FIXED SERVICE APPLICATION FORM

Sales Person: ....................................................................................................................................................................................................................................

Agency/Dealer:................................................................................................................................................................................................................................
Region:.............................................................................................................................................................................................................................................

Customer Details:
ICT
Industry:...........................................................................................................................................................................................................................................
Company Name:...............................................................................................................................................................................................................................
Email Address:...................................................................................................................................................................................................................................

Physical Address
MILIMANI
Road/Street: ....................................................................................................................................................................................................................................
Building: ...........................................................................................................................................................................................................................................
1557
Floor: .................................................................................................................. Postal Address:...................................................................................................
KITALE
City/Town: .......................................................................................................... 30200
Code: .................................................................................................................

A007763963K
V.A.T. Registration No.:......................................................................................... PIN Number.........................................................................................................
DENNIS KITIABI KINGASIA
I.T. Mgr/Technical Contact Name: .....................................................................................................................................................................................................
+254 720 264550
Tel No.: ............................................................................................................... [email protected]
Email Address:......................................................................................................
Billing/Key Contact Person Name: .....................................................................................................................................................................................................
Tel No.: ............................................................................................................... Email Address:......................................................................................................

Tel. numbers for accessing support line:

0724931560
1……….....................……………….……………......................................................... +254 748614868
2 .........................................................................................................................
*Please attach copies of ID/registration certificate/certificate of incorporation & vat registration certificates/pin certificate.

Tick Service Required:

Additional Details (Bandwidth/Licenses/Credit Limit)

Internet: ......................................................................................................................................................................................................................................
Wide Area Network (MPLS): ........................................................................................................................................................................................................
Fixed Data
P2P: ............................................................................................................................................................................................................................................
Price Excl. Tax: ............................................................................. Price Incl. Tax: .....................................................................................................................
(Indicate currency)

Reserved Member.....…………….......................................
One Connect Business Per Minute (KES)...................................................................................
Number of extensions to be activated…….........................
Reserved Credit Limitations (KES).........................................................................
Sequence to be activated.................................................

Silver Credit Limit per SC

..................................................
One Connect Plus (HCS) Gold No. of seats....................................
..................................................
Platinum ..................................................

• Reserved Number …………………………….....................

• Extension sequence to activate………………...................
• No. of extensions.............................………..................
• Price per minute…………….........................…..............

Activate International Calling? Yes No

*Security on Fixed Voice products is outlined on the minimum security guidelines document. Please ask for it from our sales representative.
Tick Appropriate Last Mile Technology:

Kifarunet WiMax Microwave LTE 5G Other

Payment Details:
Payment Method: M-PESA Cash Direct Debit Cheque EFT
Contract Term:

Contract period attached to the service requested: 1 Year 2 Years 3 Years 4 Years 5 Years Other: ……………Years

Customer Declaration:

Conditions contained overleaf. I/we hereby authorise Safaricom PLC to approach our bankers and any other trade reference for any information Safaricom PLC may
require.
DENNIS KITIABI KINGASIA ICT OFFICER
Applicant Name: ..................................................................................................Designation:..........................................................................................................
20/11/2024
Date: ...................................................................................................................Authorised Signature..............................................................................................

