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I <br /> � � ADDITIONAL SERVICES RIDER I���III���IIIIII�t�llllll�ll�I1��1�1�1�1�11��� j <br /> 5412UEQt <br /> accouNr xo � ��='��•�'i S���! � � r�o m <br /> Ir1"'i1�/'V/'� /I I f'71 is part of and is to be attached to � • by and betwecn ADT LI.0 dba ADT Sewlity <br /> Tt{SS RlOfR madc ljl�jj tt A��t u� the Contratt{�Contract')made r� Services("ADT"),with officez at <br /> Aedress �._._ � / L <br /> City G-�--�� •— � _ �1 �L- State���LG.a ZIP1�?l7�l�� <br /> �nd Cuziomet J � - <br /> ('Customer") L <br /> 8usiness taame �r. � r <br /> {-Customcr`) �f�I° <br /> fflr servicr i�the Premises of the Customer at '" t' <br /> � / <br /> City I > State� ZIP ��("Premfses") <br /> The Customer fiereby requests,and ApT agrees,to install the following additional protection: <br /> i- 5����r f����i �/G��� <br /> 1 - ���:� /?��� /Za 1��. S�r�P - � <br /> � - ,�,',�,���. — {WZ.i` f�L,D�r� �UIciC� � 1'�7��c'f�-, c�n <br /> } �� ,p �r.�-'; ,i <br /> The Customer hereby egrees to pay ApT,its Agents or Assigns the sum of �j �_,�G^7/ � «.'� �t �I (��t�-�''� <br /> �-„C����z;t �---�— / <br /> �''' r� c� $ o <br /> payable upon the signing of this Rider and the balance payable upon completion of this installation,and to pay the additional sum <br /> of ������ <br /> per annum. <br /> All equipment installed pursu�nt to this Rider shall remain the property of ADT,according to the ownership terms in the Contract. <br /> The partics hereto mutua(!y agree tfiat this Contrad,of which this Rider is made a part,is and shatl 6e and remain in fuli farte and effect in <br /> accordance with all the terms and conditions thereof. <br /> 7Fii5 R2pER REQUIRES FtNAi APPROVAC OF AN ADT AUTNdR1ZED MANAGER SEFORE ANY EQUIPMENTlSERViCES MAY BE PROVIDEd.IF APPRQVAL <br /> IS DENIED,THI5 RIDEft WILL BE TERMINATED AND AD7'5 ONLY 4BLIGATION TO YOU WILL BE TO NOTIFY YOU QF SUCH TERMINATION AND REFUND <br /> ANY AMOUNTS PA1D!N ADVANCE. <br /> ADT L4C dba ApT SERVICES /''�} ��� <br /> __�;, / / �J �J� ae � <br /> L�� } P <br /> ID No_ <br /> AD ' ve - <br /> Accepted and Copy Received By: <br /> Namemer � � ;� _ 1.� :�, � "�' �; �'�, ��i " � <br /> � <br /> X ��.�.�" � �..�.� 1 �7/�� � <br /> Custamer Signaiure <br /> &�2dt4 AQT LLC dba ADT Security Services. <br /> All rights reserved,(07/14) <br /> Oft{ce Copy <br /> Scanned by CamScanner <br />