REQUEST FOR MONITORING SERVICES We’d Love to Hear From You Client Name Installation Address Contact Person Premise Phone Number Mobile Phone Number Facsimile Phone Mailing Address (if different) Monitoring Code Alarm Type Alarm Model No. Reporting Format Commercial Domestic Installation Date Activation Only - Fully Scheduled - Radio – Medic - Permaconn ZONE 1 ZONE 2 ZONE 3 ZONE 4 ZONE 5 ZONE 6 ZONE 7 ZONE 8 ZONE 9 ZONE 10 ZONE 11 ZONE 12 ZONE 13 ZONE 14 ZONE 15 ZONE 16 RESPONSE DISPATCH GUARD, NOTIFY KEYHOLDER IN EVENT THAT BREAK-IN DETECTED. DISPATCH GUARD, PLUS NOTIFY KEYHOLDER OF DISPATCH NOTIFY KEYHOLDER, IF NO KEYHOLDER CONTACTED, DISPATCH GUARD NOTIFY KEYHOLDER ONLY - Client must initial to accept responsibility. ALARM ON DISARM – NO ACTION REQUIRED - Client must initial to accept responsibility GUARD RESPONSE COMPANY: User 1 Code/Password User 1 Name User 1 User 1 Phone User 2 Code / Password User 2 Name User 2 Phone User 2 User 3 Code / Password User 3 Name User 3 Phone User 3 User 4 User 4 Code / Password User 4 Name User 4 Phone FULLY SCHEDULED CLIENTS ONLY: Note these are not business hours. These are the earliest and latest time staff are permitted to be on site. A 30 minute window is permitted either side of these times. Sunday OPEN CLOSE Monday OPEN CLOSE Tuesday OPEN CLOSE Wednesday OPEN CLOSE Thursday OPEN CLOSE Friday OPEN CLOSE Saturday OPEN CLOSE State Holidays Observed - Other Instructions RESPONSE FOR MAINTENANCE ALARMS Technician Client Both Send Call Today For A Free Estimate 0800 427 747 Address 101 Diana Drive, Glenfield, Auckland Contact Us Phone: 09 520 4875Fax: 09 442 4534