Member Change of Info Request

1
Is your company/utility a member of Alabama 811?* This field is required.Members receive locate request tickets from AL 811 in order to locate their underground facilities.
YESNO
2
Company/Utility Information* This field is required.If your membership includes more than one code, please enter all codes that you'd like us to apply the edits to.
Company/Utility/Municipality Name
Member Code(s) If unknown, type unknown
3
Are you employed by or do you represent this company/utility Member?* This field is required.
YESNO
4
You may be lost but we are here to help!* This field is required.If you were trying to update your AL 811 Portal Account information, log into the portal & select the excavator tab (left-hand side of the ticket entry screen). If your company/utility operates underground facilities and would like to become a member of AL 811 to receive locate requests, please fill out our application. If you are still lost and you'd like us to contact you, please enter your information below:
Contact Name
Best Contact Number
Email
Please type a summary of what you'd like us to help you with.
5
Tell us who you are!Please provide your contact information. If we have any questions regarding your submission, we will contact you.
Contact Name
Email
Office Phone Number
6
When would you like these updates to take effect?* This field is required.
Date
Month
Day
Year
7
Is this a permanent change?* This field is required.
YESNO
8
Temporary Change* This field is required.When would you like us to revert back to your existing information?
Date
Month
Day
Year
9
What brings you here today?* This field is required.Please select all that apply
Add, Edit, Remove an Individual Contact (will not change how you receive tickets)
Add, Remove, Replace how locate request tickets are received
Add/Edit after hours/holidays emergency contacts
Update Observed Holidays
Update Address (Physical and/or Mailing)
Other
10
You Chose Add, Edit or Remove Individual Contact* This field is required.Please choose ONE option below that best suits your needs.
Add New Contact
Edit Existing Contact's Details
Remove Existing Contact
11
Add ContactEnter new contact's name & details below
Contact Name
Position/Title
Email
Office Phone
Cell Phone
12
Remove ContactEnter existing contact's name & details below for removal
Contact Name
Email
Reason for Removal
Admin/Main Contact
Billing Contact
IT Contact
Mapping Contact
Positive Response - Responds to tickets
Other
Alabama 811 Roles - Choose ALL that apply. (Select one at a time from dropdown menu.)
13
Replace Contact - CARD INACTIVEEnter the name of the contact for removal in the 1st blank. Then enter their replacements name & contact details.
REMOVE - Existing Contact
ADD - New Contact
Position/Title
Email Address
Office Phone
Cell Phone
14
Edit Existing Contact on FileEnter existing contact's name & details below for update
Existing Contact Name
Position/Title
Email
Office Phone
Cell Phone
15
Alabama 811 Roles for New Contact:* This field is required.Select all that apply
Admin/Main Contact
Billing Contact
IT Contact
Mapping Contact
Positive Response User - Responsible for Ticket Response
Other
16
Select AL 811 Contact Roles assigned to the individual being REMOVED - INACTIVE:Select all that apply
Billing
IT
Main Contact/Admin
Mapping Contact
Positive Response - Response to Locate Request Tickets
Other
17
Alabama 811 Roles for Existing Contact:* This field is required.Select all that apply
Admin/Main Contact
Billing Contact
IT Contact
Mapping Contact
Positive Response User - Responsible for Ticket Response
Other
18
Invoicing Preference* This field is required.How would you like to receive your invoices? (Select One Option)
Mailing Address
Physical Address
Billing Contact's Email Address
A Different Email Address
Other
19
Billing Email Address* This field is required.
Example@example.com
20
Positive Response* This field is required.Select each facility that the individual will be posting ticket responses for:
Cable
Electric
Fiber
Gas
Petroleum
Phone
Pipeline
Sewer
Traffic
Water
21
Is this individual replacing someone that is currently a member contact?* This field is required.
YESNO
22
Remove Contact* This field is required.Enter existing contact's name & details below for removal
Contact Name
Email
Reason for Removal
Admin/Main Contact
Billing Contact
IT Contact
Mapping Contact
Positive Response - Responds to tickets
Alabama 811 Roles - Choose ALL that apply. (Select one at a time from dropdown menu.)
23
Would you like to add a new member contact to replace this individual?* This field is required.
YESNO
24
Add New Contact to Replace Existing ContactEnter new contact's name & details below
Contact Name
Position/Title
Email
Office Phone
Cell Phone
25
Alabama 811 Roles for New Replacement Contact:* This field is required.Select all that apply
Admin/Main Contact
Billing Contact
IT Contact
Mapping Contact
Positive Response User - Responsible for Ticket Response
Other
26
Invoicing Preference for Replacement Billing Contact* This field is required.How would you like to receive your invoices? (Select One Option)
Mailing Address
Physical Address
Billing Contact's Email
A Different Email Address
Other
27
Updated Billing Email Address* This field is required.
Example@example.com
28
Mailing Address for Replacement Billing Contact* This field is required.
