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Complete Contact Details ( ALL CAPS ) CUSTOMER TYPE: INDIVIDUAL COMPANY COMPANY REG NO: FIRST NAME: LAST NAME: TITLE: IDENTITY NUMBER: BIRTH DATE: DD / MM / YY MOBILE NUMBER: EMAIL ADDRESS: HOME NUMBER: WORK NUMBER: PHYSICAL ADDRESSS: POSTAL ADDRESSS: RECEIVE EMAILS / UPDATES ON SPECIALS: YES NO RECEIVE EMAILS / DATA USAGE : YES NO Select your Equipment Installation Type 24 MONTH CONTRACT 24 MONTH CONTRACT RENT ONLY: R100p/m RENT TO OWN: Rent: Antenna, Bracket, Pole, 1 x Network Point*Excluding Wi-Fi Router* Rent: Antenna, Bracket, Pole, 1 x Network Point*Excluding Wi-Fi Router* MONTH TO MONTH CONTRACT ONCE OFF: R2500 Once Off: Antenna, Bracket, Pole, 1 x Network Point*Including STD Wi-Fi Router* Select Wi-Fi Router Type TOTO-LINK N600R WIRELESS ROUTER TOTO-LINK N300RH WIRELESS ROUTER TOTO-LINK AC WIRELESS ROUTER 600Mbps Wireless N speed Stable Wireless Perfomance Boost your wi-fi by Turbo Switch 4 x 10/100Mbps Ethernet LAN Ports 600Mbps Wireless N speed Ultra-broad Wireless Coverage 11dBi High Gain antennas 4 x 10/100Mbps Ethernet LAN Ports 1.2Gbps Fast Wi-Fi MU-MIMO Technology / 802.11ac wave2 Simultaneous Dual Band 1Ghz CPU for Powerful Performance 4 x 10/100Mbps Ethernet LAN Ports R499.00 R750.00 R750.00 Wireless Internet Application form Address 22 Debussy street Dalvale Paarl 7646 Contact us Office: 021 001 8851 Accounts: 021 001 8820 Email [email protected] [email protected] [email protected] Reg.No: 2014/029533/07 R125p/m

Wireless Internet Application form · TOTO-LINK N600R WIRELESS ROUTER TOTO-LINK N300RH WIRELESS ROUTER TOTO-LINK AC WIRELESS ROUTER 600Mbps Wireless N speed Stable Wireless Perfomance

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Page 1: Wireless Internet Application form · TOTO-LINK N600R WIRELESS ROUTER TOTO-LINK N300RH WIRELESS ROUTER TOTO-LINK AC WIRELESS ROUTER 600Mbps Wireless N speed Stable Wireless Perfomance

Complete Contact Details ( ALL CAPS )

CUSTOMER TYPE: INDIVIDUAL COMPANY COMPANY REG NO:

FIRST NAME: LAST NAME: TITLE:

IDENTITY NUMBER: BIRTH DATE: DD / MM / YY

MOBILE NUMBER: EMAIL ADDRESS:

HOME NUMBER: WORK NUMBER:

PHYSICAL ADDRESSS:

POSTAL ADDRESSS:

RECEIVE EMAILS / UPDATES ON SPECIALS: YES NO RECEIVE EMAILS / DATA USAGE : YES NO

Select your Equipment Installation Type

24 MONTH CONTRACT 24 MONTH CONTRACT

RENT ONLY: R100p/m RENT TO OWN: Rent: Antenna, Bracket, Pole, 1 x Network Point*Excluding Wi-Fi Router* Rent: Antenna, Bracket, Pole, 1 x Network Point*Excluding Wi-Fi Router*

MONTH TO MONTH CONTRACT

ONCE OFF: R2500 Once Off: Antenna, Bracket, Pole, 1 x Network Point*Including STD Wi-Fi Router*

Select Wi-Fi Router Type

TOTO-LINK N600R WIRELESS ROUTER TOTO-LINK N300RH WIRELESS ROUTER TOTO-LINK AC WIRELESS ROUTER

600Mbps Wireless N speed Stable Wireless Perfomance Boost your wi-fi by Turbo Switch 4 x 10/100Mbps Ethernet LAN Ports

600Mbps Wireless N speed Ultra-broad Wireless Coverage 11dBi High Gain antennas 4 x 10/100Mbps Ethernet LAN Ports

