Safety Alarm Application

SAFETY ALARM APPLICATION AND SERVICE AGREEMENT

This Safety Alarm Application and Service Agreement ("Agreement") is made and entered into by and between Applicant Name: and Alarm Provider Name: .

WHEREAS

WHEREAS, Applicant seeks authorization for installation and monitoring of a safety alarm system at the service premises listed below; and

WHEREAS, Provider is duly qualified and equipped to install, maintain and monitor alarm systems and to coordinate emergency response consistent with local responder policies; and

WHEREAS, the parties desire to set forth the scope of services, fees, response policies and mutual obligations governing the alarm system registered under this Application and Agreement.

APPLICANT INFORMATION

Email:

ALARM SYSTEM DETAILS

Alarm Type(s) (check all that apply): Burglar Fire Medical Panic/Duress Silent

SCOPE OF SERVICES

Describe the alarm system components, monitoring services and any site-specific instructions. Installer or Provider shall perform services in accordance with industry standards and applicable local ordinances.

EMERGENCY CONTACTS / KEYHOLDERS

PAYMENT TERMS

Applicant agrees to pay fees as set forth below. Fees are non-refundable except as expressly provided in this Agreement.

Payments unpaid beyond the due date are subject to the stated late fee and collection costs. Provider may suspend monitoring after written notice if fees remain outstanding as specified in the Payment Schedule.

TERM AND TERMINATION

The initial term begins on Start Date: and ends on End Date: , unless earlier terminated in accordance with this Agreement.

Either party may terminate this Agreement for convenience upon written notice delivered at least Notice Period (days): days prior to termination. Provider may terminate immediately for material breach, including nonpayment or conduct that jeopardizes safe operation or responder safety.

CONFIDENTIALITY

Provider and Applicant acknowledge that certain information exchanged under this Agreement may be confidential. Each party shall protect confidential information and shall not disclose alarm system codes, keyholder identities, monitoring procedures or other sensitive security data except (a) as required for emergency response, (b) to authorized service personnel, or (c) as required by law or valid legal process.

FALSE ALARMS AND RESPONSE POLICY

Applicant certifies that the alarm system will be maintained and tested to minimize false alarms. Applicant acknowledges and agrees to be responsible for false alarm fees, fines or penalties assessed by responding authorities or Provider when an alarm is determined to be false or preventable. Applicant acknowledges the Provider's right to charge fees for repeated false alarms in accordance with Provider policy.

Applicant acknowledges receipt of the response policy and agrees to notify Provider promptly of changes in occupancy, keyholders, or circumstances that may affect response.

GOVERNING LAW; ENTIRE AGREEMENT

This Agreement shall be governed by the laws of the State of without regard to its conflict of laws principles. This Agreement, together with any attachments or addenda executed by the parties, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior negotiations and representations.

INDEMNITY AND LIMITATION

Applicant shall indemnify and hold harmless Provider for liabilities arising from Applicant's negligence or failure to maintain the premises or system. Provider's liability for any claim arising out of this Agreement is limited to direct damages and shall not include punitive, incidental or consequential damages except to the extent prohibited by law.

AUTHORIZATION & CERTIFICATION

By signing below, Applicant certifies under penalty of perjury that the information provided in this Application is true and accurate, that Applicant is authorized to request alarm services for the stated premises, and that Applicant has read and accepts the terms and conditions of this Agreement, including fees, response policy, confidentiality and indemnity provisions.

Sign Now