Street Address
Street Address Line 2 (Apt/Suite)
City
State
Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
29
Physical Address same as Mailing?* This field is required.
YESNO
30
Physical Address* This field is required.
Street Address
Street Address Line 2 (Apt/Suite)
City
State
Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
31
Positive Response Access for Replacement Contact* This field is required.Select each facility that the individual will be posting ticket responses for:
Cable
Electric
Fiber
Gas
Petroleum
Phone
Pipeline
Sewer
Traffic
Water
32
Select AL 811 Contact Roles assigned to the individual being REMOVED -INACTIVESelect all that apply
Billing
IT
Main Contact/Admin
Mapping Contact
Positive Response - Response to Locate Request Tickets
33
Reason for removing contact INACTIVE
(Example: No longer employed, retired, promoted, etc.)
34
Mailing Address* This field is required.
Street Address
Street Address Line 2 (Apt/Suite)
City
State
Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
35
Physical Address same as Mailing?* This field is required.
YESNO
36
Physical Address* This field is required.
Street Address
Street Address Line 2 (Apt/Suite)
City
State
Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
37
Replace, Add, or Remove Locate Request Receiving MethodReceiving Method = How a member receives locate request tickets. (email, ticket mgmt. system, contract locator, etc.)
A. Replace current receiving method
B. Add receiving method to current list (Results in additional fee per transmission.)
C. Remove receiving method
D. I would like to be contacted for a KorTerra (KorWeb) ticket management system demo.
E. I would like to be contacted to discuss integration with my current ticket management system.
38
Replace current locate request receiving method* This field is required.Remove current method & Add replacement
REMOVE - Current Method
ADD - New Method
39
Add locate request receiving method to current list* This field is required.AL 811 bills based on the number of receiving methods, not ticket count. By selecting this option, your bill will increase. If you would like to change your selection, please clear this card & click previous on the bottom left. For the purpose of this section, the phone number will only be used if the ticket transmission fails.
ADD - New Method
Phone Number
I approve the additional transmission fee
40
Remove current locate request receiving method* This field is required.By selecting this option, you will no longer receive locate request tickets at the method entered below. If you need to REPLACE the receiving method, leave this option blank. Click "previous" below, and choose option A "Replace current receiving method".
REMOVE - Current Method
41
Optional Service - After Hours/Holiday Emergency Locate ContactsProvide up to 3 contacts. Courtesy calls for emergency locate requests will only occur outside of your hours of operation and on selected holidays. Alternates will only be called if the previous contact on the list does not answer. (Please note that this update will override your emergency contact list if you currently have one in place.)
Primary Contact (required)
Primary Phone Number (required)
1st Alternate
1st Alternate Phone Number
2nd Alternate
2nd Alternate Phone Number
42
Hours of Operation -* This field is required.Are your operating hours the same each day Monday through Friday?
YESNO
43
Hours of Operation Monday Through Friday* This field is required.If you receive an emergency locate request outside of these hours, your designated contact(s) will receive a courtesy call.
1
2
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Hour
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59
Minutes
AM
AM
PM
Until
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Hour
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Minutes
AM
AM
PM
44
Hours of Operation (Varying Times)Enter operating hours for each weekday. Example: 8:00 AM - 5:00 PM. Open to Close Hours Only. Type zeros "00:00 AM - 00:00 PM" if you're closed a particular day.
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
45
Observed Holidays* This field is required.Pre-selected days are observed by Alabama 811. These holidays will not count towards the working day window for locates. If your company observes additional holidays, please select them from the list below for emergency call out purposes only.
New Years Eve - Tues, 12/31/24
New Year's Day - Wed, 1/1/25 (AL 811)
Martin Luther King Jr./Robert E. Lee - Mon, 1/20/25
Presidents' Day - Mon, 2/17/25
Mardis Gras - Tues, 3/4/25
Good Friday - Fri, 4/18/25
Confederate Memorial Day - Mon, 4/28/25
National Memorial Day - Mon, 5/26/25 (AL 811)
Jefferson Davis Birthday - Mon, 6/2/25
Juneteenth - Thurs, 6/19/25
Independence Day - Thurs, 7/4/25 (AL 811)
Labor Day - Mon, 9/1/25 (AL 811)
Columbus Day - Mon, 10/13/25
Veterans' Day - Tues, 11/11/25 (AL 811)
Thanksgiving Day - Thurs, 11/27/25 (AL 811)
Day After Thanksgiving - Fri, 11/28/25 (AL 811)
Christmas Eve - Wed, 12/24/25 (AL 811)
Christmas Day - Thurs, 12/25/25 (AL 811)
New Year's Eve - Wed, 12/31/25
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Main Office Phone Number - INACTIVEThis will replace the main office number on file.
Updated Main Office Phone
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Additional details?Please type any details below that you'd like us to know about.
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Alabama 811 will apply these changes as soon as possible unless specifically noted.* This field is required.AL 811 Operating Hours M-F 7:00 AM - 5:00 PM
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