SAMFS IP Fire Line
Application Form
Email a signed and completed copy to: Telstra.Business.IP@team.telstra.com
For further assistance please contact your Telstra Representative or call 13 22 53.
*Office Use Only – Network Number N8008285R*
Company Name is the legal
entity under which the service
will be registered. In this
Application Form, references
to "you", "I" or “us” refer to the
entity listed under Section A
(Customer Details).
ACN / ABN is Australian
Company Number or
Australian Business Number.
Trading / Business Name is
not a legal entity but is the
name under which your
business trades.
Contact Name is the person
representing the customer for
billing and contract
administration.
Section A: New or Incoming Customer Details
Company Name
ACN or ABN
Registered Address
Trading / Business Name
Contact Details
Contact Name
Contact Details
Ph (wk):
Ph (mb):
Fax:
Email:
You must promptly notify
Telstra of any changes to the
details in this Application
Form.
Service charges
The fees and charges for your
IP Fire Line are the applicable
fees and charges set out in
Our Customer Terms and this
Application Form, in addition to
the maintenance fee below.
Section B: Service Details
I am applying for (note that SAMFS approval is required for all applications):
CONNECTION of a new IP Fire Line
-
Telstra to install, test and tag a PSTN (“Site Service”) to the site MDF only (you must
arrange for the supply of and termination to ASE Fire Panel).
-
Telstra to connect an IP WAN Port for connection to the SAMFS VPN (“Network
Service”).
Maintenance fee
If Telstra is requested to
attend the customer’s site to
attend to a fault subsequently
proven to be in the customer’s
equipment or otherwise
outside of Telstra’s control, an
incorrect call out charge will
apply.
Last updated 31 July 2013
CHANGE OF LESSEE of an existing IP Fire Line
-
IP WAN Port FNN: N
R
-
IP WAN PSTN: 08
-
Incoming customer to complete this IP Fire Line Application Form (except Section G)
-
Outgoing Customer to complete Section G
Telstra Corporation Limited
ABN 33 051 775 556
Page 1
South Australian
Metropolitan Fire Service
(“SAMFS”) Authorisation
You must obtain SAMFS
Authorisation on all
applications - see section F.
CANCELLATION of an existing IP Fire Line (note that the SAMFS will require Council
Approval for this cancellation)
-
IP WAN Port FNN : N
-
IP WAN PSTN: 08
R
Council approval
documentation is required for
IP Fire Line cancellation by the
SAMFS
Address where IP Fire Line
will be connected. Note: a
new PSTN service must be
installed for the IP Fire Line you cannot nominate an
existing service.
Section C : Site Details
IP Fire Line Site Address
Address where the IP Fire
Line Site Service will be
connected
Building/Site Name :
Contact Details
Shop/Unit/Floor :
Street No. and Name:
Suburb/Town:
Postcode:
IP Fire Line Site Contact
Name of on-site contact
Phone No. of on-site contact
Building Details
Is the building owned or leased?
If leased, building owner/agent:
Leased
Owned
Name:
Phone No:
Does the building exist or is it under
construction?
Existing
Under construction
What type of building is it?
Residential
Commercial
Is the building multi-storey?
Yes
No
Is lead-in required?
Yes
No
If yes, please add details in the “Additional Customer
Info” section below.
Please indicate whether you
require a new Telstra Account
or have an existing Telstra
Account.
Section D : Billing Details
New account
OR
Bill services to existing account
For New Accounts, please specify the address you want your bill sent to:
Billing Address
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Telstra Corporation Limited
ABN 33 051 775 556
Page 2
Full National Number (FNN)
is the number Telstra uses to
identify your service. It is listed
on your bill.
If you have an existing Telstra
Account, you may include a
Billing Reference ID. This
should be 16 alphanumeric
characters in length and will
identify bills for your service if
the same Account No. is used
for multiple services.
If you have an existing Telstra Account, please specify your Account / Full National Number
(FNN), Billing Reference ID and Billing Aggregator number (if applicable):
Existing Account No. / FNN
Billing Reference ID
Billing Aggregator No.
Our Customer Terms means
the Standard Form of
Agreement formulated by
Telstra for the purposes of
Part 23 of the
Telecommunications Act 1997
(Cth), as amended by Telstra
from time to time.
Section E : Customer Declaration
You may view Our
Customer Terms at
http://www.telstra.com.au/c
ustomerterms/ or obtain a
copy from Telstra.
I acknowledge that I have either received, or have had the opportunity to review, a copy of Our
Customer Terms
Privacy
Telstra’s Privacy
Statement is available at
http://www.telstra.com.au/
privacy or by calling
Telstra on 1800 039 059.