Stamp:..................................................................................................................
 GENERAL TERMS AND CONDITIONS FOR DELIVERY OF SERVICES
1. INCORPORATION OF OTHER DOCUMENTS transmission or reception of signals by your equipment. You shall ensure that your equipment does not interfere
Thank you for choosing Safaricom. This Agreement sets out the general terms that apply to the Service you have with or otherwise degrade the operation of the Safaricom Equipment or the Safaricom Network. Safaricom shall
ordered from us. Your usage of the Service may be subject to additional terms and conditions that are set out in have full control over the configuration of the Safaricom Network and Safaricom Equipment. You may choose
a separate Service Schedule that you will be required to sign. Each applicable Service Schedule and Order Form to buy equipment from Safaricom at an amortized rate.
that you sign in respect of a Service are hereby incorporated into this Agreement by this reference. 4.8 Services Provided by Safaricom Affiliates. If an Order Form requires the provision of a Service to you in a
jurisdiction other than a jurisdiction within which Safaricom is authorized to provide services, such Service may
2. HOUSEKEEPING be provided to you by an Affiliate of Safaricom or through a third party service provider. If the provision of the
2.1 WHAT SOME OF THE WORDS MEAN Services in such a jurisdiction requires that, in order for such Order Form to be enforceable, additional terms
2.1.1 Some of the words used in this Agreement have specific meanings. These words are capitalized throughout must be added or an additional contract be entered into with such a Safaricom Affiliate or third party provider,
the Agreement and explained in clause 2.2 (Defined Terms). then the Parties shall incorporate such additional terms in the Order Form or enter into such an additional
2.1.2 The words below have the following meanings: contract preserving to the fullest extent the terms set out in this Agreement.
‘you’ and ‘your’ means you, the party that Safaricom is contracting.
Phrases that refer to ‘we’, ‘our’, ‘us’, ‘each of us’, ‘each of our’ and the like will mean either one or both of 5. OWNERSHIP
Safaricom and you, whichever makes sense in the context of the sentence. 5.1 Intellectual Property. You shall remain entitled to all right and interest in and to all of Your Technology and
2.1.3 The words ‘include’ or ‘including’ do not limit something to just the examples that follow. confidential information, and Safaricom is and shall remain exclusively entitled to all right and interest in and
2.2 Defined Terms to all Safaricom Technology and its confidential information. Neither Party shall, directly or indirectly, reverse
“Affiliate” means an entity that now or in the future, directly or indirectly controls, is controlled by or is under engineer, de-compile, disassemble or otherwise attempt to derive source code or other trade secrets from the
common control with a Party. For purposes of the foregoing, “control” shall mean the ownership of more than property of the other Party.
fifty percent (50%) of the
i. voting power to elect the directors of the entity or 6. LIABILITY AND LIMITATION OF LIABILITY
ii. ownership interest in said entity. 6.1 Damages. NOTWITHSTANDING ANY OTHER PROVISION HEREOF, NEITHER PARTY SHALL BE LIABLE FOR
“Agreement” means this agreement that is made up of these general terms and conditions, the applicable ANY INDIRECT, INCIDENTAL, SPECIAL, CONSEQUENTIAL, OR PUNITIVE DAMAGES (INCLUDING BUT NOT
Service Schedules, the Order Form and if applicable to the Service, the Price List. LIMITED TO DAMAGES FOR LOST PROFITS, LOST REVENUES, LOSS OF GOODWILL, LOSS OF ANTICIPATED
“DTA Country” means a country which has entered into a double tax agreement with Kenya and which SAVINGS, LOSS OF DATA, INTERFERENCE WITH BUSINESS OR COST OF PURCHASING REPLACEMENT
agreement would allow Safaricom not to pay tax twice on the same income. SERVICES) ARISING OUT OF THE PERFORMANCE OR FAILURE TO PERFORM UNDER ANY ORDER OR THESE
“Force Majeure Event” is any unforeseeable and exceptional situation or event beyond the control of the TERMS AND CONDITIONS, WHETHER OR NOT CAUSED BY THE ACTS OR OMISSIONS OR NEGLIGENCE OF
rel¬evant Party which prevents either of them from performing any of their obligations under the Agreement, ITS EMPLOYEES OR AGENTS, AND REGARDLESS OF WHETHER SUCH PARTY HAS BEEN INFORMED OF THE
was not due to error or negligence on their part or on the part of a subcontractor or representative, and could POSSIBILITY OF THE LIKELIHOOD OF SUCH DAMAGES.
not have been avoided by the exercise of due diligence. Defects in equipment or material or delays in making 6.2 NOTWITHSTANDING ANY OTHER TERM UNDER THIS AGREEMENT, SAFARICOM’S LIABILITY TO YOU
it available, labour disputes, strikes or financial problems cannot be invoked as force majeure unless they stem AND YOUR REMEDIES ARE LIMITED TO ANY APPLICABLE SERVICE CREDIT DUE TO YOU AND YOUR RIGHT
directly from a relevant case of force majeure. TO TERMINATE A PARTICULAR SERVICE ORDER.
