Remove
Over 60 channels of 100% commercial-free music
Sports Packages (requires subscription to one core package)
$0.50
Price Per
Drop
Add
Remove
ESPN A La Carte
Add
Remove
$6.52
ESPN Pak 3 (All channels in the package must be displayed)
Add
Remove
$5.94
ESPN Pak 4 (All channels in the package must be displayed)
Add
Remove
$5.47
ESPN Pak 5 (All channels in the package must be displayed)
Add
Remove
$5.38
ESPN Ultimate (Five (5) of the seven (7) channels in the package must be displayed)
Add
Remove
$6.38
Puerto Rico / Virgin Islands ESPN Package (All channels in the package must be displayed)
Add
Remove
$5.38
ESPN Deportes - Requires Subscription to ESPN pack 4 or 5 (Hotels/Motels Only) (All channels in the package must be displayed)
Add
Remove
$0.00
Multi-Sport Package (available only with America's Top 200 or 250)
Add
Remove
$5.65
Regional Sports a la carte (Hotels/Motels only)
Quantity
Add
Remove
$1.05/ea
Regional Sports a la carte (all other bulk properties)
Quantity
Add
Remove
$1.30/ea
Big Ten Network
Add
Remove
$2.24
PAC 12
CBS Sports Network
Add
Remove
$1.99
Add
Remove
$0.15
Sports Time Ohio
Add
Remove
$2.00
Please Specify
SEC Network (Requires AT120)
Add
Remove
$2.00
Longhorn Network (Requires AT 120)
Add
Remove
$0.50
MLB Network
Add
Remove
$0.30
NFL Network
Add
Remove
$0.33
The Tennis Channel
Add
Remove
Premium Packages
Add
$0.25
Remove
Price Per
Drop
EPIX (FTG properties only, must subscribe to Essentials or above)
Add
Remove
$1.00
HBO
Add
Remove
$4.40
HBO Promotional Rate (New HBO Subscription for Hotel/Motel, Expires 1/15/2016)
Add
Remove
$4.05
HBO Free-to-Guest and Dorms, commitment offer
I accept terms and conditions. HBO commitment offer requires a three (3) year subscription. By selecting the promotion
on the first page, and submitting to DISH you agree to subscribe to HBO for a period of no less than three (3) years commencing
on the date identified on the first page. This contract will be binding and may be renewed automatically for additional one (1) year
terms unless you contact DISH customer service to cancel the services.
Add
Remove
$2.75
HBO & Cinemax
Add
Remove
$7.40
HBO & Cinemax Free-to-Guest and Dorms, commitment offer
I accept terms and conditions. HBO & Cinemax requires a three (3) year subscription. By selecting the promotion on the first
page, and submitting to DISH you agree to subscribe to HBO for a period of no less than three (3) years commencing on the date
identified on the first page. This contract will be binding and may be renewed automatically for additional one (1) year term
unless you contact DISH customer service to cancel the services.
Add
Remove
$2.75
Showtime
Add
Remove
$3.95
Showtime Promotional Rate (New Showtime Subscription for Hotel/Motel, Expires 1/15/2016)
Add
Remove
$3.05
Starz!
Add
Remove
$3.30
HBO, Cinemax, Showtime, and Starz!
