AA/INONET Service Application Form eanmooncaasaaaer ena tingutccr! Cae Binge Owen CPhtn say \2eangcts ots oe Ga Cond ‘CLocal Loop (Crop & Cary CMx Bandwidth Peering Dark Fiber Others 114 Bandwidth (In MBPS). 1.5 No of circuits DNs 17 Proposed ready for Service dato 1.6 Customer of Type Corporate asp co oBPO others, 1.8 Purpose (write in deta |F DETAILS : Number of IP's required. Static routing (YIN). BGPEYIN) a i") DFUIBGP — ODefauit GP Last mile deta: Media (tick one) CFiber Wireless ‘Customer end interface (lick one) Optical Ethernet, Earthing Status. ‘Customer end equipment Provided by : tick ono): Customer Anonet Details of Customer end equipment: Router.. ay. Stitch 1.9 Customer Purchase order No... Purchase Order Date, 2.0 Linktaken by customer for Own use _CReseling PSM EEN ‘Leased crcut tamination details at End Contact Person Name Dept. Nam Adres. Caco Cee ee ‘State Nam Landmark - e-invoice- Please tck Yes No Contact Email Last Mile Provider -A End DAnonet Oe... Customer end interface Gethemet Optical ‘Dothe ‘Customer end equipment Oswiten convertor MUX Other. 3c) PVT. LTD. ig neTSOL (OF Bor, VAIO RGM « Aytharicodl Sonatory © scanned with OKEN ScannerLeased excultaeminaon doa at 8 End ‘Contact Person Name Dept. Nome, Address CityVilagelPost Offee State Name. Landmark e-nvolee - Please tick OYes = No Contact Email id Last Mile Provider -A End DAnonet Other Customer end interface CEthemet Optical Doth Customer end equipment switch Convertor = MUX Other. CEN esr sooo ‘Specity Curency (INR) One Time (A) _ Annual Recurring (8) Grand Total (A¥B) "Payment Cycle Payment term 1. Bandwith Co) Ee _) Ba) Cd) Ba} 2. Hardware CE Ga) Ge) Be 2.4 Router CGE) B=). Bd) Be) 22 0ners CoE) Ba) Gd) Ga) suinsataton crawes § CJ) FJ) CD ) Fd) Fd) 4. Other Charges CO) Ga) Gd) 5. Total Charges CE 2 Ga) Ga Total order Value SS) be Be) Price Above excludes any Taxes as Applicable [Comments Dectaration ‘tena tan a csi nr ot ‘Stuindoeth puna oat ris bcos sw ond ‘Boies ede ance cover aes ie eer dana ee aeE pra nasesteascnsins es Applicant Name (Authorised Signatory). Designation... ‘Anonet Account Manager Emp. Code. © scanned with OKEN Scanner