Service Application Form - Sanctuary Cove ( this agreement )

Transcription

1 - Web: Customer Details ( the customer ) Primary Contact Information Address Account Password of Birth Passport/Licence # ID Expiry Mobile Landline Fax Service Address Level Unit Street No. Street Name Suburb State Sanctuary Cove QLD Postcode Activation 4212 Billing Details (if different) Business Entity - Use this field when services are to be billed to a business Unit, Street Number, Street Name/PO Box or Address ABN - Use this field when services are to be billed to a business Suburb State Postcode Paper bills attract a $2.50 fee per printed Statement. billing is free. If you require business billing but are unsure of the Business Entity, please visit and enter the related ABN. 1.2 Applicant Declaration The Customer ( you or I or my ) apply to The Company ( we or us or our ) for the supply of Internet Services for the plans listed in section 2.1 and/or for the supply of Telephone Services as specified in section 2.2 of this agreement. You acknowledge that: Internet Services as listed under section 2.1 and/or Telephone Services as listed under section 2.2 of this agreement are provisioned subject to the Standard Form of Agreement, which is a Standard Form of Agreement for the purposes of Part 23 of the Telecommunications Act 1997 (Cth). By signing this agreement you agree that you have been given the opportunity to read, or have read, and agreed to abide by the terms and conditions set out in the Standard Form of Agreement; This agreement is deemed accepted by us at the time your Telephone Services or Internet Services are activated; If you agree to a minimum term contract then the following Early Termination Fee (ETF) will apply if you terminate during that minimum term: Telephone and/or Internet Services - $15 per line or channel or service multiplied by the months remaining in your contract, plus the relevant installation fee for the service (where such installation fee was waived or credited as part of the contract) and/or relevant charges for any Telephone or Internet connectivity hardware waived or subsidised as part of the contract. By signing this agreement, you agree that: (a) Any Internet or Telephony communication hardware supplied by us remain our property when you vacate the premises, unless otherwise purchased by you. (b) The person submitting this agreement warrants that they are duly authorised to execute this application as, or on behalf of The Customer. (c) Issues with and remediation of internal cabling are the sole responsibility of the tenant/owner of the property, as per Part 3.14 of the Telecommunications Act 1997 (Cth). The Network Management team is responsible for cabling and issues up to the Boundary Point of the network (ONU). 1.3 Privacy & Spam We will collect personal information about you, including but not limited to your electronic contact details such as address and telephone numbers for the purpose of administering the services for which you apply, and as set out in our privacy policy. Please contact us directly to obtain a copy of our privacy policy. If you would prefer that we do not use your personal information for direct marketing and/or for sending commercial electronic messages, please check this box: 1.4 Credit Checks Prior to accepting your application, you have provided to us all information relevant to our assessment of your credit rating. You consent and acknowledge that you: Understand that the Privacy Act 1988 (Cth) allows us to give a credit reporting agency certain personal information about you; The information we disclose to a credit reporting agency includes information which will allow you to be identified, the fact that you have applied for credit and the amount, that we are a current credit provider to you, repayments that are more that 60 days overdue and for which debt collection action has started, information that in our opinion you have acted fraudulently or shown an intention not to comply with your credit obligations, and cheques drawn by you for $100 or more which have been dishonoured more than once; Agree to our obtaining from a credit reporting agency a credit report containing information about your personal credit worthiness for purposes of assessing your application and assisting in collecting overdue payments, and to our obtaining information about your commercial activities or commercial credit worthiness from any business which provides information about the commercial credit worthiness of persons, your accountant or any other supplier to you; Agree to our giving to and obtaining from any credit provider named in your application or in a credit report on you issued by a credit reporting agency, information about your credit arrangements for the purpose of assessing your application, notifying a default by you, allowing another credit provider to ascertain the status of your arrangements with us where you are in default with one or more other credit providers and generally assessing your credit worthiness; and Understand the information exchanged can include any information about your business, personal and/or commercial credit worthiness, credit history or credit capacity which the Privacy Act allows credit providers to give to or receive from each other. 1.5 National Relay & Interpreting Service If you have a disability or do not have English as your first language, the Australian Government provides services to assist in understanding & communicating with us. The National Relay Service contact number is The number for the Translating & Interpreting Service is Authorisation 1.2 Applicant Declaration, 1.3 Privacy & Spam, 1.4 Credit Checks, 1.5 National Relay & Interpreting Service and 1.6 Authorisation of this agreement. I have also read and understood the Standard Form of Agreement which is available on our website. I confirm that I am a current legal tenant of the Service Address as specified in section 1.1 Customer Details. If it is subsequently found that I am not a legal tenant or not authorised to sign on behalf of the legal tenant, I agree that any outstanding debt in relation to the services may be transferred into a new account created in my name, and that I will become personally liable for all debts relating to these services. I understand that Direct Debit from either a bank account or credit card is required.

