Key Tech Quote Request

Service and Account Information Form

I would like to personally thank you for choosing Key Tech as your new contact/answering service. We strive to work closely with you because we understand we are an extension of your business. When our representatives receive calls for you, we know the caller believes they are speaking directly to YOUR business. In essence, your clients are our clients and we don't please them, we don't please you.

Please be sure and take advantage of our referral program. You can instantly get up to $20.00 OFF your first month's invoice if you simply give us 3 friends or business associates who you believe could benefit from a service like ours. This is located at the bottom of this form.

Once again, thank you for choosing Key Tech Communication as your contact/answering service provider.

Warmest regards,

Cheryl Wade
C.E.O.
Key Tech Communication Services, LLC

How did you find out about our service?

	Yellow Pages
	Website
	Mail-out
	Search Engine
	Referral Name:

Please check which service plan is right for your business and fill in all the information on this form with as much detail as possible. The more information we have about your company and it's needs the better we can service you. Once you have completed this form and submitted it, you will be contacted within 24 hours with all the information you need to begin your service. Please feel free to contact us with any questions you may have.

Minutes are defined as any operator assisted usage. There is a $00.25 per minute charge for any patching. It is the responsibility of your company to keep all employee information updated.

Please choose your answering service plan? (Please note the setup fee is $40.00)

Please provide the following Contact Information:

Company:
Street Address:
Suite/Apartment #:
City:
State:
Zip Code:
Type of Business:
Office Hours:
Main Telephone Number
Back-line Telephone Number:
Fax:
Your Name:
Title:
Cellular Phone Number:
Pager Number:
Residence Phone Number:
Your answer phrase - How do we answer your phone (Please limit to 35 characters):
Email:
Web Address: www.
Your birth date.
Date your business started.

What information should we obtain from the caller?

	Name
	Phone Number
	Address
	Regarding

Please list any other information we may need to obtain from the caller.

On-Call personnel or other employees who will need to be contacted:

1. Name:
Pager Number:
Residence Number:
Cellular Phone Number:
2. Name:
Pager Number:
Residence Number:
Cellular Phone Number:
3. Name:
Pager Number:
Residence Number:
Cellular Phone Number:
4. Name:
Pager Number:
Residence Number:
Cellular Phone Number:
5. Name:
Pager Number:
Residence Number:
Cellular Phone Number:

Please include any additional personnel that may need to be contacted, along with their contact information.

What protocol should we follow when contacting you or your personnel?

Example: 1. Pager 2. Call cell phone 3. Call residence

How will you notify us of who, if anyone, is on-call and how will we receive your on-call schedule?

	Call In
	Fax
	Mail
	Using Key Tech's website

What type pagers does your company use?

	Numeric - Only the phone number shows on our pagers
	Alphanumeric- We can get text messages sent to our pagers

What pager company do you use?

Example: MetroCall, BellSouth, Arch, etc.

Do your cellular phones have text messaging capability?

	Yes
	No

Would you like us to page your messages to your cellular phone?

	Yes
	No

What company supplies your cellular phone service?

Please give us any other instructions we may need to better service your business.

How many Incoming calls do you estimate? (Only fill in those that you have an estimate for)

# Of Calls Per Hour:
# Of Calls Per Day:
# Of Calls Per Week:
# Of Calls Per Month:

What do you expect the length of each call will be (Minutes)?

	1 Minute
	2 Minutes
	3 Minutes
	4 Minutes
	5 Minutes
	More than 5 minutes

What is your anticipated start date?

Who was your sales representative?

Service Agreement

This agreement is between (your company/your name) hereinafter known as client, and Key Tech Communication Services, LLC, hereinafter known as Key Tech.

Client requests that Key Tech supply messaging services subject to the following conditions:

Key Tech shall treat all messages as confidential.
Client agrees to all service charges explained in "Answering Service Pricing".
Payments on accounts are due upon receipt. If no payment has been received thirty (30) days from invoice date, Key Tech will charge all amounts owed, by the client, to the below listed credit card or draft the clients checking account including a 2% late fee. If the credit card of checking account is invalid for any reason the service will be suspended and all messages will be held until full payment is received.
Both parties understand and acknowledge that this is a service agreement. Key Tech shall not be liable to client, its employees, agents, customers, or to any third-party for any consequential damages that may arise with the services provided herein.

As a deposit please fill out the following form. If you do not have a credit card you must submit a voided check to our company for deposit. Please call for more information.

Credit card information:

Name on Card:
Type Card:
Card Number:
Expiration Date:	Debit Monthly? or Monthly Invoice?

Get up to $20.00 off your very first invoice:

Company Name:
Contact Name:
Street Address:
City:
Zip:
Phone:
Company Name:
Contact Name:
Street Address:
City:
Zip:
Phone:
Company Name:
Contact Name:
Street Address:
City:
Zip:
Phone:

Thank you for choosing Key Tech Communication Services as your answering service.

We look forward to a great relationship with you. Remember, we know we are an extension of your business!

By submitting this form, you agree to all information stated in the service agreement.

If you are not contacted by a representative from Key Tech within 24-48 hours, please call us at 1-800-734-0761

Key Tech Communication Services, LLC

1-800-734-0761
400 Hart Street, Monroe, LA 71201
http:/www.keytechcommunication.com