(a)
use and disclose information about each of us in accordance with Telstra’s Privacy
Statement; and
(b)
give to, seek and obtain from, a credit reporting agency, information (including
personal and credit information) about each of us to assess your credit worthiness.
By signing you represent and
warrant that you have the
authority to make this
application on behalf of the
customer named above.
I agree that Telstra may send commercial electronic messages (including information about
Telstra’s products and services) to each of the electronic addresses for which I am the account
holder, unless I tell Telstra otherwise.
I apply for Telstra’s IP Fire Line service described in this Application Form and acknowledge
that if Telstra accepts my application, the service will be provided on the terms and conditions
set out in this Application Form (including the IP Fire Line Terms and Conditions below) and Our
Customer Terms. To the extent of any inconsistency between those documents, the following
order of precedence applies – Our Customer Terms and then this Application Form.
I agree, and will ensure that any of our related bodies corporate which receive services
connected with this Application Form and our representatives are aware, that Telstra may:
I agree to ensure that the equipment attached to the IP Fire Line service is compatible with the
IP Fire Line service as specified by SAMFS and I confirm that my purpose is to use the IP Fire
Line service within those specifications.
I acknowledge that additional costs may apply if I request that the information I have provided
on this Application Form be changed or withdrawn. I agree to pay those additional costs on
request.
I agree to pay the charges for the IP Fire Line service as set out in this Application form.
I agree and acknowledge that the SAMFS' authorisation of this Application Form is for
administrative purposes only, to assist Telstra and SAMFS to manage and coordinate their
records. In some cases, the authorisations made by SAMFS in this Application Form will be
based on information provided by third parties and SAMFS will be in no way liable for any harm
(including death), loss, damage or cost arising from reliance on any such representation. In the
case of an application for a cancellation of an IP Fire Line service, I acknowledge that SAMFS'
authorisation is based upon information provided to SAMFS by me and the local council body in
which my building is located and agree to release and indemnify SAMFS against any loss,
damage or cost arising from a representation which I have made being incorrect. I also
acknowledge and agree that I am solely responsible for determining whether my building's fire
alarm needs to be monitored, for ensuring that the proper equipment is installed and is in
working order and for obtaining and maintaining an IP Fire Line service to allow my building's
alarm to be monitored by SAMFS.
Important Information for Incoming Customer relating to Change of Lessee
- Before agreeing to take over the ownership of the services listed in Section G, you should
satisfy yourself of the details of the services. You may want to contact the Outgoing Customer
or Telstra to discuss this.
On behalf of the Incoming Customer, I request Telstra transfers the services listed in Section G
from the Outgoing Customer, whose details appear in Section G of this form to me, the
Last updated 31 July 2013
Telstra Corporation Limited
ABN 33 051 775 556
Page 3
Incoming Customer.
I agree:
- that if Telstra accepts this request, the services listed in Section G will be provided by Telstra
to me, the Incoming Customer, in accordance with Our Customer Terms (located at
http://www.telstra.com.au/customerterms/index.htm), this Application Form and any Telstra
agreement with me;
- Telstra’s acceptance of this request is subject to, amongst other things, Telstra’s credit
approval process;
- and acknowledge that I have had the opportunity to review a copy of Our Customer Terms;
- and acknowledge that I have read and understand all statements made in this form;
- I will be liable for all debts incurred on the services listed above from the date of transfer; and
- I will be liable for all outstanding charges for the Fixed and Internet services listed above.
I warrant that I am authorised to make this request on behalf of the Incoming Customer
SIGNED by me, for and on behalf of the Customer as its authorised representative:
Signature
Date
Print Name
Position
Additional Customer Information
Customer must send this
Application Form to SAMFS
for authorisation:
Section F: SAMFS Authorisation
Approval given for
CONNECTION of a new IP Fire Line to SAMFS’ VPN
Email :
Site within SAMFS gazetted area
communitysafety@samfs.sa.g
ov.au
(if ‘No’ application to be rejected)
Or
Yes
No
CANCELLATION of an existing IP Fire Line
Postal :
Council Approval provided
SAMFS, Alarms Officer
GPO Box 98,
Adelaide SA 5001
Yes
No
(if ‘No’ application to be rejected)
CHANGE OF LESSEE of an existing IP Fire Line
Or
Fax : 08 8204 3781
Once SAMFS authorisation is
granted, customer to submit
this Application Form to
Telstra for provisioning.
SAMFS
Representative
Name
Contact Details
Ph (wk):
Fax:
Email:
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Telstra Corporation Limited
ABN 33 051 775 556
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Section G: Change of Lessee - Outgoing Customer Authorisation
Services to be transferred:
IP Fire Line service to be
transferred. Please include
PSTN and IP Port Number
Service Numbers :
Transfer date:
I apply for the transfer to occur on
(The transfer date is the day transfer of ownership of the accounts/services takes place and
cannot be a date before this application is provided to and accepted by Telstra.)