Add
Remove
$14.65
Encore (East/West)
Add
Remove
$0.66
Encore + 1
Add
Remove
$0.87
Encore + 2
Add
Remove
$1.08
Encore + 3
Add
Remove
$1.29
Encore + 4
Add
Remove
$1.50
Encore + 5
Add
Remove
$1.71
Encore + 6 (Action, Black, Classic, Family, Suspense, Westerns)
Add
Remove
International Packages
Add
Remove
$1.92
Price Per
Drop
Arabic - Arabic Enhanced Pack
Add
Remove
$0.60
Brazilian - TV Globo
Add
Remove
$0.85
Brazilian - Brasil Mais
Add
Remove
$1.60
Cantonese: Jadeworld
Add
Remove
Chinese - Chinese Elite Pack
Add
Remove
Chinese - Great Wall TV Package
Add
Remove
$0.35
$1.10
$2.10
French - TV5Monde
Add
Remove
$1.35
French - French Bouquet
Add
Remove
$1.35
German - Mega
Add
Remove
$1.85
Greek - Greek Elite Pack
Add
Remove
$0.50
Hindi - Hindi Mega Pack
Add
Remove
$1.10
Israeli - The Israeli Network
Add
Remove
$0.60
Itailian - RAITALIA
Add
Remove
$0.60
Japanese - TV Japan
Add
Remove
$1.10
Polish - Super Pack
Add
Remove
$0.50
Portuguese - Luso Pack
Add
Remove
Russian - Russian Mega Pack
Add
Remove
$1.10
$1.10
Taiwanese - Taiwanese Elite Pack
Add
Remove
Tamil - Sun TV
Add
Remove
$0.85
$1.10
All rates are based on a per room/unit basis, per month and applied to the total number of units.
In order to subscribe to the ESPN Package, all programming in that package must be delivered in each room
All channels may not be available if you live in the following areas: Alaska, Puerto Rico, U.S. Virgin Islands, or Hawaii. Please visit our website at www.dish.com/commercial for further details
6/16/2015
*“DISH Network” and “DISH” are trademarks of DISH Network L.L.C.
For purposes of this Activation Form, “DISH Network”, and
“DISH” shall mean DISH Network L.L.C.
Initial: Operator_____
EQUIPMENT INSTRUCTIONS
Add All
Remove All
Clear All
Please complete this page if you are activating a new bulk account or adding or removing receivers to an existing bulk account. For SMATV (head
end) systems, you must indicate the programming package and channel name that will be assigned to each receiver. For L-Band systems, all
receivers must receive the same programming and no more than six (6) packages may be selected. Premier cannot be used for L-Band installations. If
headend, only smartbox, 311, ViP 211(K), ViP 222(K) will be authorized. Up to two (2) 722(K)s may be authorized if used for SLING Remote
Monitoring only.
If using dual-tuner receivers with the Premier package, italicized and non-italicized channels (as indicated on the Rate Card) cannot be put together on
the same receiver. Only two italicized channels or two non-italicized channels can be put on the same dual-tuner receiver. If you have more receivers
to list, please attach additional spreadsheets.
Receiver Number
Smart Card Number
Model No.
Package
Channel
Add/Remove
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
6/16/2015
*“DISH Network” and “DISH” are trademarks of DISH Network L.L.C.
For purposes of this Activation Form, “DISH Network”, and
“DISH” shall mean DISH Network L.L.C.
Initial: Operator_____
EQUIPMENT INSTRUCTIONS
Add All
Remove All
Clear All
Please complete this page if you are activating a new bulk account or adding or removing receivers to an existing bulk account. For SMATV (head
end) systems, you must indicate the programming package and channel name that will be assigned to each receiver. For L-Band systems, all
receivers must receive the same programming and no more than six (6) packages may be selected. Premier cannot be used for L-Band installations. If
headend, only smartbox, 311, ViP 211(K), ViP 222(K) will be authorized. Up to two (2) 722(K)s may be authorized if used for SLING Remote
Monitoring only.
If using dual-tuner receivers with the Premier package, italicized and non-italicized channels (as indicated on the Rate Card) cannot be put together on
the same receiver. Only two italicized channels or two non-italicized channels can be put on the same dual-tuner receiver. If you have more receivers
to list, please attach additional spreadsheets.
Receiver Number
Smart Card Number
Model No.
Package
Channel
Add/Remove
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
6/16/2015
*“DISH Network” and “DISH” are trademarks of DISH Network L.L.C.
For purposes of this Activation Form, “DISH Network”, and
“DISH” shall mean DISH Network L.L.C.
Initial: Operator_____