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Name *

First

Last

Company Name

if applicable

Email *

Phone *

Business Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Delivery Address

Same as business address

Delivery Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Start Date *

Estimated length of project *

Comment or Message

Payment Method *

Pay with credit card (+1.8% credit card surcharge)
Pay via EFT/Bank Transfer

Bank transfer details will show on next page.

Initial 3 Months Service per camera @ $320+gst /month= 1,056.00 +1.8% credit card surcharge *

1 Camera - $ 1,075.00
2 Cameras - $ 2,149.00
3 Cameras - $ 3,224.00
4 Cameras - $ 4,298.00

Three months minimum as it includes setup costs.

Initial 3 Months Service per camera @ $320+gst /month= 1,056.00 *

1 Camera - $ 1,056.00
2 Cameras - $ 2,112.00
3 Cameras - $ 3,168.00
4 Cameras - $ 4,224.00

Three months minimum as it includes setup costs.

Total Amount

$ 0.00

Credit Card *

Card

Name on Card