Your Business Information
Outgoing Customer Details:
Company Name :
You must be an authorised
representative of the Outgoing
Customer to request this
transfer.
Trading Name :
ACN/ABN/ABRN :
Billing Address :
Full Name :
Contact Number :
Email Address :
I am the Authorised Representative of this account
Terms and conditions
Please read and understand
all terms and conditions before
signing.
Last updated 31 July 2013
Agreement - Outgoing Customer to sign:
Important Information
On behalf of the Outgoing Customer, I request that Telstra transfer the services listed above to
the Incoming Customer whose details are included in Part C of this form and I acknowledge
that:
- I will remain liable for all debts incurred on the services listed above prior to the date of
transfer and for any applicable Early Termination Charges;
- acceptance of this request by Telstra is subject to Telstra’s ordinary credit approval process;
- I have read and understand all statements made in this application form; and
- I agree that I will not seek to recover any loss I have suffered or may suffer (either directly or
indirectly) as a result of this transfer.
I warrant that I am authorised to make this request on behalf of the Outgoing Customer.
Signature
Date
Print Name
Position
Telstra Corporation Limited
ABN 33 051 775 556
Page 5
IP Fire Line Terms and Conditions
The South Australian Metropolitan Fire Service (“SAMFS”) entered into an agreement (“MFS Agreement”) with Telstra under which
Telstra will provide SAMFS with the capability to monitor your fire alarm (“Monitoring Service”).
This Application Form relates to Telstra’s provision of an IP Fire Line service to connect your fire alarm to SAMFS’ Monitoring Service
to enable SAMFS to monitor your fire alarm.
The Fire Line service is made up of:
•
an IP WAN port (“Network Service”); and
•
an IP WAN standard connection using the public switched telephone network (“Site Service”).
Your IP Fire Line service will be supplied to the site(s) nominated in Section C (Site Details) of this Application Form on the following
terms and conditions:
1. Term
1.1. Telstra will provide you with the IP Fire Line service for the Term. The Term starts on the date Telstra starts supplying the IP Fire
Line service to you and ends on the earlier of the date:
a) you or Telstra cancel the IP Fire Line service in accordance with these terms and conditions; or
b) Telstra stops supplying the Monitoring Service to SAMFS.
1.2. The IP Fire Line service is a bundled service. This means you must acquire both the Network Service and the Site Service from
Telstra at all times during the Term.
1.3. You may cancel your IP Fire Line service at any time by giving Telstra at least 30 days prior written notice. You must first obtain
approval from the SAMFS in the form set out in Section F (SAMFS Authorisation) of this Application Form and provide this written
approval to Telstra.
1.4. If your IP Fire Line service is cancelled within the first year of the Term and you are a VGDL migration customer (which we can
confirm on request), you must promptly repay any waived connection charges to Telstra.
1.5. In addition to Telstra’s termination rights in Our Customer Terms and this Application Form, Telstra may cancel your IP Fire Line
service, or refuse to commence supplying your IP Fire Line service, if SAMFS requests Telstra to do so.
2. Our Customer Terms
2.1. We will provide your IP Fire Line service on the terms of Our Customer Terms (including the applicable General Terms section)
and this Application Form.
2.2. In addition to the provisions set out below, Telstra may notify you of any other provisions of Our Customer Terms that do not
apply to your IP Fire Line service from time to time.
3. Monitoring Service
3.1. Your IP Fire Line service aims to enable you to connect to SAMFS’ Monitoring Service.
3.2. The Monitoring Service is an IP WAN based community virtual private network, for access to and use by a particular “community
of interest”. It provides separation between community members.
3.3. For your IP Fire Line service to be and remain connected to the Monitoring Service, you must at all times comply with any
additional:
a) terms imposed by SAMFS relating to that connection from time to time; and
b) authentication details and procedures that SAMFS requires from time to time.
3.4. You must not disclose any IP address you become aware of through using your IP Fire Line service or accessing the Monitoring
Service (other than for the sole purpose of using your IP Fire Line service in accordance with the terms of this Application Form).
3.5. SAMFS may require you to agree to additional terms and conditions in relation to accessing the Monitoring Service. It is your
responsibility to check with SAMFS whether any additional charges or terms apply.
3.6. You acknowledge that Telstra is not responsible for, and accepts no liability in respect of, any additional requirements of SAMFS
in order for you to access the Monitoring Service. In particular, Telstra is not responsible for any authentication procedures or
details required to access the Monitoring Service, or for monitoring your access to the Monitoring Service.
4. Network Service
4.1. The IP Solutions Section of Our Customer Terms applies to the Network Service, except as otherwise set out in this Application
Form.
