HOSTED SERVICE AGREEMENT FOR INMARSAT BGAN
Agiosat Global Communications
Toll Free: 877.728.2668
Outside U.S.: +1.818.526.1700
FAX:+1.818.526.1715
agiosat™
... Hosted Service Agreement For Inmarsat BGAN
Part 1 Customer Information
A. Business Account /1. / . ~ ,;1/ /
Company Name: t.:t!;l- ~4YWA#y
Primary Contact: ~ 'A~ ~ Fed 101 Tax 10 #: ~ '2. - O"l. - /1 &o{i S", -'SI.{ c.
Business Type: Corporation D GSA D Government (Non-GSA) g-
If Federal Tax exempt check box < Must provide Documentation> czr
B. Individual Account *
Name:
Social Security #:
Date of Birth:
*Note Individual Account's must attach a legible copy of Govt. Issued ID/Driver's License or Passport
C. Billingl Contact Information
Address: 100 ~~..~
City: I! /~ J,f/t:' 4r-
?t~A
Phone (Daytime): 7];.7" 5'1,1 ~ 'IC,61..--
Avv/fe
/
State :
Fax:
Postal Code (ZIP)
Phone (Evening): 72-7- ;,z,'1-71cro
Cellular: ? Z, 7 - "72 t/ - 73M)
~'.!.Ie /. flA7,v(!7 ~I',p'!~",v_..h.--. ~
Country:
Email Address:
Shipping Address (If Different from above)
Address: ~
City: . State :
Country:
Postal Code (ZIP)
Please Initial All Pages And Fax Form to Agiosat
Page 1 of 6
v1
***** Warning to Customers *****
All BGAN terminals are capable of making high speed (broadband) Internet connections
that can result in SIGNIFICANT AIRTIME BILLS for satellite airtime if usage is not
monitored and controlled. Service Users must use extreme caution when connecting this
terminal to a computer network or to the Internet. It is very easy to use a lot of MB when
surfing the Internet. If you have any questions about connecting your terminal to a
network or the Internet, contact Agiosat or a computer network specialist to help you
quantify your usage. Please be aware that there are significant differences between
direct ISDN Connections, Streaming IP and background IP connections, all of which have
different tariff & rate tables outlined at the end of this BGAN Service Agreement. BE
AWARE Customer is responsible for all charges incurred during all sessions of use on
each BGAN terminal they possess. By signing the line below you acknowledge that you
will pay all charges incurred in all sessions of use during your contracted period with
Agiosat for your BGAN usage.
I (The Customer) Understand the potential for Significant Airtime Bills, a#ind
will pay all charges incurred thro th use of e AN terminal.
Customer Signature: Date: / Z) 'tJ 7
Part 2 Payment Information
Choose you Payment choice from the plans below.
g A.) Direct Billing (For U.S. based billing addresses only, billed monthly)
<All Direct Billing subject to individual or business credit check>
DB.) Pay Via a Wire Transfer
Contact Agiosat For Wire Transfer Information
D C.) Pay Via Credit Card (Please check one box)
D Visa D Master card D AMEX D Discover
Expiration date :
Security Code*
(* 4 digit code on front of AMEX Card
(MMNY) 3 digit code on back of Visa/MC)
Card Number:
Name (As it appears on card) :
Company Name on Card (If applicable) :
Credit Card Billing Address:
(If different from above addresses)
City:
State :
Post Zip Code
Country :
Card Holder Signature:
Date:
Page 2 of 6
Note- Agiosat DOES NOT ACCEPT third party credit cards or Non-U.S. Originated Credit Cards
BGAN Hosted Service Agreement Multiple Signature Page
Approved as to form:
By:
J William .