“Governmental Authority” means any national or county government or any other administrative or regula¬tory 6.3 When Safaricom is not liable to you. Notwithstanding any other term under this Agreement, Safaricom will
body including without limitation, courts and public utilities. not be liable if it fails to do something that it is supposed to do under this Agreement, whether or not there is a
“Order Form(s)” means the document you shall use to order for a Service(s). The Order Form shall be in the Force Majeure Event, to the extent Safaricom’s failure is due to:
form of purchase order or such other form (physical or electronic) as may be required by Safaricom that sets out 6.3.1 your failure to carry out any of your responsibilities under the Agreement, or you carrying them out late,
information that includes the Services that you require, the applicable Service Fees and the Term. in which case you will pay Safaricom (where demanded) for any reasonable costs Safaricom incurs as a result
“Price List” means the price for the Service(s) in the applicable Service Schedule. of your failure;
“Ready for Service Notification” means a written notice from Safaricom to you that the Service ordered has been 6.3.2 a restriction or prevention by applicable law, a court order, an application for interlocutory relief or
installed, tested and is functioning properly in accordance with Safaricom’s specifications for the Service. injunction.
“Safaricom” means Safaricom PLC. 6.3.3 your or your representatives written direction.
“Safaricom Equipment “ means any and all devices supplied by Safaricom that are used to deliver the 6.4 Disclaimer of Warranties. EXCEPT FOR WARRANTIES EXPRESSLY MADE IN THIS AGREEMENT AND TO
Ser¬vices, including but not limited to all terminal and other equipment, wires, fiber optic cables, lines, circuits, THE FULLEST EXTENT PERMITTED BY THE APPLICABLE LAW, SAFARICOM MAKES NO WARRANTIES OR
ports, routers, switches, cabinets, racks, private rooms and the like. Safaricom Equipment shall not include any REPRESENTATIONS EXPRESS OR IMPLIED, EITHER IN FACT OR BY OPERATION OF LAW, STATUTORY OR
devices sold to you by Safaricom or owned by you. OTHERWISE, INCLUDING WARRANTIES OF MERCHANTABILITY, SATISFACTORY QUALITY AND FITNESS FOR
“Safaricom Network” means the telecommunications network which is owned and/or leased, operated and A PARTICULAR USE.
maintained by Safaricom or its Affiliates and that is used to deliver the Services.
“Safaricom Technology” means Safaricom’s proprietary technology, including without limitation, Services, 7. TERMINATING THIS AGREEMENT OR ORDER FORM
software tools, hardware designs, algorithms, software (in source and object forms), user interface designs, 7.1 Termination by you. You may terminate an Order Form by sending to us your written notice of termina¬tion
architecture, class libraries, objects and documentation (both printed and electronic), network designs, know- if we breach a material term of this Agreement and, if such breach is capable of remedy, we fail to cure such
how, business methods, and any related intellectual property rights throughout the world (whether owned by breach within thirty (30) days after receipt of your written notice
Safaricom or licensed to Safaricom from a third party). 7.2 Termination or Suspension by Safaricom. Safaricom shall have the right, upon written notice, to
“Services” or “Services” means the service that Safaricom will provide to you as listed in the Order Form. imme¬diately terminate or suspend this Agreement or any Order Form(s), and discontinue or suspend the
“Service Commencement Date” means the date indicated in the Ready for Service Notification. delivery of the affected Services (without liability) in the event that:
“Services Fees” means charges for Services (including but not limited to monthly recurring charges and non- i. you breach a material term of this Agreement or Service Schedule including the failure by you to pay sums
recurring charges) that you will be required to pay as identified in the Order Form(s), Service Schedule or Price when due;
List as the case may be. Services Fees exclude applicable transaction taxes including but not limited to VAT which ii. you commit a violation of: (i) any communicated Acceptable Use Policy or other rules relating to use of, access
will be billed to you at the prevailing rate at the time of the invoice. to, or security measures relating to the Services, or (ii) any law rule, regulation or policy of any Government
“Service Schedule” means the schedule that sets out service specific information including terms and condi¬tions, Authority related to the Services or your use thereof;
specifications, the applicable solution design/architecture and other technical information applicable to the iii. you engage in conduct that has caused or may cause material damage to Safaricom’s Equipment, Network
Service ordered. or third parties;
“Term” means the period of time, as set out in the relevant Order Form, during which Safaricom will provide the iv. Any bankruptcy, insolvency, administration, liquidation, receivership or winding up proceeding are
