Job # JOB- _____________________ Name: ___________________________________________ Date:_____________

T/Customer ID: ____________________________ CS: _________________________ Dealer #: ____________________

Address: _____________________________________________________________Cross St. ( )

Equipment Credit: $850 Essential + $____________ EC = $____________ Pocket: ____________ Points $$$

Note _________________________________________________________. IMEI: _______ _______ _______ _______

Receiver #: __________________________________

Name: _____________________________________________________ Phone: ________________________________

Name: _____________________________________________________ Phone: ________________________________

PIN: _______________ VPW: ____________________ EMAIL: _____________________________________________

# Location Device Group # 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36

# Location Device Group # 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64

Confirmation: 888-238-3282

Confirmation #:

Verification: 877-454-2425

Zone Location Device Group # 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113

Zone Location Device Group # 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162

FORT KNOX AGREEMENT

Panel (AIO 7”): $299 X $299 = $299 _____ $ 299 ______________

Panel (2x16): $259 X $259 = $259 _____ $ 259 ______________

4 Button: $139 X ________ = ________ _____ $___________________

Em. Pendant: $139 X ________ = ________ _____ $___________________

Touch Screen $299 X 2 |______ = 598|____ _____ $___________________

2 Way Keypad $259 X ________ = ________ _____ $___________________

DW $139 X ________ = ________ _____ $___________________

>>Shock: $169 X ________ = ________ _____ $___________________

Glass Break: $239 X 3 |______ = 717 |____ _____ $___________________

Smoke: $239 X 5 |______ = 1195|____ _____ $___________________

Carbon: $239 X 5 |______ = 1195|____ _____ $___________________

Motion: $239 X 2 |______ = 478 |____ _____ $___________________

Flood: $159 X 1 |______ = 159 |____ _____ $___________________

Siren (Int.) $159 X 2 |_______ = 318 |_____ _____ $___________________

Siren (Ext.) $299 X 2 |______ = 578 |_____ _____ $___________________

Camera: $299 +$299 X 3 |______ = 897 |_____ _____ $___________________

Door Lock: $399/299 X 2 |______ = 698 |_____ _____ $___________________

Lamp Control: $ 69 X 2 |______ = 138|______ _____ $___________________

WiFi Extender: $ 69 X 1 |______ = 69 |______ _____ $___________________

Garage Bracket: $159 X 2 |______ = 318|_____ _____ $___________________

Shocks $169

2 3 4 5 6 7 8 9 10 11 $ 338 $ 507 $ 676 $ 845 $ 1,014 $ 1,183 $ 1,352 $ 1,521 $ 1,690 $ 1,859

12 13 14 15 16 17 18 19 20 21 $ 2,028 $ 2,197 $ 2,366 $ 2,535 $ 2,704 $ 2,873 $ 3,042 $ 3,211 $ 3,380 $ 3,549

DW / Key FOB / EM Pendant $139

2 3 4 5 6 7 8 9 10 11 $ 278 $ 417 $ 556 $ 695 $ 834 $ 973 $ 1,112 $ 1,251 $ 1,390 $ 1,529

Smoke / Carbon / Motion / Glassbreak $239

2 3 4 5 6 7 8 9 10 11 $ 478 $ 717 $ 956 $ 1,195 $ 1,434 $ 1,673 $ 1,912 $ 2,151 $ 2,390 $ 2,629

Camera / Door Lock (+$100) $299

2 3 4 5 6 7 8 9 10 ! ! ! ! ! ! ! $ 598 $ 897 $ 1,169 $ 1,495 $ 1,794 $ 2,093 $ 2,392 $ 2,691 $ 2,990

Installation Details ADT Command Base Kit

Item Used Model In Kit Used Not Used Owed Panel AIO 7” / 2 x 16 1 1 0 Radio ATT / Verizon 1 1 0 KeyFob SiX™FOBA 1 Door/Window SiX™CTA DW 2 Motion SiX™PIRA 80 Lb. 1

Security Item Used How Many On Hand Owed Enrolled Signal Sent

SiX™SHOCKA Sensor SiX™CTA Sensor Garage Rail Brackets SiX™PIRA Motion Sensor SiX™GBA Glass Break SiX™FOBA KeyFob (4 Button) SiX™WTS700 AIO 7” SiX™WLTP100 2 by 16 SiX™SIRENA Siren (Indoor) SiX™SIRENODA Siren (Outdoor)

Life Safety Item Used How Many On Hand Owed Enrolled Signal Sent

SiX™SMOKEA Smoke Sensor SiX™COA Carbon Sensor SiX™PANICA Pendant Flood Sensor

Home Automation Item Used How Many On Hand Owed Enrolled On PULSE

DBC835 Doorbell Cam OC835 Outdoor Cam RC8326 Indoor Cam Wifi Extender Kwikset 888 Deadbolt B Bz N Jasco Appliance Module

Agreement: $____________ Flex? YES NO Were all sensors installed? YES NO Anything Owed? ______________

IF NO: ___________________________________________________________________________________________

NOTE: