Protecta Security Service Agreement 11 Harleyne StreetWitbank 1035Controlroom: 064 514 0757 Alarm-RegistrationContract No.Radio / Account No.Title- Select -MrMrsMissDoctorProfessorFirst NameLast NameID No.Company NameCompany Registration NumberEmailHome Tel No.Cell No.Alternative No.Tel No. that System will use.Address at which the system is installed (which you hereby elect your domicillum citandi et executandi) and previous address if you have lived in the Premises less than 2 years.AddressStreet AddressSuburbCity, CodeProvinceErf/Stand NoPostal AddressPO BoxSuburbCity, CodeProvincePostal Address (for account)PO BoxSuburbCity, CodeProvinceTo provide the Services to the Customer from the Start Date at the Premises on the terms and subject to the conditions contained in this document and the instructions. Please read all of the terms and conditions in this document before signing.Service CategoryCategory Maintenance Guarding Radio Monitoring Armed ResponseAnnual Radio License FeeOtherBasic System Rented OwnedPro Rata ChargeMonthly ChargeContract Period 12 Months 24 Months 36 MonthsService LevelsThe Maintenance Services consist only of: Inspection and repair of the system upon your reasonable request during Normal Working Hours in terms of Clause 5.1 The Monitoring Services consist only of: Monitoring of the System by telephone and/or radio: Notification to: the chosen armed response service provider (if indicated): the Customer or the police (if the armed response box is not ticked, the Customer has not indicated an armed response service provider and Protecta is unable to contact the Customer), the fire authority and/or medical service provider, if indicated by the Customer and Protecta deems it necessary in its sole discretion. If an activation signal is received from the System and no Satisfactory Explanation is given telephonically from the Premises, provided that RA's reasonable endeavours to contact such person shall constitute notification. The Armed Response Services are only applicable for Premises in areas which are patrolled by Protecta and consist only of: Attendance by armed personnel at the Premises as quickly as operational circumstances may permit in response to activation signals received from the System if no satisfactory explanation is given telephonically from the Premises. On arrival of such armed personnel at the Premises, such further steps as may be reasonably necessary to safeguard the Premises, the contents thereof, the Customer's and/or invitees. The Services to be provided to you under this Agreement are determined by the customer's choice of service category by ticking the appropriate box(es).SignaturesPlease ensure that all of the details contained in this document are correct. You should only sign this document if you are prepared and able to keep to its legal terms and conditions. If there is more than one customer, you should all sign. If the customer is a tenant, the Landlord may also be required to sign this document and in so signing binds himself as surety and co-principal debtor in favour of Protecta for the fulfilment by the customer of all of the customer's obligations in rerms of the Agreement. By your signature on this document, you acknowledge that you have read and understood the terms and conditions.Customer's SignatureDateAccepted on behalf of Protecta SecurityDateCustomer's Print NameNameCapacityKey Holder DetailsKey Holder Name1Key Holder Name2Key Holder Name3Home Tel No1.Home Tel No2.Home Tel No3.Work Tel No1.Work Tel No2.Work Tel No3.Cell No1.Cell No2.Cell No3.Password / Code:Special Instructions:Medical:Dogs:KEYHOLDERS AND THEIR DUTIES In order to comply with Protecta policy, you are required to provide details of at least two people to be contacted In case of emergency when no one is available on the Premises. They must: (i) live at separate addresses within 20 minutes travelling distance of the Premises. (ii) have agreed to hold the keys to the Premises (iii) be able to operate your security system. (iv) be available to attend the premises if required.Instruction to Bank to Pay by Direct DebitName of Account HolderType of AccountBranch CodeBank NameBranch NameBank Account NumberAmount (Excl. VAT)Effective DateToday's DateI hereby instruct and authorise Protecta to draw against my Bank Account the payment required in terms of my Service Agreement dated thisService Agreement Dateon the 1st day of each and every month commencing on the 1stCommencing Dateand continuing for the duration of the abovementioned agreement. I undertake against the said bank that I shall regard receipt and acknowledgement by Protecta of this request, as receipt and acknowledgement by the bank.SignatureFor Office UseProfile No.Customer/Debitor Account No.Cat.Ex.AddressWithdrawal FormYou have the right to withdraw your offer within 48 hours of the signature of this document. To do so, you must deliver written notice of such withdrawal to the Authorised Dealer within 48 hours of the signature of this document. Your right to withdraw is terminated by the installation of the System. You can use the withdrawal form provided if you so wish. Complete, detach and return this form ONLY IF YOU WISH TO WITHDRAW YOUR OFFER.To: Dealer NameDealer FaxI/We hereby give notice that I/We wish to cancel my/our AgreementDate of CancellationAddressStreet AddressSuburbCityProvinceCode I have read and agree to the Terms and Conditions and Privacy PolicySubmit Form