2 - Web: Internet & Voice Internet Options No Internet Required Silver Unlimited - $39 per month (minimum cost: 6 months $333, 12 months $517) Gold Unlimited - $69 per month (minimum cost: 6 months $513, 12 months $877) Platinum Unlimited - $99 per month (minimum cost: 6 months $693, 12 months $1237) Phone Options SC FTTH Phone Monthly Fee: $9.95 / month Included Call Value: Local + National Calls (non SC fibre): N/A 16 per call Calls to other residents on SC fibre network: Calls to Mobiles: Cost of additional extension/line: FREE 22 / min + 20 flagfall $0 / month Timed calls are billed in 30 second increments. Minimum cost: 6 months $158.70, 12 months $ Note: The setup fee is only billed once if connecting both services - it will not be billed for each service. No Phone Plan required First Line Monthly Fee Service Number - if transferring existing service $9.95 Additional Line Monthly Fee Service Number - if transferring existing service $0 I am transferring a landline that is not currently connected to the SC FTTH network. If transferring your existing non-sc FTTH connected Landline, please fill in Section 5 - Port Authority Form. Connection/Setup Charges & Minimum Term For houses where the Fibre To The Home (FTTH) network has been connected to the Network Terminating Unit (NTU) at your home, and is cabled through to ports throughout your home, there will be a Basic Setup fee. For houses where the FTTH network is connected from the street to the NTU, but needs to be patched through to network ports in the home or a wireless router, then a technician will need to attend (rates below). If the FTTH network is not connected from the street to the NTU you will need to contact Sanctuary Cove Body Corporate on Please note, our professional install includes travel and one hour of work. Pricing after this is $165/hour, charged in 15 minute increments. Professional Installation does not include cabling - we can quote on this if required. Minimum Monthly Term & Basic Setup fee - Required: 12 months: $49 Optional Professional Installation (charge is in addition to Basic Setup fee): Yes: +$200 No: +$0 Optional Wireless Router D-Link DIR-853 AC1300: $ D-Link DIR-878 AC1900: $ Transfer Authority You, the authorised signatory, are authorised to sign this transfer authority and make the changes to the services listed in the sections above and agree that the telephone service number(s) under the accounts identified above are to be transferred to us. You acknowledge that the service numbers provided above are correct and correspond to the service numbers you require to be transferred to us. There may be consequences from the transfer arising from an existing telephone contract and it is your responsibility to check the terms and conditions of any existing contracts relevant to the services being transferred. We may choose your carrier. You acknowledge that you may surrender all incentives and benefits with your current telephone company (eg. discount plans, charity concessions). We may ask your current telephone company to release you. You authorise us to sign on your behalf and in your name forms of authority to any current Supplier to transfer your services into your name. The telephone service number(s) will remain active with your current telephone company until the transfer is effective. You will be solely responsible to us for all charges incurred by you on the service numbers you have provided to us for transfer, after the date the transfer is effective. You understand you will still be responsible to your current telephone company for any charges which are incurred and/or billed up to the date the transfer is effective. You will contact your current telephone company in relation to providing service and any faults until the transfer is effective. 2.3 Authorisation 2.1 Internet & Voice, 2.2 Transfer Authority and 2.3 Authorisation, plus sections 4.1 Customer Service Guarantee Waiver, 4.2 Priority Assistance & Emergency Calls Acknowledgement and 4.3 Authorisation of this agreement. I have also read and understood the Standard Form of Agreement which is available on our website. I confirm that I am a current legal tenant of the Service Address as specified in section 1.1 Customer Details. If it is subsequently found that I am not a legal tenant or not authorised to sign on behalf of the legal tenant, I agree that any outstanding debt in relation to the services may be transferred into a new account created in my name, and that I will become personally liable for all debts relating to these services. I understand this service is only available to residents connected to the Sanctuary Cove FTTH Network. I understand that speeds are not guaranteed, and actual speeds may be less due to network contention, and the transmission protocol which uses a portion of the access bandwidth of the Fibre connection to manage the transmission of data (IP overheads). I understand and agree that the Service is not permitted to be re-sold or used for any commercial activities and is provided as a residential service only. If my service is cancelled or terminated for any reason, I will be charged an early termination fee (ETF). This ETF equates to $15 multiplied by the months remaining in your minimum term. Direct Debit from either a bank account or credit card is required.

