SERVICE ORDER FORM

A. DETAIL PERUSAHAAN / Customer Detail

Nama Perusahaan / Company Name :
Alamat / Address of Business :

Kota : Kode Pos :

Telepon / Fax Telephone/Faximile : Telepon: Faximile :

Npwp / Tax Registration Number :

Nama Pemilik Perusahaan/ Owner : Tn/Mr.

Ny/Mrs.

Nomor Ponsel/Mobile Number :

Nomor Identitas/Id Number : Ktp Sim

B. PENANGGUNG JAWAB KEUANGAN / Authorized Financial Personnel

Nama / Name :
Jabatan / Job Title :
Telepon /Fax Telephone/Faximile : Telepon: Faximile :

Nomor Ponsel / Mobile Number :

Alamat Email / Email Address :
Alamat Penagihan / Billing Address :

Kota : Kode Pos :

C. Penanggung Jawab Teknis / Authorized Technical Personnel

Nama / Name :
Jabatan / Job Title :
Telepon /Fax Telephone/Faximile : Telepon : Faximile :

Nomor Ponsel / Mobile Number :

Alamat Email / Email Address :
Alamat Pemasangan /Installation Address : Kantor Pusat Kantor Cabang

PT. Solusi Trimegah Persada

021-55766372
 Kota : Kode Pos :

D. JASA LAYANAN / Service Requirement

Jenis Berlangganan Baru Perpanjangan

Jenis Layanan Corporation Game Personal Others

Center
Paket Bandwith Custom IIX Mbps IX Mbps
Office
Global Mbps

Periode 1 Tahun 2 tahun Others :

Berlangganan

E. Biaya Berlangganan / Biaya PPN 10% JUMLAH

Subscription fees
Biaya Bulanan Rp. Rp. Rp.
Biaya Registrasi & Instalasi Rp. Rp. Rp.
Biaya Lainnya
Total Biaya Rp.

Technical Information
Interfaces : RJ 45 / UTP
Location :

A. SERVICE LEVEL GUARANTEE

1. Customer will get a trial period connection for 7 days.
2. PT STP shall guarantee COSTUMER in service availability of telecommunication service
at 99% every month.
3. The service level guarantee is determined with the following formula :
Service Level Guarantee (%) : (available hours per month – down time) x 100
Total hours per month

PT. Solusi Trimegah Persada

021-55766372
 B. RESTITUTION
1. If the network availability is lower than the service level guarantee described above,
COSTOMER will receive restitution from the monthly cost by making adjustment as
follow.
2. The amount of restitution in a current month shall not be higher than 20% of the Month
Payment.
3. The provision of restitution is claimed by both parties signing the Service Level
Agreement Report.
4. The provision of the restitution is performed by deducting the amount payable for the
next following payment with the amount of the restitution that has been approved.

City : Date : Month : Year :

PT SOLUSI TRIMEGAH PERSADA PT. ………………………………….

Hendry A
__________________________ ____________________________
TSD Staff

Harap melampirkan :

 Tanda tangan diatas materai dan

stempel
 Fotokopi Ktp Penanggung Jawab
 NPWP Perusahaan

PT. Solusi Trimegah Persada

021-55766372