1.2Gbps Fast Wi-Fi MU-MIMO Technology / 802.11ac wave2 Simultaneous Dual Band 1Ghz CPU for Powerful Performance 4 x 10/100Mbps Ethernet LAN Ports

R499.00 R750.00 R750.00

Wireless Internet Application form

Address

22 Debussy street Dalvale Paarl 7646

Contact us

Office: 021 001 8851 Accounts: 021 001 8820

Email

[email protected] [email protected] [email protected]

Reg.No: 2014/029533/07

R125p/m

Page 2: Wireless Internet Application form · TOTO-LINK N600R WIRELESS ROUTER TOTO-LINK N300RH WIRELESS ROUTER TOTO-LINK AC WIRELESS ROUTER 600Mbps Wireless N speed Stable Wireless Perfomance

Uncap Lite Uncapped Lite packages have a thresholds after which speeds could be subject to shaping and throttling of up to 75%.

Packages are subject to throttling only when a user has reached their monthly threshold. These packages also have standard priority during business hours.

Speed Threshold Speed Reduces / Throttled

2Mbps - after 80GB > 512Kbps

4Mbps - after 175GB > 1Mbps

8Mbps - after 220GB > 2Mbps

10Mbps - after 350GB > 2Mbps

Page 3: Wireless Internet Application form · TOTO-LINK N600R WIRELESS ROUTER TOTO-LINK N300RH WIRELESS ROUTER TOTO-LINK AC WIRELESS ROUTER 600Mbps Wireless N speed Stable Wireless Perfomance

Terms & Conditions

1.1 “Acceptance Date” means the date, on which you accepted the Agreement, be that in writing or by way of electronic

medium, for example by clicking “I agree” on a web page or via your mobile phone, or telephonic acceptance;

1.2 “Activation Date” means the date on which EM-i.t Technologies will give you access to and/or enable you to use a product

or service;

1.3 “Agreement” means the agreement concluded between you and EM-i.t Technologies in respect of the product or service

contemplated in the Application Form which agreement will be exclusively governed by these general terms and conditions

and the product specific terms and conditions applicable to the relevant product or service ("Product Terms") read together

with the Application Form;

1.4 “Application Form” means the document (including any electronic document) on which (inter alia) you selected your

service or product of choice;

1.5 “AUP” means our Acceptable Use Policy (including our FUP) attached hereto as part of the Agreement, and which policy all

Customers must adhere to and which policy was made by us to ensure: that we honour our commitment to comply with

legislation; that all Customers use our network and services in a safe and responsible manner and without interference or

harassment from others; that we protect our network against security threats; and that we ensure that the conduct of no one

Customer prejudices the user experience of other Customers.

1.6 “Business Day” means Monday to Friday, but excludes Saturday, Sunday and a day which is an official public holiday in the

Republic of South Africa;

1.7 “Business Hours” means the hours between 07h30 and 18h00 on a Business Day;

Page 4: Wireless Internet Application form · TOTO-LINK N600R WIRELESS ROUTER TOTO-LINK N300RH WIRELESS ROUTER TOTO-LINK AC WIRELESS ROUTER 600Mbps Wireless N speed Stable Wireless Perfomance

1.8 "CPA" means the Consumer Protection Act, 2008; 1.9 “Electronic Communications Act” means the Electronic

Communications Act, 2005; 1.10 “ECT Act” means the Electronic Communications and Transactions Act, 2002;

1.9 “Equipment” means any device, equipment or hardware used to access the services or used in conjunction with the

services, including any SIM (Subscriber Identity Module) card;

1.10 “FUP” means the Fair Use Policy forming part of our AUP;

1.11 “ICASA” means the Independent Communications Authority of South Africa;

1.12 “Intellectual Property Rights” means the copyright in any work in terms of the Copyright Act, No. 98 of 1978, and includes

without limitation the right to reproduce that work, the rights in respect of a trade mark conferred by the Trade Marks Act, No.

