)343
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Serial No.:
PLEASE FILL OUT THE FORM IN CAPITAL LETTERS
SERVICE ORDER FORM - DATA SERVICES
Customer Segment (SME/Corporate) SME OPCO
Customer Type (New/Old) NEW Order Nature(BW/HW)
Order Number 01 Order Date
Bill Type (Individual/Combined) INDIVIDUAL PO Number
Service SHARED
Service Description
Upto 25mbps
Client Name BWANIKA GODFREY Account No.
Client Address Contract Start Date AFTER
INSTALLATIO
Busukuma, Nansana N
Town council, Wakiso
Contact Person BWANIKA GODFREY Contract End Date 12 MONTHS
Contact Number 0703205729 Billing Amount 170000
Client Email ID garaybale@gmail.com Billing Frequency MONTHLY
BIiiing Contact Person BWANIKA GODFREY One Time Charge 100000
20%
discount
BIiiing Email Address garaybale@gmail.com Billing Date
Network Bandwidth Up to 25 mbps
Billing Bandwidth
I hereby confirm that the information provided is correct and wish to subscribefor the services indicated here-in. I have read and agreed to the terms and
conditions as stated overleafand undertake to abide by the same. I hereby certify that in case ofthis b�ing a corporate entity, I am duly authorised to bind the
entity indicated herein. This Service Order Form together with the said terms and conditions constitute a binding agreement with Airtel
Signed for and on behalf of Classic Net Uganda Signed for and on behalf of Customer
Name
Date
Name
Date
BWANIKA GODFREY
11/09/2023
..
-·
I warrant that I have been duly authorised to sign the agreement I warrant that I have been duly authorised to sign the agreement
Classic Net Uganda limited, US Mall, Kyanja P.O. Box 200771 Nakawa Uganda, Tel: 0200952680 www.classicnet.co.ug