ALARM MONITORING SERVICE AGREEMENT

Lic: AL 99-40 FL EF0000964 OK 648 TX B-09590 VA 11-2850

DATE DEALER # SYSTEM #/ACCOUNT # POLICE ALARM PERMIT # FIRE ALARM PERMIT #

This agreement is made this_________________day of___________________________, by and between RRMS INC. (“Company”) andITEM “1.” ABOVE (“Subscriber”).

Location of Subscribers (“Premises”) ITEMS “2.,” “3.,” ABOVE. In consideration of and subject to the terms and conditions herinafter set forth Companyagrees to monitor and Subscriber agrees to permit Company to monitor a [ ] U.L. [ ] remote programmable [ ] commercial [ ] residential signaling system(“System”) in subscribers Premises as a subcontractor of_______________________________________________________________________(“Dealer”).

SUBSCRIBER SPECIFICALLY ACKNOWLEDGES AND ACCEPTS PARAGRAPHS 3 AND 6 HEREOF. TERMS AND CONDITIONS ON THE REVERSE SIDE ARE ANINTEGRAL PART OF THIS CONTRACT. SUBSCRIBER ACKNOWLEDGES RECEIPT OF A COPY OF CONTRACT. READ THE FRONT AND REVERSE BEFORE SIGNING.

THERE ARE NO WARRANTIES, EXPRESS OR IMPLIED, WHICH EXTEND BEYOND THE DESCRIPTION ON THE FACE OR REVERSE HEREOF, INCLUDING ANYIMPLIED WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE.

IN WITNESS WHEREOF, and intending to be legally bound, the parties have executed or caused this Agreement to be executed on the date first above written.

By: ________________________________________________________________ SUBSCRIBER: _________________________________________________________

Approved: _____________________________________ Date ________________ Date: __________________________________________________________________RRMS-FM-101

/ /

= Authority Level*A.L.

1. NAME ________________________________________________________________________________

2. ADDRESS ____________________________________________________________________________

3. CITY __________________________ STATE ______ ZIP _________ CROSS STREET ____________

4. TELEPHONE # ______________________________ 5. _______________________________________

COMMUNICATOR MAKE (MODEL #) _______________ FORMAT TYPE ____________________________

DIRECTIONS TO PREMISES: ________________________________________________________________

DEFAULT # TIME ZONE

PHONE NUMBERS CONNECTED TO COMMUNICATOR:

#1 __________________________________________ #2 ______________________________________

TEST TIMER❑ DAILY❑ WEEKLY❑ MONTHLY

OPEN/CLOSE ❑

ADDITIONAL ZONE ❑

ADDITIONAL ❑PASSCODE

MEDICAL ❑

RESIDENTIAL ❑

COMMERCIAL ❑

OTHER __________

ATTACHED RIDERS

INSTALLATION TYPE

LOCAL AUTHORITIES

AUTHORIZED INDIVIDUALS TO BE NOTIFIED (in sequence)

ALARM CONDITION RESPONSE OPTIONS

AGENCY CODE AUTHORITY TELEPHONE NUMBER

( )

( )

( )

( )

( )

( )

( )

( )

( )

( )

( )

NAME TELEPHONE NUMBER PHONECODE

1.

2.

3.

4.

5.

6.

*Phone Code Descriptions Are: = Home = Work = Cellular = Pager❑H ❑W ❑C ❑P

= Fire

= Police

= Emer./Medical

= Guard

= Other

❑F

❑P

❑E

❑G

❑O

ZONE DESCRIPTIONAGENCYCODE VERIFY DISPATCH NOTIFY RP

❑ Y ❑ N ❑ Y ❑ N ❑ Y ❑ N

❑ Y ❑ N ❑ Y ❑ N ❑ Y ❑ N

❑ Y ❑ N ❑ Y ❑ N ❑ Y ❑ N

❑ Y ❑ N ❑ Y ❑ N ❑ Y ❑ N

❑ Y ❑ N ❑ Y ❑ N ❑ Y ❑ N

❑ Y ❑ N ❑ Y ❑ N ❑ Y ❑ N

❑ Y ❑ N ❑ Y ❑ N ❑ Y ❑ N

❑ Y ❑ N ❑ Y ❑ N ❑ Y ❑ N

❑ Y ❑ N ❑ Y ❑ N ❑ Y ❑ N

❑ Y ❑ N ❑ Y ❑ N ❑ Y ❑ N

❑ Y ❑ N ❑ Y ❑ N ❑ Y ❑ N

❑ Y ❑ N ❑ Y ❑ N ❑ Y ❑ N

❑ Y ❑ N ❑ Y ❑ N ❑ Y ❑ N

❑ Y ❑ N ❑ Y ❑ N ❑ Y ❑ N

❑ Y ❑ N ❑ Y ❑ N ❑ Y ❑ N

❑ Y ❑ N ❑ Y ❑ N ❑ Y ❑ N* Agency Codes Are: = Police, = Fire, = Emergency Svc, = Guard, = OtherP❑ ❑ F ❑E ❑G ❑O

USER ID PASSCODE A.L.* NAME USER ID PASSCODE A.L.* NAME