3 - Web: Direct Debit By signing this document, The Customer authorises The Company and/or its agents (including, but not limited to Telcoinabox Operations Pty Limited trading as Telecommunications Payment Services, Direct Debit User ID and/or Ezidebit Pty Ltd trading as Ezidebit, (Direct Debit User ID number , , , , , ), acting on behalf of The Company, to debit The Customer s account detailed in the Schedule below. Debits may be in any amount and at the time due according to the arrangement between the Customer and The Company concerning charges incurred by the Customer and services provided by The Company. This authority remains in force until you notify The Company that you wish to cancel it. Customer Information of Birth Passport/Licence # ID Expiry Please choose only one method of Direct Debit below: Direct Debit my Bank Account Name on Account Name of Financial Institution BSB Account Number Or Direct Debit my Debit/Credit Card Where payment method is Credit Card or Debit Card, I authorise The Company and/or its agents as specified above to charge the nominated account below. Type of Card (Visa, MasterCard, American Express only) Name on Card CCV Number Card Number Expiry Card Holder s Signature You can find your 3 digit CCV on the signature strip on the back of your card. For American Express, your 4 digit CCV is above the card number on the front. 3.2 Direct Debit Terms & Conditions 1. We agree to be bound by this agreement when we receive your Direct Debit details complete with the particulars we need to draw an amount under it. 2. We only draw money out of your account in accordance with the terms of your agreement with The Company. 3. On giving you at least 14 days notice, we may: Change our procedures in this agreement; Change the terms of your Direct Debit; or Cancel your Direct Debit. 4. When contacting us, you may ask us to cancel your Direct Debit. Please be aware that if direct debit or card charge is required for your service and you ask to cancel or alter the terms of your Direct Debit, this may also involve cancellation of your service with us (and may result in costs and charges). 5. You may dispute any amount we draw under Direct Debit by contacting us, detailing your customer reference details and your bank account or credit card number as applicable. You must provide a detailed explanation of the basis for the dispute to assist in a resolution. 6. We deal with any dispute by the following procedure: We will investigate the dispute, and where necessary you are expected to provide your cooperation. This cooperation may include contacting your bank, providing account statements, or other means of substantiating a dispute. While a dispute is being investigated, you may request that we suspend pending payments until a resolution is reached. Please note that we will keep written record of dispute proceedings to assist in dispute resolution 7. If the day on which you must make any payment to us is not a business day, we will draw on your account under your Direct Debit on the following business day. If your financial institution rejects any of our attempts to draw an amount in accordance with your Direct Debit, we may continue to seek that payment and recoupment of any fees incurred by us as a consequence of that rejection until all amounts due are paid. 8. We will not disclose to any person any information you give us on your Direct Debit, which is not publicly available, unless you dispute any amount we draw under your Direct Debit and we need to disclose any information relating to your Direct Debit or to you or your financial institution to resolve the dispute. 9. To contact us in accordance with the above, please use the contact details available on our website by clicking on the link titled Contact Us. 3.3 Authorisation 3.1 Direct Debit, 3.2 Direct Debit Terms & Conditions and 3.3 Authorisation of this agreement. I have also read and understood the Standard Form of Agreement which is available on our website. I confirm that I am a current legal tenant of the Service Address as specified in section 1.1 Customer Details. If it is subsequently found that I am not a legal tenant or not authorised to sign on behalf of the legal tenant, I agree that any outstanding debt in relation to the services may be transferred into a new account created in my name, and that I will become personally liable for all debts relating to these services. Direct Debit from either a bank account or credit card is required.

