| DSL Service Provided To: | DSL Service Provided By: |
| Name __________________________________ | SOTA Technologies, Inc. |
| Address __________________________________ | 441 Main St. |
| __________________________________ | Coshocton, OH 43812 |
| Contact Phone ___________________________ | 740-623-2662 |
| Phone # for DSL ___________________________ | 740-623-2690 (fax) |
| I wish to order the services and/or equipment noted below. I understand this contract apply. I have read this contract and agree to pay all charges as described. | is for a 12-month period and that early termination fees |
Signature _________________________________________ New Logon name to be established * ___________________ (*cannot be the same as your dial-up account) Computer type (please circle) - Desktop OR Laptop Operating System _______________________________ |
Date ____________________________ Password_________________________ Number of computers to be connected to DSL __________ Number of phone jacks (other than for computer) ________ Number of wall phones _________ |
Do you have multiple phone lines? Y or N (If yes, this could affect the cost of your installation. Talk to your phone company.) |
|
Please bill me MONTHLY or Bi-MONTLY or QUARTERLY or Semi-ANNULLY or ANNUALLY via EMAIL (email address _______________________________) or US MAIL or CREDIT CARD Type: VISA, MASTER CARD, DISCOVER, Card number _________________________________ |
|
| Equipment/Service provided by SOTA Technologies |
| (Please indicate the desired services and/or equipment and place your initials beside the item.) |
Residential DSL Package |
Price |
Standard Equipment/Features |
|
____ Primary + |
$29.95/month |
DSL Circuit |
|
____ Basic I |
$69/month |
DSL Modem * |
|
____ Basic + |
$89/month |
Content Filtering |
|
____ Self Install |
$ 0 |
Personal Homepage (up to 5 mg) |
|
____ SOTA Install |
$149 |
Email Scanning |
|
____ Saferinternet OR |
Spam Blocking |
||
____ Gurulink |
Virus Blocking |
||
Optional Equipment/Service |
Price |
Up to 5 email accounts |
|
____ Single Static IP |
$10/month |
10 foot CAT-5 cable |
|
____ 2- 5 Static IP ** |
$20/month |
* Must be returned upon termination of service |
|
____ 5 Additional Email accounts |
$ 1/month |
** Additional hardware required |
|
Email Account(s) Ex: me@saferinternet.com |
Password |
Optional Email Account(s) |
|
1. (Main account from above) |
(Above) |
1. |
|
2. |
2. |
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3. |
3. |
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4. |
4. |
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5. |
5. |
Applicable to Dynamic Products
Laptop users and some desktop users may need to purchase an Ethernet card.
Applicable to Static Products
Offer includes the use of a DSL router. The DSL router must be returned upon termination of service.