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email: orders@cellutrak.ca
fax: 514.341.4431
Agreement number:

Dealer Code:

KCL Approval#:

EQUIPMENT AND SERVICE AGREEMENT

55 Louvain Street West Suite 402 Montreal, Quebec H2N 1A4 CANADA Tel: 514-341-9788 Web: www.cellutrak.ca

New Activation Transfer

SECTION A: CUSTOMER INFORMATION

Bill to: Ship to:
Business Name: Business Name:
Contact: Contact:
Address: Address:
City: City:
Postal Code: Postal Code:
Telephone: Telephone:
Fax: Mobile: Fax: Mobile:
Email: Shipping Service: Account Number:

SECTION B: EQUIPMENT

Product Description Quantity            
Number of Unit(s)            

SECTION C: INSTALLATION

Installer Quantity Unit Price Total        
Cellutrak $ $0        
Kubota $ $0        
Others $ $0        

SECTION D: SPECIAL INSTRUCTIONS

SECTION E: SERVICE PLAN

Basic
Advanced
Term Quantity Price Per Month Total Term Quantity Price Per Month Total
1 Year ( 12 month ) $18 $0 1 Year ( 12 month ) $30 $0
2 Years ( 24 month ) $17 $0 2 Years ( 24 month ) $29 $0
3 Years ( 36 month ) $16 $0 3 Years ( 36 month ) $28 $0
4 Years ( 48 month ) $16 $0 4 Years ( 48 month ) $28 $0
5 Years ( 60 month ) $16 $0 5 Years ( 60 month ) $28 $0
6 Years ( 72 month ) $16 $0 6 Years ( 72 month ) $28 $0
7 Years ( 84 month ) $16 $0 7 Years ( 84 month ) $28 $0
*Monthly Service Plan Total

$0

*Monthly Service Plan Total

$0

TPS/GST/HST: 827104696
TVQ/QST: 1215808960
*All amounts are before tax

*SECTION F: PROPERTY INFORMATION

Vehicle / Equipment Make License Plate
Model Serial / Vin Number
Year Color
* For multiple vehicles please see Annex A  

SECTION G: PAYMENT METHOD

Credit Card: Master  Visa
Name (as it appears on the card) Expiration Date: Mo. Yr.
Credit Card #: Security Code:

OR

Pre-authorized Payment
Branch:
Institution:
Account Number: Void Cheque

I AUTHORIZE CELLUTRAK CANADA INC. TO DIRECTLY CHARGE MY CREDIT CARD OR DEBIT MY ACCOUNT ON A MONTHLY BASIS AS INDICATED ABOVE FOR THE SERVICE PLAN AND PAYMENT OPTION SELECTED.

ALL PAYMENTS FOR SERVICE MUST BE MADE PAYABLE TO CELLUTRAK CANADA INC. IF PAYMENT IS MADE BY CHEQUE, SERVICE WILL NOT BEGIN UNTIL AFTER CHEQUE HAS CLEARED; CUSTOMER IS LIABLE FOR A FEE OF $50.00 FOR ALL RETURNED CHEQUES.

TERM OF THE AGREEMENT.

This Agreement will become effective at the time it is signed by CUSTOMER and shall continue for the period of time selected above.

This Agreement shall be automatically renewed thereafter for an indeterminate period of time unless CUSTOMER sends a notice to CELLUTRAK no later than thirty (30) days prior to the end of the initial term indicating that he shall not renew this Agreement.

Right of cancellation by the Customer: During the term of this Agreement, the CUSTOMER may cancel the Agreement at any time by written notice to CELLUTRAK and by paying to CELLUTRAK a cancellation indemnity per unit equal to the lesser of $50 and an amount representing 10% of the Monthly Service Fee multiplied by the number of months remaining in the term, plus applicable taxes. In the event that the CUSTOMER is not a consumer (as defined in the Consumer Protection Act (Québec)) the cancellation indemnity shall be equal to the Monthly Service Fee multiplied by the number of months remaining in the term, plus applicable taxes. During the renewal period, the CUSTOMER may terminate the Agreement at any time by sending a written notice of termination to CELLUTRAK. In this event, the Agreement shall terminate upon receipt by CELLUTRAK of the notice of termination and the CUSTOMER shall remain responsible for the payment of any past services.

Right of cancellation by CELLUTRAK: During the term of this Agreement, CELLUTRAK may cancel this Agreement and disconnect or terminate any or all Services, only if the CUSTOMER is in default to respect his obligations thereunder (including the failure to pay the Monthly Service Fee on due date with respect to any unit) pursuant to Articles 1604, 2126 and 2129 of the Civil Code of Québec or should CUSTOMER breach any other agreement that CELLUTRAK has with CUSTOMER, the whole subject to CELLUTRAK’s right to claim all damages and/or losses sustained by CELLUTRAK as a result of such default. During the renewal period, CELLUTRAK may terminate this contract and disconnect or terminate any or all Services upon no less than 60 days advance notice to the CUSTOMER, unless the CUSTOMER is in default hereunder in which case Cellutrak shall be entitled to immediately cancel this Agreement and disconnect or terminate any or all Services.

This Equipment and Service Agreement is subject to those Terms and Conditions attached hereto and which are hereby incorporated by reference. By signing below, CUSTOMER acknowledges that he has reviewed and understood these Terms and Conditions and that he received a copy of this Agreement signed by CELLUTRAK.

ANNEX A

Vehicle Make Model VIN Color Plate Basic/Advance Unit IP
Basic
Advance
Basic
Advance
Basic
Advance
Basic
Advance
Basic
Advance
Basic
Advance
Basic
Advance
Basic
Advance
Basic
Advance
Basic
Advance

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