4 - Web: Customer Service Guarantee Waiver Part 5 of the Telecommunications (Customer Service Guarantee) Standard 2011 (the CSG Standard) allows us to propose that you waive the protections and rights provided under the Customer Service Guarantee (CSG). The CSG contains performance standards which carriage service providers such as us are required to fulfil (unless the customer has waived these performance standards). A complete version of the CSG and an explanation of its terms are available at the Australian Communication and Media Authority website ( au). The services to which the waiver applies are voice and Internet services delivered using Telair and MyOwn Tel Fibre including: - Home Bundled & Home Standard The protections and rights you are waiving are: 1. The provision of written information The CSG requires carriage service providers to at least every two years give written information to each customer about: - the performance standards that apply to supply of specified services; - the obligations of the provider under those standards; - the customer s entitlements to damages under the Act for contravention of the performance standards; and - rights to receive, on request, information about a performance standard. 2. Guaranteed maximum service connection periods The CSG provides timeframes within which connection to services should occur. 3. Guaranteed maximum fault rectification periods The CSG provides timeframes within which rectification of service faults should occur. 4. Making and changing appointments The CSG requires carriage service providers to: - make appointments with customers at times that are convenient for the customer; - make appointments with customers that are either for a particular time of the day or to nominate a five hour period during which the appointment will occur; and - Change appointments by giving at least 24 hours notice or by obtaining the agreement of the customer to the change. If you waive your rights under the CSG you will not be able to claim compensation from us for any failure to meet the prescribed performance standards in relation to the supply of the service. We ask for this because the Sanctuary Cove Body Corporate own and maintain the fibre network, and as such, MyOwn Tel have no control over its functionality or performance standards. This waiver will take effect when you agree to the waiver as part of the application for the service. You may choose to not agree to a CSG waiver, however, we will not be able to provide this service to you. You may elect to instead use the free Internet provided by Body Corporate, or a 3G/4G mobile broadband service. 4.2 Priority Assistance & Emergency Calls Acknowledgement Due to limitations on the current interface between Internet Voice services and the Emergency Call System 000 number, making calls to the emergency 000 number may not be available from your Fibre Phone service. Please ensure you have access to the emergency 000 number via an alternative mobile number in the event of an emergency or power outage. Priority Assistance is also not available on this service. 4.3 Authorisation 4.1 Customer Service Guarantee Waiver, 4.2 Priority Assistance & Emergency Calls Acknowledgement and 4.3 Authorisation of this agreement. I have also read and understood the Standard Form of Agreement which is available on our website. I confirm that I am a current legal tenant of the Service Address as specified in section 1.1 Customer Details. If it is subsequently found that I am not a legal tenant or not authorised to sign on behalf of the legal tenant, I agree that any outstanding debt in relation to the services may be transferred into a new account created in my name, and that I will become personally liable for all debts relating to these services. Direct Debit from either a bank account or credit card is required.

5 - Web: Porting Authority Form (PAF) Site Contact Information Mobile Landline Port Fees Simple Port: Single Number Cost: $99 each Complex Port: 1 to 2 Number Block Cost: $265 Single Number Port Rejection: $89 Complex Port Rejection: $89 Emergency Return: $60.50 Reschedule: $250 Emergency Return: $ Reschedule: $633 Please ensure there are no additional features such as, but not limited to; Line Hunt, MessageBank, Calling Number Display, Call Control, Call Forward, or Number Redirection etc as your port may fail and a port rejection fee will be charged. Services which are attached to, or are dependent on another service (such as Line Hunt) must be made independent before requesting porting of the service(s), otherwise the port may be rejected. This means any existing Line Hunts need to be removed from all services in the Line Hunt group before you commence porting to Telair. The only exception to this is if you are requesting the port of all linked service numbers in the one application; for example, all linked services in a Line Hunt group, or both the primary and auxiliary number of a Fax Duet service. We do still recommend the services are made independent to ensure the ports are processed smoothly. Number Details Please provide the telephone number(s) below, indicating your choice of Telair or MyOwn Tel as your preferred provider of pre-selectable and local telephone services. Service Type 10 Digit Phone Number Address Losing Carrier Losing Carrier A/C # 5.2 Customer Declaration Porting Authority: I certify that I have the authority as lessee of the telephone numbers listed on this form, or as the authorised agent for the lessee, to request porting of these telephone numbers to Telair and that I, or the lessee (as the case may be), do