1980-34
Agreement #80-34
Additional Work Order Form
Customer Number
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- RIDER -
.
THIS RIDER made this
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day of
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is part
of and is to be attached to Agreement made the
day of
by and between ELECTRO PROTECTIVE CORPORATION hereinafter called the "Contractor", and
fort} .~~f elf r;i;ont
hereinafter called the "SUBSCRIBER", for
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service in the premises of the Subscriber at
in the City of
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, State of
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SCHEDULE OF PROTECTION
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I nstallation Charge
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Annual Service Charge
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Except as amended be this Rider agreement, all the terms and conditions of
said Agreement shall remain in full force and effect and the terms and conditions
of the within Rider Agreement shall be a part of said Agreement, as if originally in-
corporated therein.
ELECTRO PROTECTIVE CORPORATIOl\l
CONTRACTOR
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SUBSC RI BER
By
AGENT
By
Title
EPC 001619 (2/78)