Commercial Monitoring and Alarm Services Agreement

Docusign Envelope ID: F2016336-3365-46C2-9CC2-948D75730C59

Customer Information For Internal Use Only

Customer Account No: 1000157544	Monitoring Account No:
Panel Model: Siemens - FCM2041-U3	Panel SN / Radio CRC:
Communicator Model:	Radio SIM / MAC:

Billing Preferences

Recurring services will be prorated to the nearest calendar interval selected and invoiced at the start of that period. Annual services may be invoiced two months prior to service period.

Frequency

Monthly (Auto-Pay only)

Quarterly

Semi-Annually

X Annually

Delivery Method

Auto-Pay (KFS will refer to Billing Contact to obtain auto-pay information)

X Mail

Portal

Purchase Order Required? Yes X No PO #: ____________________ Exp: ____________________

Authorized User / Contact and Notification Information

Authority Level	Account Changes	Place On Test	Cancel Dispatch
Admin	✓	✓	✓
Limited Admin		✓	✓
User			✓

User / Contact Call Order

Please complete the list with the contact information of those you would like to have notified when an alarm or trouble occurs.
Please list at least 3 different contacts. See below for more information.

	myAlarms.com Access	User / Contact Name	Phone	Pref. Contact Method	Email	Monitoring Password	Auth. Lvl
1	X	Don Chambers	(765) 749-9461	Both	dchambers@co.delaware.in.us	0000	Admin
2
3
4
5
6
7
8

Clarifications

Web Portal Access is a web based app that provides visibility into your monitoring account. It allows for viewing signal history, placing the system in and out of test and viewing and managing contacts for central station notifications.

Pass Code is a number or word the user identifies themselves with when engaging with central station operators to cancel a dispatch or with Koorsen offices to request information. It is important for the user to not only know their user code for the alarm panel, but also remember their pass code for interaction with central station and Koorsen. If a user forgets their pass code, a false dispatch may result and Koorsen will not be able to provide information to the user. For issues with retrieving a passcode, call 866-KOORSEN or email customerservice@koorsen.com.

Fire alarm signal notification procedure is to notify the 1st then 2nd contact, if the 1st does not respond. From there, the central station operators will notify the fire department emergency dispatch center unless the first or second contact responded to the notification and provided a valid pass code and instruction to not dispatch. Once the fire department is dispatched, the operator will continue down the notification list until someone acknowledges the call. Trouble signals will be notified upon by means of email or text messages unless "call notification" is selected on the first page of this Agreement.

Intrusion alarm signal notification procedure is to notify the 1st then 2nd contact, if the 1st does not respond. From there, the central station operators will notify the police department emergency dispatch center unless the first or second contact responded to the notification and provided a valid pass code and instruction to not dispatch. Once the police are dispatched, the operator will continue down the notification list until someone acknowledges the call. Trouble signals will be notified upon by means of email or text messages unless "call notification" is selected on the first page of this Agreement.

By signing below the customer agrees that they have received and accepted the limited warranty, limit of liability and other conditions on PAGES 1 and 2.