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Site Service Order Form

Please refer to your Commercial Addendum or reach out to your regional sales rep to confirm pricing.

"*" indicates required fields

Company*

Organization ID*

Inovonics Account Number*

Site Name

Site ID*

The Site ID number will be assigned by logging onto the Inovonics Cloud Services and clicking the “Add Site” button and naming your new site. Please make note and complete this field using the assigned Site ID.

Site Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Authorized Representative Name*

First Last

Title*

Phone*

Email*

Confirm Email*

Cloud Connect*

Cloud Connect (SW-CLDCNCT)

Cloud Connect is required for all sites. If no other features are selected, Cloud Connect will be billed on the Billing Start Date. If any additional Site Services are enabled, Cloud Connect is included in that price and will not be billed as a separate line item.

Requested Site Services(s) - Security

Please select all services below that apply. Pricing is determined based on your existing Commercial Addendum to Inovonics Cloud Service Agreement. Service availability is based upon your current product certifications. Any order for an uncertified product will be rejected.

Advanced Location (SW-ADVL)

Mobile Duress (SW-MBLDRS)

Smart Alerts (SW-SMRTALRT)

Requested Site Services(s) - Senior Care

Please select all services below that apply. Pricing is determined based on your existing Commercial Addendum to Inovonics Cloud Service Agreement. Service availability is based upon your current product certifications. Any order for an uncertified product will be rejected.

Fall Detection (SW-FALLDET)

Advanced Location (SW-ADVL)

Smart Alerts (SW-SMRTALRT)

Number of Fall Detection Pendants

Number of Locators

Required if Advanced Location is selected

PO Number (Optional)

Please provide your PO number if required by your company.

Billing Start Date

I am authorized to submit this Site Service Order form and acknowledge that the submission of this form and subsequent activation of applicable Inovonics hardware is governed by the Inovonics Cloud Services Agreement. Orders for Inovonics Cloud Services will be acknowledged by an Inovonics order confirmation emailed after initial service activation and referenced on the monthly summary invoicing for your Organization. All site orders will have a Contract Start Date on the "Billing Start Date" shown above.*

I confirm

In compliance with industry best practices including HIPAA and other standards, Inovonics may need to occasionally send time-sensitive Inovonics Cloud Services notifications (Examples: connectivity, system health, data breach, critical information requests, etc…).*

I am the correct contact for Inovonics Cloud Services notifications.

I am not the correct contact for Inovonics Cloud Services notifications. Please contact me to update this record.

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Status

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Market Segment

Domestic Security

International Security

Submetering

Senior Care

Signal & Control

EMDS

Other

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Subject

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Case Origin

Inovonics Wireless Corporation

11000 Westmoor Circle
Building 10, Suite 250
Westminster, CO 80021
sales@inovonics.com
Phone: 303.939.9336
Toll-Free: 800.782.2709

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