Ver 1.1
DOMESTIC BANDWIDTH SERVICE ORDER FORM
PLEASE READ THE TERMS AND CONDITIONS AS PRINTED IN THE MASTER SERVICE AGREEMENT (MSA) AND THE SPECIFIC
TERMS AND CONDITIONS APPLICABLE TO THE SERVICE THAT YOU REQUIRE AS ATTACHED BEFORE COMPLETING THIS
SERVICE ORDER FORM.
REGISTRATION BY COMPANY MUST BE MADE BY AUTHORISED PERSONNEL OF THE COMPANY.
IMPORTANT:
INSTRUCTIONS:
1.
2.
3.
Please double click the shaded fields to fill out, delete or amend details.
Please fill out ALL shaded fields.
Please send this application to TM Sales
Customer
Reference: No:
1 - CUSTOMER INFORMATION
Date: dd-mm-yyyy
Business Registration Number :
Company Name:
Correspondence Address:
Postal Code:
City/State:
Contact Person Details:
Title:
Mr.
Mrs.
Miss
Name:
Telephone Number:
Mobile Number:
Fax Number:
E-mail:
2 - BILLING AND PRICING DETAILS
Company Name:
Correspondence Address:
Postal Code:
City/State:
Contact Person Details:
Title:
Mr.
Mrs.
Miss
Name:
Mobile Number:
Telephone Number:
Fax Number:
E-mail:
Payment Term:
Monthly In Advance
Quarterly In Advance
Half Yearly In Advance
Yearly In Advance
Pricing Details:
Charge Type
Charges (RM)
Installation (One Time)
Rental of Domestic Bandwidth Service
Others
3 – SERVICE DETAILS AND CONTRACT INFORMATION
Order Type:
New Installation
Termination
Contact Person :
Relocation
Leg B Address:
Leg A Address :
City/State :
Upgrade
Postal Code :
Tel No :
Requested Ready For Service (RFS) Date : dd-mm-yyyy
Postal Code :
City/State :
Contact Person :
Initial Term :
Tel No :
year(s)
4 – TECHNICAL DETAILS
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Ver 1.1
DOMESTIC BANDWIDTH SERVICE ORDER FORM
Narrowband Bandwidth
1) Speed
64 kbps
128 kbps
192 kbps
256 kbps
384 kbps
512 kbps
768 kbps
1 Mbps
1.5 Mbps
2 Mbps
Broadband Bandwidth
1)
2)
Interface Protocol
V.35
V.36
G 703
Direct Access
Others : : please
specify
3)
Service Assurance :
Standard : 1+0 No
Protection
Premium : 1+1
Protection *
2) Interface Protocol
V.35
V.36
G 703
Direct Access
Others : : please specify
3)
Service Assurance :
Standard : 1+0 No Protection
Premium : 1+1 Protection *
4)
Service Delivery :
Standard
Express**
Speed
34 Mbps
45 Mbps
155 Mbps
622 Mbps
4)
Service Delivery :
Standard
Express**
Ethernet Private Line
1) Speed
4 Mbps
6 Mbps
8 Mbps
10 Mbps
20 Mbps
30 Mbps
40 Mbps
50 Mbps
60 Mbps
70 Mbps
80 Mbps
90 Mbps
100 Mbps
Optical Bandwidth
1) Speed
2.5 Gbps
10 Gbps
2)
Interface Protocol
STM - 1 / 4 / 16 / 64
ESCON - 200 Mbps
Fiber Channel – 1.062
Gbps
FICON - 1.062 Gbps
GbE - 1.25 Gbps
Others : : please
specify
2) Interface Protocol
FE
GE
Others : : please specify
3) Service Assurance :
Standard : 1+0 No
Protection
Premium : 1+1
Protection *
3) Service Assurance :
Standard : 1+0 No Protection
Premium : 1+1 Protection *
4) Service Delivery :
Standard
Express**
4) Service Delivery :
Standard
Express**
Note:
* please specify SLG package
** After infra-checking and confirmed that infra is available
Additional Information:
5– DECLARATION OF APPLICATION
We hereby agree to be bound by the terms and conditions stated in the Master Service Agreement and the Specific Terms and
Conditions, for the provision of the telecommunication service requested by us and provided by you. We further confirm that the
information given on this form is true and correct.
Signature
:______________________________
Name
:______________________________
Designation
:______________________________
Witness by
:______________________________
Name:
:______________________________
Designation
:______________________________
Date:___________________________
Business Stamp:
6– FOR TM OFFICE USE ONLY
1.
2.
3.
Date of Service Order Form Received :
Mutually Agreed RFS Date :
Remarks :
Signature
:______________________________
Name
:______________________________
Designation
:______________________________
Date:___________________________
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