194 of 1993, the rights in respect of a design conferred by the Designs Act, No. 195 of 1993, and the rights in respect of a patent

conferred by the Patents Act, No. 57 of 1978 including any applications for the a foregoing and any names, licenses,

know how, trade secrets and data associated with the afore going;

1.13 “IP Services” means services or products that provide (or include) internet services, including but not limited to, any service

providing access to the internet or using internet protocols, any hosting services (data/content hosting, server hosting, web

hosting, e-mail services, etc.) or any other services provided over our network or the internet;

1.14 "Juristic Person" means a company or close corporation and includes a body corporate, partnership, association or trust;

1.15 “EM-i.t Technologies Marks” means any trademarks, logos, brand names, trade names domain names or other names or

marks of EM-i.t Technologies whether registered or not;

1.16 “NCA” means the National Credit Act, 34 of 2005;

1.17 “Network” or “network” or “our network” means any network, electronic communications network, system, server,

hardware or technology infrastructure, or the like, including without limitation third party networks and/or Network Operator

networks, owned or used by us or provided by us or our third party suppliers or the Network Operators, for purposes of

providing any EM-i.t Technologies service or product to Subscribers or providing access thereto;

1.19 “Network Coverage” means the geographical area within which the service can be accessed and used by you as

determined at the time coverage was established;

1.20 “Network Operator” means a company that owns or operates an electronic communications network, and which makes

such network and the electronic communications services conveyed over such network available to other industry players for

commercial purposes (e.g. Vodacom, MTN, Cell C, and Telkom);

1.21 “Subscriber”, “you” or “Customer” means a user of any of our products or services;

1.22 “Uncontrollable Event” means (including without limitation) any fire, flood, earthquake, elements of nature or acts of God,

riots, civil disorders, rebellions or revolutions in any country or any other cause beyond the reasonable control of EM-i.t

Technologies including the termination or suspension of a service or product provided by a Network Operator and/or third

party suppliers, that may result in a delay or a failure to provide any product or service; and

1.23 “VAT” means Value Added Tax as provided for in the Value Added Tax Act, 1991.

Page 5: Wireless Internet Application form · TOTO-LINK N600R WIRELESS ROUTER TOTO-LINK N300RH WIRELESS ROUTER TOTO-LINK AC WIRELESS ROUTER 600Mbps Wireless N speed Stable Wireless Perfomance

Privacy Policy

1. EM-i.t Technologies will protect the confidentiality of its subscribers' information, and use its subscribers'

information only for the purpose permitted or required.

2. EM-i.t Technologies will only release its subscriber's information to a third party under the following

circumstances:

2.1 when directed by the written instruction of the subscriber or prospective subscriber;

2.2 when directed by an order of Court;

2.3 to the Independent Communications Authority of South Africa for the purpose of compiling, verifying or

auditing any reports, accounts or other information required under EM-i.t Technologies licence or in terms of the

Electronic Communications Act, 2005 and the regulations made pursuant to that Act;

2.4 where it is necessary to properly deal with and comply with any legislative enactment or regulation in respect

of any complaint lodged in terms of EM-i.t Technologies complaints handling procedure;

2.5 during the process of debt collection;

2.6 to EM-i.t Technologies attorneys in connection with any potential, threatened or actual litigation;

2.7 to EM-i.t Technologies auditors for the purpose of auditing their accounts; and

2.8 in terms of any applicable law.

3. We are not responsible for the privacy practices of or the content on sites linking out of EM-i.t Technologies

network. You agree to exclude EM-i.t Technologies from any liability arising from your access to sites other than

those on the EM-i.t Technologies network.

Service Delivery Policy

1. EM-i.t Technologies will make all its services and products available to you in accordance with the provisions of its Code of

Conduct and Service Charter.

2. EM-i.t Technologies will use reasonable endeavours to make its services available to its Subscribers, and to maintain the

availability thereof for use by its Subscribers. However, we provide the services “as is” and “as available” and we do not make

any express or implied representations or warrant or guarantee the quality or security of the services or that the services will at

all times be free of errors or interruptions, be always available, fit for any purpose, not infringe any third party rights, be secure

and reliable, or will conform to your delivery timeline requirements subject always to the provisions of the CPA where

applicable.

3. EM-i.t Technologies will use its best endeavours to notify you in advance of any maintenance and repairs, which may result

in the unavailability of a service, but cannot always, guarantee this. We are committed to provide you with uninterrupted

services. However, we cannot guarantee that service and the allocated capacity will always be available.

4. We can terminate the service at any time if we decide to discontinue the service offering for any reason whatsoever, without

any further liability to you.

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Cancellation / Refund Policy

1. EM-i.t Technologies policy in respect of exchanges, returns and refunds depends on, inter alia, the type goods and the

policy of the manufacturer or supplier thereof. Where the CPA applies to you, EM-i.t Technologies policy in this regard will

comply with the requirements of the CPA in relation to exchanges, returns and refunds.

