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Service Order Form New

This document is a service order form containing details of a company requesting internet service. Section A requests company and owner details. Section B requests contact information for the authorized financial personnel. Section C requests the same for the authorized technical personnel. Section D specifies whether this is a new subscription or renewal and the desired package, bandwidth, and period. Section E outlines the subscription fees, taxes, and total cost. The document also provides details on service level guarantees, restitution policies, and spaces for signatures and attachments.

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Apri Thea
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458 views3 pages

Service Order Form New

This document is a service order form containing details of a company requesting internet service. Section A requests company and owner details. Section B requests contact information for the authorized financial personnel. Section C requests the same for the authorized technical personnel. Section D specifies whether this is a new subscription or renewal and the desired package, bandwidth, and period. Section E outlines the subscription fees, taxes, and total cost. The document also provides details on service level guarantees, restitution policies, and spaces for signatures and attachments.

Uploaded by

Apri Thea
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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SERVICE ORDER FORM

A. DETAIL PERUSAHAAN / Customer Detail


Nama Perusahaan / Company Name :
Alamat / Address of Business :

Kota : Kode Pos :


Telepon / Fax Telephone/Faximile : Telepon: Faximile :

Npwp / Tax Registration Number :


Nama Pemilik Perusahaan/ Owner : Tn/Mr.

Ny/Mrs.

Nomor Ponsel/Mobile Number :


Nomor Identitas/Id Number : Ktp Sim

B. PENANGGUNG JAWAB KEUANGAN / Authorized Financial Personnel

Nama / Name :
Jabatan / Job Title :
Telepon /Fax Telephone/Faximile : Telepon: Faximile :

Nomor Ponsel / Mobile Number :


Alamat Email / Email Address :
Alamat Penagihan / Billing Address :

Kota : Kode Pos :

C. Penanggung Jawab Teknis / Authorized Technical Personnel


Nama / Name :
Jabatan / Job Title :
Telepon /Fax Telephone/Faximile : Telepon : Faximile :

Nomor Ponsel / Mobile Number :


Alamat Email / Email Address :
Alamat Pemasangan /Installation Address : Kantor Pusat Kantor Cabang

PT. Solusi Trimegah Persada


021-55766372
Kota : Kode Pos :

D. JASA LAYANAN / Service Requirement


Jenis Berlangganan Baru Perpanjangan

Jenis Layanan Corporation Game Personal Others


Center
Paket Bandwith Custom IIX Mbps IX Mbps
Office
Global Mbps

Periode 1 Tahun 2 tahun Others :

Berlangganan

E. Biaya Berlangganan / Biaya PPN 10% JUMLAH


Subscription fees
Biaya Bulanan Rp. Rp. Rp.
Biaya Registrasi & Instalasi Rp. Rp. Rp.
Biaya Lainnya
Total Biaya Rp.

Technical Information
Interfaces : RJ 45 / UTP
Location :

A. SERVICE LEVEL GUARANTEE


1. Customer will get a trial period connection for 7 days.
2. PT STP shall guarantee COSTUMER in service availability of telecommunication service
at 99% every month.
3. The service level guarantee is determined with the following formula :
Service Level Guarantee (%) : (available hours per month – down time) x 100
Total hours per month

PT. Solusi Trimegah Persada


021-55766372
B. RESTITUTION
1. If the network availability is lower than the service level guarantee described above,
COSTOMER will receive restitution from the monthly cost by making adjustment as
follow.
2. The amount of restitution in a current month shall not be higher than 20% of the Month
Payment.
3. The provision of restitution is claimed by both parties signing the Service Level
Agreement Report.
4. The provision of the restitution is performed by deducting the amount payable for the
next following payment with the amount of the restitution that has been approved.

City : Date : Month : Year :

PT SOLUSI TRIMEGAH PERSADA PT. ………………………………….

Hendry A
__________________________ ____________________________
TSD Staff

Harap melampirkan :

 Tanda tangan diatas materai dan


stempel
 Fotokopi Ktp Penanggung Jawab
 NPWP Perusahaan

PT. Solusi Trimegah Persada


021-55766372

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