not have a contractual obligation with another carrier or service provider, relating to these telephone numbers. I request that Telair and/or its agents port the telephone numbers listed and understand that porting will result in disconnection of these telephone numbers from your current carrier and finalisation of the current account(s) for these telephone numbers. I indemnify Telair against any loss or damage it may suffer as a result of any information included in this form or the above certification being incorrect. I also authorise Telair and/or its agents to obtain from my current carrier service details to facilitate this port for services listed above. You warrant that the service numbers provided above are correct and correspond to the service numbers you require to be transferred to us. Providing incorrect information may result in the transfer failing and a port rejection fee being payable. There may be consequences from the transfer arising from an existing telephone contract and it is your responsibility to check the terms and conditions of any existing contracts relevant to the services being transferred. Emergency Return Authority: Emergency Return means the establishment of an interim service by return to your original service, or if that is not possible, establishment of an alternative service. The interim service will operate during the Emergency Return Request period. You will agree to and will seek agreement from your previous supplier to the terms and conditions of the supply of this service prior to the Porting. This includes agreeing to the timeframe in which it will be restored in the event that an Emergency Return is required. You agree that if an Emergency Return is required Telair will request an Emergency Return from your previous carrier during the Emergency Return Request Period without further consultation with you. Acting in accordance with the LNP Code and any other bilateral arrangements, in the event of an Emergency Return to your previous Supplier, Telair: a) will notify your previous Supplier of the Emergency Return requirement; b) is not responsible for any period of outage; and c) is not liable to you or any person claiming through you for any damage, loss, costs or expenses or other liability in contract, tort or otherwise direct or indirect, for or in relation to the Emergency Return (including the negligent act or omission of Telair). Agency Section: I authorise the Telair nominated representative to complete and sign a new PAF for the purposes of carrying out the port to Telair in circumstances where: this PAF expires, additional details are to be added, editing or deleting of details is required, Telair requires an agent or 3rd Party to perform part or all of the port. This authority will remain in place for 12 months from the date of signature or until such time as Telair is otherwise notified. Local Number Portability: The Porting of your Phone Number will be conducted in accordance with the Australian Communications Industry Forum, Industry Code - Local Number Portability ACIF C540 September 1999 ( LNP Code ) and any bilateral arrangements. Subject to the terms and conditions of the Standard Agreement, you may Port your Phone Number from your previous Supplier to Telair if that Phone Number is declared Portable under the ACA Numbering Plan 1997 and no exemption has been granted by the ACA. If you wish to Port your Phone number from Telair to another Supplier, then you must contact that other Supplier. Porting from Telair to another Supplier will be conducted in accordance with the LNP Code and any other bilateral arrangements. Porting away from Telair is at the cost of $ per request and may incur a contract payout fee if the service is still under contract. In order for Telair to Port your Phone number you must complete and sign this Porting Authority Form (PAF), which also includes authority for Emergency Return. In order for the Port to proceed, this form must be completed in accordance with the LNP Code and any other bilateral arrangements. In accordance with the LNP code, a request for Porting shall be rejected if: a) the request is for the Porting of Out of Area Numbers; b) the request is for the Porting of non-portable telephone Numbers; c) the LNP Code requires the request to be rejected; d) Telair cannot otherwise provide portability for that Phone Number in that circumstance; or e) account information provided in this form is incorrect or incomplete. Telair cannot Port your Phone Number and move the address of your Phone Number on the same day. If your Phone Number(s) is inactive at the time of the Porting by Telair, you must notify Telair as soon as the Phone Number(s) become active. Telair charges you for the Porting of a Phone Number. For charges please refer to the Section 5.1 of this application form. You acknowledge that by Porting the Telephone Number, any DSL/Spectrum Sharing Service associated with that Telephone Number is disconnected and may result in finalisation of the Customer s DSL/Spectrum Sharing account for that service. You acknowledge that although you have the right to Port your Telephone Number(s) to Telair, there may be costs and obligations associated with the Port which may include Early Termination Fees and Porting fees for your existing carrier. 5.3 Authorisation I have read and understood the Standard Form of Agreement available on our website, and understand and agree to sections 5.1 Porting Authority Form (PAF), 5.2 Customer Declaration and 5.3 Authorisation of this agreement. Direct Debit from either a bank account or credit card is required.