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Maintenance Contract Application

Your Details

Telephone No:
Telephone No:	Note: The telephone number must start with the area code without white spaces or - signs e.g. 014589765
Contact Name:
Address:


Email:

Billing Address: (if different to the above address)
Name:
Address:

Maintenance Options:

	(Option 1) 09.00-17.00 5 day cover, excluding Bank Holidays
	(Option 2) 7 day 24 Hour Service
	(Option 3) Customised: As per customised schedule agreed
	(Option 4) SystemWatch 09.00-17.00 or 24x7
	(Option 5) Sureswitch Emergency Standby PABX

Start Date:

Note: Cover will begin from date of signed contract

System Type:

Software Details:

No. of Trunks:

No. of Extensions:

No. of Telephone Sets:

Type of Telephone Sets:

Other Applications:

Other Details:

Note: The following items and/or consumables are specifically excluded from the provisions of this agreement

Exclusions:

Other: