Fill and Sign the Indefeasible Right of Use Agreement Qwest Communications Form

Page 1 of 2 REGENERATION FACILITY EASEMENT STATE: COUNTY: The undersigned (the “Grantor”), grants to _____, whose address is _____, its subsidiaries, successors and assigns (collectively referred to as the “Grantee”), an excl usive easement to construct, maintain, operate, inspect, repair, replace, and remove the communications facilities as Grantee may from time to time require, (incl uding all rights of ingress and egress) consisting of regenerators, optical amplifiers, crossarms, poles, anchors, guys, cables, wires, conduits, manholes, handholes, markers, pedestals, electrical conductors, structures with electronic communication equipment, and associated paving, fencing, and other necessary fixtures and appurtenances related to it; in, over, under, and on the real property i n _____ County, _____, described as follows:: (Description of Land) Grantor covenants not to do or permit anything to interfere with the rights granted to Grantee, and without in any way limiting the generality of the foregoing, further covenants not to erect or construct, or permit to be erected or constructed, any fence, building, or any other structure of any kind within the limits of the easement and right of way; and, not to grant other easements on, under, or over this easement and right of way without Grantee’s prior written approval. Grantor also grants to Grantee the right to cut, fill, or otherwise change the grade of the property and to place drainage and retaining structures on it, as Grantee may elect for the protection of the facilities, provided the grading does not affect the drainage of any propert y belonging to the Grantor(s); and, during construction periods, the right to clear and use additiona l areas as required. Grantee shall be responsible for damage caused intentionally or by any negligent act or omissions of Grantee, its agents or employees while exercising the rights granted by this Easement. Should Grantee abandon the premises or fail to use the premises for the purposes granted for a period of two years, in that event, all rights granted by this Easement shall cea se and the title to the premises shall be freed from the burden of this Easement. The covenants, terms, conditions, and provisions of this Easement shall extend to and be binding on the heirs, executors, administrators, personal representatives, successor, assigns, lessees, and agents of Grantor(s) and Grantee. Date: Grantor Page 2 of 2 Grantee (Acknowledgments)