V City Man
Attest:
agiosat~
Agiosat's Hosted Postpaid Plan For BGAN-North America
All airtime billed from U.S. in U.S. Dollars
~ ACTIVATION CHARGE FOR BGAN TERMINAL (one time cost)
$ 50 < per unit>
~ MONTHLY SERVICE CHARGE FOR BGAN TERMINAL (monthly recurring cost)
$ 40 < per unit I per rmnth >
~ VOICE b FIXED (per minlie),
~ VOICE to GSM CELLULAR (per minlie)'
~ BGAN to BGAN (per minlie),
$0.99
$1.10
$0.90
~ ACCESS TO BACKGROUND IP DATA SERVICES (perMS)
(Billed with 50 KB rrinirrum and at 10KB increments thereafter)
$6.95
~ ISDN (per minlie)
$5.95
~ STREAMING 32Kbs VolP ENCRYPTED
~ STREAMING 32Kbs*
~ STREAMING 64Kbs*
~ STREAMING 128Kbs*
~ STREAMING 256Kbs*
$2.25
$2.90
$6.00
$11.50
$19.95
Page 3 of 6
~
Customer Initials
agiosat™
Agiosat's Hosted Postpaid Plan For BGAN continued
All aitfime billed from U.S. in U.S. Dollars
~ SMS (per message 160 character maxi
$0.50
~ VOICE, FAX & DATA - BGAN to INMARSA T A (per mirnAe)
~ VOICE, FAX & DATA - BGAN to INMARSA T B (per mirnAe)
~ VOICE, FAX & DATA- BGAN to INMARSAT MINI M (perrrrmie)
~ VOICE - BGAN to INMARSA T GAN I FLEET I S\llAFT (per mirnAe)
~ VOICE - BGAN to IRIDIUM & THURAY A VOICE (per rrrrnAe)
~ VOICE - BGAN to GLOBALST AR VOICE (per rrrmle)
~ HSD (ISDN) to INMARSAT B (perrrrrl1e)
~ HSD (ISDN) to INMARSAT GAN I FLEET I SWFT (permirnAe)
$6.00
$3.25
$2.50
$2.75
$3.75
$5.35
$14.95
$13.90
Page 4 of 6
AgiosalBGAN Terms & Conditions
. A$j()satrequiresltl';~,~ve(S)~, ' l)~j~,~e~~~~~.
.AvaiJabilityQ€ ','.... ; ........... ..... "
satelli1e footprint ...... ..' isfuridSbedto
morethan.one tennimtl.Custotner hlJ$no . ...,' rigbtin'such number. Agiosatreserves the right to assign, designate, ~
chqe suoh number,}Vhen, in its sole clisorl;tion, sucb action is reasonably necessary in the conduct of its b~siness.
,. ,
... Taxes: lbeprioeof the service does not.~Jtldesa1es;..usage..~xoise. ad valorem, property or any llther~~s now or here
impOSed,clirectlyorincJireotly. byanygovenui1entalautl'lqrltyor agency with respect to the Servioe; C~q:j~er,shallpay
taxes directly or reimbnrse Agi~ for any~ taXes'.
Page 5 of 6
C~itialS
Agiosat BGAN Terms & Conditions cont.
Page 6 of 6
88
"
DEI'^RTMENT
OF REVENUE
II Consumer's Certificate of Exemption II
Issued Pursuant to Chapter 212, Florida Statutes
DR-14
R. 01/02
62-02-134859-54C
Certificate Number
07/23/02
Effective Date
xpiration Date
This certifies that
CITY OF CLEARWATER
100 S MYRTLE AVE
CLEARWATER FL 33756-5520
~
~'f'~
DEPARTMENT
OF REVENUE
Important Information for Exempt Organizations
OR.14
R.01/02
,. You must provide all vendors and suppliers with an exemption certificate before making tax-exempt purchases.
See Rule 12A-1.039, Florida Administrative Code (FAC).
2. Your Consumer's Certificate of Exemption is to be used solely by your organization for your organization's
customary nonprofit activities.
3. Purchases made by an individual on behalf of the organization are taxable, even if the individual will be
reimbursed by the organization.
4. This exemption applies only to purchases your organization makes. The sale or lease to others by your
organization of tangible personal property, sleeping accommodations or other real property is taxable. Your
organization must register, and collect and remit sales and use tax on such taxable transactions. Note: Churches
are exempt from this requirement except when they are the lessor of real property (Rule 12A-1.070. FAG).
.. - .
5. It is a criminal offense to fraudulently present this certificate to evade the payment of sales tax. Under no
circumstances should this certificate be used for the personal benefit of any individual. Violators will be liable for
payment of the sales tax plus a penalty of 200% of the tax, and may be subject to conviction of a third degree
felony. Any violation will necessitate the revocation of this certificate.
6. If you have questions regarding your exemption certificate, please contact the Exemption Unit of Central
Registration at 850-487-4130. The mailing address is 5050 West Tennessee Street, Tallahassee,
FL 32399-0100.