PLEASE FILL OUT THE FOLLOWING INFORMATION TO CREATE THE NEW CLIENT ACCOUNT BUSINESS NAME * SELECT INDUSTRY * OIL & GAS ASPHALT & CONCRETE FOOD & BEVERAGE PORT & MARITIME PROPERTY MANAGEMENT AGRICULTURE PHYSICAL ADDRESS Address 1 Address 2 City State/Province Zip/Postal Code Country WEBSITE http:// POINT OF CONTACT * First Name Last Name MOBILE PHONE (###) ### #### WORK EMAIL * PROPOSAL ITEMS * INTRODUCTORY PACKAGE LONG-TERM AGREEMENT SETUP & CONFIGURATION INSTALLATION & TRAINING HARDWARE PURCHASE HARDWARE LEASE OTHER SENSOR LIST * GATEWAY > CELLULAR GATEWAY > WI-FI SENSOR > DOOR OPEN/CLOSE SENSOR > ENERGY SENSOR > GPS SENSOR > LEAK DETECTION SENSOR > MOTION SENSOR > TANK LEVEL SENSOR > TANK PRESSURE SENSOR > TEMPERATURE SENSOR > VIBRATION SENSOR > OTHER INTRODUCTORY PACKAGE > SENSOR 1 EQUIPMENT BEING MONITORED INTRODUCTORY PACKAGE > SENSOR 2 EQUIPMENT BEING MONITORED ADDITIONAL NOTES FOR THE RECORD ENTER YOUR PARTNER NAME * Thank you!
