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BUSINESS USE

FIBER BIZ
APPLICATION FORM
BUSINESS NAME AND TYPE
Company/Business Name

Nature of Business

TIN No.

NAME OF PROPRIETOR/ AUTHORIZED SIGNATORY


Name

Position/Designation

Email Address

ID Presented

Mobile Number :

PACKAGES

COMMITTED
IP
INFORMATION
ADDRESS
RATE

PLAN

MONTHLY
FEE

ONE-TIME
CHARGE

SPEED
(UP TO)

Fibrbiz 12

8,000

5,000

12mbps

1.2mbps

Fibrbiz 15

12,000

5,000

15mbps

Fibrbiz 30

15,000

5,000

Fibrbiz 60

18,000

Fibrbiz 100

25,000

LOCK-IN
PERIOD

MODEM

1 Static

2 YEARS

FREE

1.5mbps

1 Static

2 YEARS

FREE

30mbps

3mbps

1 Static

2 YEARS

FREE

5,000

60mbps

6mbps

1 Static

2 YEARS

FREE

5,000

100mbps

10mbps

1 Static

2 YEARS

FREE

*Minimum speeds of 10% of subscribed speed at 80% reliability were available

Optional Add-on:
Additional Static
IP Address /29

MONTHLY
FEE

ONE-TIME
CHARGE

2,250

500

PHYSICAL & BILLING ADDRESS


(Please indicate complete address where service will be connected and provide a SKETCH )

I have read & understood the terms and conditions. My signature below signifies that all information stated herein are true &
correct to the best of my knowledge.

Subscriber/Authorized Representative
Signature over printed name

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