4.2. The following provisions of the IP Solutions Section of Our Customer Terms do not apply to the Network Service:
a) provisions in Part A of the IP Solutions Section that relate to uses of the IP Solution, value added services, charges for a
New IP Solution, charges for adds/moves/changes and IP addresses;
b) provisions in Part B of the IP Solutions Section that relate to minimum commitments, cancelling your service, connecting
services and IP WAN Design Consultancy Charge; and
c) Parts C and D of the IP Solutions Section.
4.3. You acknowledge and agree that SAMFS will provide Telstra with details of the IP addresses for your IP Fire Line service.
5. Site Service
5.1. Part A - General of the Basic Telephone Service Section of Our Customer Terms, applies to the Site Service, except as otherwise
set out in this Application Form.
5.2. Due to the nature of the IP Fire Line service, you cannot block calling line identification, receive calls or hear a dial tone and you
will not receive a free listing of the telephone number in a telephone directory. In addition, the following provisions of Part A General of the Basic Telephone Service Section of Our Customer Terms, do not apply to your Site Service:
a) the connection timeframes; and
b) provisions relating to Telstra Velocity, rental telephones, change of customer and Local Number Portability.
6. Charges
6.1. Connection charges:
a) The connection charges for the Network Service and the Site Service are set out in Our Customer Terms.
6.2. Monthly charges:
a) The monthly charge for the IP Fire Line service is $106.43 (GST excl) until the expiry of the MFS Agreement; and
b) for any period during which your IP Fire Line service is supplied by Telstra after the expiry of the MFS Agreement, the
monthly charge for the IP Fire Line service is the total of the monthly charges for the Network Service and the Site Service
as set out in Our Customer Terms.
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Telstra Corporation Limited
ABN 33 051 775 556
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6.3. All prices referred to or set out in this Application Form do not include the cost of any cabling needed to connect from Telstra’s
network boundary at your site to the fire alarm panel. If you need this cabling, you may request that Telstra supply it to you for
additional charge.
6.4. You must ensure that installation of your own cabling to access the Fire Line is installed:
a) by a registered cabling contractor; and
b) to, and continues to meet at all times, the minimum technical requirements determined by the Australian Communications
and Media Authority.
6.5. You must, at your own cost, provide Telstra with all reasonable assistance and take all safety precautions reasonably necessary
to ensure the safe and proper performance by Telstra of all work at your site.
6.6. Any other charges that may be payable by you for the IP Fire Line service from time to time are as set out in Our Customer
Terms.
7. Permitted uses
7.1. You must ensure that the IP Fire Line service is used as a “fire line” only. That is, as a telecommunications line used to send
automatic fire alarm monitoring signals from your premises to SAMFS. You must not use or allow any third party to use, the IP
Fire Line service for any other purpose.
7.2. The use of the IP Fire Line service as a fire line does not affect or limit Telstra’s rights to suspend, limit or cancel the IP Fire Line
service if you fail to breach any of the terms in this Application Form or in Our Customer Terms.
8. What you must do if your IP Fire Line service is cancelled or suspended
8.1. If you cancel your IP Fire Line service, or fail to comply with the terms and conditions applicable to the IP Fire Line service, or if
Telstra is entitled to suspend, limit or cancel the IP Fire Line service, you must:
a) comply with any applicable statutory requirements or regulations relating to the installation and maintenance of monitored
fire alarms; and
b) immediately notify any persons (including, without limitation, any tenants, co-tenants, landlords or neighbours of the site or
any fire brigades or fire alarm service providers) who may be affected by the suspension, limitation or cancellation of the Fire
Line service.
9. Adds/moves/changes
9.1. You may request a change of lessee for an existing IP Fire Line Service by obtaining SAMFS authorisation and completing the
Change of Lessee Form set out in Attachment A and this Application Form.
10. 10 General
10.1.In addition to any other rights under this Application Form, Telstra may refuse to supply you with the IP Fire Line service in
Telstra’s discretion (for example, if you do not meet the requirements set out in this Application Form).
10.2.In addition to the limitations of liability contained in Our Customer Terms, Telstra excludes all liability for any loss suffered by you
as a result of your failure to comply with any of the requirements set out in this Application Form.
10.3.Telstra will use reasonable endeavours to aim to ensure that your IP Fire Line service is secure, but Telstra does not guarantee
the security of your IP Fire Line service.
10.4.You must separately acquire suitable alarm signalling equipment as specified by SAMFS.
10.5.Telstra is not responsible for, and accepts no liability in respect of, connecting your IP Fire Line service to the alarm signalling
equipment.
Last updated 31 July 2013
Telstra Corporation Limited
ABN 33 051 775 556
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