2024 Smart Monitoring Contract Form

From Email
Submission Type
Contract
Smart Monitoring

Contractual Connection Form
Promo Code:
if you were supplied a special code enter it here.
Contract Term Override
Custom Term
Base Charge Override
Custom Base Monthly Charge
Customer Details
Name

First NameLast Name
Company Name
Premises Address

Address Line 1

Address Line 2

CityState / Province

Postal / Zip Code
Premises Phone Number

Area CodePhone Number
Mobile Number

Area CodePhone Number
Customer Email
example@example.com
Connection Details
I Am
Form Type
Panel Account #
Contact us if you don't know it
Voice Code
Connection Date

DayMonthYear
Monitoring Plan
Premium incurs additional charges (see further down for more info)
Connection Type
4G Options incur additional charges (see further down for more info)
Extra Areas
How many extra areas are going to be monitored?
Other Connection Type

Zone List

Rows	Zone Name
1
2
3
4
5
6
7
8
9
10

If there are more than 10 zones please submit a separate list
Emergency Response Instructions
Medical Response
please specify who you want us to call for this event.
Fire Response
please specify who you want us to call for this event.
Panic Response
please specify who you want us to call for this event.
Duress Response
please specify who you want us to call for this event.
Burglary Response
please specify who you want us to call for this event.
Late to Close / Early To Open
please specify instructions for this event.
Special Instructions
If the dropdown boxes don't suit your needs please type them here
Patrol Company

Other

Contacts

Rows	Name	Has Keys? Y/N	Phone	Mobile	Extra Number
1st Person
2nd Person
3rd Person
4th Person

Cost Schedule
Base Rate
excl. GST
4G Surcharge
excl. GST
Premium Surcharge
excl. GST
Monthly Total
excl. GST
Contract Term
months
Actual Months
Months Free
Extra Area Surcharge
Contract Value
Standard Monitoring
consists of Alarm Response via phone call as per the instructions you have supplied. Email Reports, Text Messages and Web Access to your account is also included.

This is normally charged at $32+GST per month
Premium Monitoring
enables extra features where we respond when the alarm is disarmed outside of normal business hours or if the alarm isn't armed in an expected time frame.

This option incurs an extra charge of $10.50+GST per month
4G Monitoring
uses cellphone networks to communicate directly to the monitoring centre and isn't reliant on standard Internet or Phone line services. This makes it the most reliable form of professional monitoring.

This option incurs an extra charge $10+GST per month
Permaconn
is a 3rd party interface that supports 4G Monitoring options. There is a surcharge that is paid to them for this service.

This option incurs an extra charge $10+GST per month
Additional Areas
on your alarm that can be armed and disarmed independantly are charged in addition to the normal monthly rate.

This option incurs an extra charge of $2.90+GST per area

Special Conditions:
- {monthsFree} Months Free Monitoring
Terms & Declaration
Declaration
By submitting my digital signature, I {name} acknowledge that I have read the provisions of this agreement based on a term of {contractTerm} months at the rate of ${monthlyTotal}+GST per month and agree to comply with my obligations as set out in the Terms & Conditions above.

Furthermore I understand that electronic contracts are legally binding.
By submitting your digital signature, you agree that the information you have submitted is correct and you agree to comply with your obligations as set out in the Terms & Conditions above.

Furthermore you understand that electronic contracts are legally binding.
Signature
Should be Empty: