SIP SERVICE ORDER FORM (sales - no payment) : Integer IT

_{All prices indicated below are ex-GST}

Business Name *

Trading Name

ABN *

Your Name *

Position/Title

Email Address *

Phone (work) *

Phone (mobile)

Customer Name *

Service Address *

Commencement Date

ASAP Preferred Date

Show Products

NBN SIP Hosted PBX

NBN Products

TC4 25/5 TC4 25/10 TC4 50/20 TC4 100/40 TC2 (1:1) 5/5 TC2 (1:1) 10/10 TC2 (1:1) 20/20 TC2 (1:1) 40/40

SIP Products

SIP 2 SIP 5 SIP 10 SIP 20 SIP 30 SIP 50 Single Number 100 number indial

Hosted PBX Products

Extensions Single Number 100 number in-dial Call recording per 1GB Disk space

Hardware Required

None - $0.00 Smart NTU 100 - $100.00 Smart NTU 1G - $150.00 Smart NTU 1G + SIM Slot - $210.00

Shipping Address *

Setup Fees

$

Total amount payable

$ 0

Sales notes (office use only)

Client Signature