2. Data packages get calculated on pro rata monthly basis for the purchase of refunds and / or invoicing.

3. Warranties, if any, will ordinarily be included in the hardware packaging.

4. Any notice to EM-i.t Technologies by you for cancellation in terms of the Agreement shall be made in writing and unless

otherwise prescribed by law, such notice must be made in accordance with the EM-i.t Technologies provisioned cancellation

procedures.

5. Termination of any agreements shall be governed by and given effect to as contemplated in the agreement. In particular,

month to month agreements may be terminated by either EM-i.t Technologies or you on 1 (one) calendar month's notice,

save to the extent provided otherwise in the Product Terms, which termination will take effect on the first day of the month

immediately following the end of the applicable notice period.

Additional mandatory documents

SA Identity Document.

Proof of address where installation will occur. ( no later than 3 months )

Proof of bank account.

Latest 3 Months Bank Statement. ( Only on Rent Only / Rent to own Contracts )

Installation Date

( Office Only)

Client Witness Phil Daniels ( Technical / Partner )

Client Signature Bevan Valentine ( Operations / Partner )

Page 7: Wireless Internet Application form · TOTO-LINK N600R WIRELESS ROUTER TOTO-LINK N300RH WIRELESS ROUTER TOTO-LINK AC WIRELESS ROUTER 600Mbps Wireless N speed Stable Wireless Perfomance

Reg Nr: 2014/029533/07

WIRELESS INTERNET SERVICE PROVIDER / COMPUTER SALES / REPAIRS / NETWORKING

22 Debussy Street

Dalval, Paarl, 7646

Written Authority and mandate for debit payment instructions

(Pty) Limited

For Office use /ref

DATE 2018/11/19

Office: 021 001 8851 / Accounts: 021 001 8820 > Technical / Sales: 021001 8851 / OPEN WEEKDAYS * 08:00am - 05:00pm

Technical / Sales: [email protected] Accounts: [email protected] Wireless Internet: [email protected]

Website: www.em-it.co.za

Customer Office Only

Customer

Date received:

Address

Cell:

Tel no:

Fax No:

Bank

To:

Bank Account number Abbreviated Shortname as registered with the acquiring bank:

EMIT

Branch Code

Beneficiary Address

Type of Account Refer to our Contract Reference Number:

I/We hereby request, instruct and authorize you to debit my/our above mentioned bank account at the above mentioned bank with R being the amount required for payment of the monthly installment due in respect of the above mentioned agreement on the chosen date below

Date to choose from

15th

16th

25th

26th

31st

I/We hereby authorise to EM-IT Technologies (Pty) Ltd issue and deliver payment instructions to your banker for collection against my/our abovementioned account at my/our abovementioned bank on condition that the sum of such payment instructions will not differ from my/our obligations as agreed to in the Contract Reference Number.

I/we understand that the withdrawals hereby authorised will be processed through a computerised system provided by the South African banks. I also understand that details of each withdrawal will be printed on my bank statement. Such must contain a number, which must be included in the said payment instruction and if provided to me should enable me to identify the Agreement.

If however, the date of the payment instruction falls on a non-processing day (weekend or public holiday) I agree that the payment instruction may be debited against my account on the following business day; or subsequent payment instructions will continue to be delivered in terms of this authority until the obligations in terms of the agreement have been paid or until this authority is cancelled by me/us by giving you notice in writing.

I/We agree to pay any bank charges relating to this debit order instruction. This authority may be cancelled by me/us

by giving you 30 day’s notice in writing, sent by prepaid registered post, but I/we understand that I/we am/are not entitled to a refund of amounts withdrawn by you while this authorisation was in force. Receipt of this instruction by you shall be deemed receipt thereof by my/our bank (as the case may be)

(B)Mandate

I/We acknowledge that my /our above-mentioned Bank shall treat all payment instructions issued by you as if the instructions have been issued by me/us personally.

(C) Cancellation

I/We agree that although this authority and mandate may be cancelled by me/us, such cancellation will not cancel the agreement. I/We shall not be entitled to any refund of amounts, which you have withdrawn whilst this authority was in force, if such amounts were legally owing to you.

(D) Assignment

I/We acknowledge that this Authority may be ceded or assigned to a third party if the Agreement is also ceded or assigned to that third party, but in the absence of such assignment of the agreement, this Authority and mandate cannot be assigned to any third party.

Customer Authorization signature Emit Technologies Representative