VOIP ORDER FORM

970 Reserve Drive, Suite 160, Roseville, CA 95678
Telephone: 530.674.4200
Contact Sales
Customer Type:
CUSTOMER SITE INFORMATION (REQUIRED)
BILLING INFORMATION (IF DIFFERENT FROM CUSTOMER SITE INFORMATION)
TRANSFERRING NUMBERS (NOT NEEDED IF NO TRANSFERS)
Phone Number Line Type
VOIP ORDER
Qty Service Description Monthly Price Per Qty
Business VOIP – Phone Enterprise Polycom Business Phone (includes 1 phone number) $29.99
Business VOIP – ATA Ethernet to Analog Telephone Adapter $24.99
Business VOIP – DID Additional phone number(s) $5.00
Business VOIP – FAX Ethernet to Analog FAX Adapter $24.99
Business VOIP – eFAX Full management portal to send and receive faxes electronically $19.99
ORDER TOTAL
Total Order MRC Total Order NRC
MRC = Monthly Recurring Costs (Service Price)
NRC = Non-Recurring Costs (Base Install Fee: $99 + $50 per phone)
USER INFORMATION

Below is the user information per phone. If a phone is not going to be designated to a specific person, then put in the name of the area it will be located for the first name. Example: Shop or Warehouse. All information listed below may be changed as needed.

EXT FIRST NAME LAST NAME Email Address
Customer agrees to pay the Total Order MRC and Total Order NRC, the amounts of which in all instances are exclusive of taxes, surcharges and fees to be imposed by Succeed.net including, but not limited to, applicable federal, state, local use, excise, sales, or privilege taxes, duties or similar liabilities either shown as Miscellaneous Charges or imposed by operation of law. If there are any discrepancies between the Total Order MRC and Total Order NRC shown above and charges appearing elsewhere in this Agreement, above totals shall be controlling. The Total Order MRC and Total Order NRC apply only to those products listed in this order, the amounts indicated do not supersede any outstanding or recurring invoiced amounts on the Clients account and are in addition to any other services and products currently billed to the customer.