Services to you. commenced against you;
“Termination Charges” means compensatory charges payable by you to Safaricom on termination of an Or¬der v. In the event Safaricom receives any direction, notification or instruction from any Governmental Author¬ity to
Form calculated in accordance with the formula set out in the applicable Order Form or Service Schedule. We suspend or terminate the provision of Services to you.
have agreed that these termination charges are a genuine pre-estimate of the loss that Safaricom would incur 7.3 Consequences of Termination. On termination of the Agreement or an Order you must stop to use the
due to the termination of the Order Form and/or the remaining balance of the equipment purchased by the Services and will pay to Safaricom all Service Fees due, including any applicable Termination Charges.
Customer on an amortized basis.
“Your Premises” means the location or locations occupied by you or your end users to which Safaricom will 8. MISCELLANEOUS PROVISIONS
deliver the Service. 8.1 Contents of Communications. Safaricom does not monitor and will have no liability or responsibility for
“Your Technology” means your proprietary technology, including without limitation, all text, pictures, the content of any data and/or communications transmitted via the Services. You acknowledge and agree
sound, video, and log files, your software (in source and object forms), user interface designs, architecture that Safaricom and its Affiliates (together “the Providers”) are only intermediaries for the transmission of
and doc¬umentation (both printed and electronic), know-how, and any related intellectual property rights your information and that the Providers play a passive role as a conduit of your information and that they
throughout the world (whether owned by you or licensed to you from a third party). neither initiate the transmission of information, select the receivers of the transmission, nor select or modify the
information contained in the transmission.
3. WHEN THE AGREEMENT STARTS AND ENDS 8.3 Force Majeure. Neither party shall be liable, nor shall any credit allowance or other remedy be extend¬ed,
3.1 The Agreement starts on the Service Commencement Date and will carry on until: for any performance that is prevented or hindered due to a Force Majeure Event. The Party claiming re¬lief
3.1.1 the end of the Term; or under this clause shall exercise commercially reasonable efforts to minimize the time for any such delay. If a
3.1.2 one of us ends it (in a manner permitted by the Agreement). Force Majeure Event persists beyond thirty (30) days, the parties agree to meet and discuss an equitable solution
taking into account the nature of the obligation involved, the likelihood of a workaround solution, and the extent
4. THE SERVICES to which the affected party is or will be adversely affected. If a Force Majeure Event persists beyond ninety (90)
4.1 General. You may submit Order Form(s) requesting for the delivery of Services, each of which when days, then you shall have the right to terminate the relevant Order Form.
accepted in writing by Safaricom will be governed by this Agreement. 8.4 Data Protection. During the performance of this Agreement, it may be necessary for Safaricom to trans¬fer,
4.2 Term/Service Fees. You agree to pay the Service Fee during the Term and for such longer time as you may process and store billing and utilisation data and other data (including personal information) necessary for the
use the Services. In the event Safaricom permits you to continue to use the Services after the end of the Term, provision of the Services and its other obligations under this Agreement. You hereby consent to Safaricom’s (a)
then the Term will automatically renew for successive twelve (12) month periods. Either Party may terminate the transfer (including to its Affiliates and relevant third parties), storage and processing of such data; and (b) use
Agreement before the end of the Term or any renewal term by providing thirty (30) days prior written notice of of such data for its own internal purposes, for the performance of this Agreement and as allowed or required
such intention to the other Party. by law.
4.3 Payment. Unless otherwise agreed between the Parties in writing, billing for the Services shall commence on 8.5 Data Privacy. Safaricom is committed to respecting and protecting the privacy of the information we
the Service Commencement Date. Safaricom shall invoice all Service Fees monthly (partial months will be pro- collect from you in compliance with the applicable laws and obligations on data use and privacy. Our privacy
rated based on a calendar month) in advance except for the One Connect Service charges that are dependent statement, as updated from time to time, explains how we treat your personal data and protect your privacy
on usage, which shall be billed in arrears and bundle top up products which You should be able to repurchase when you use our Service and can be found on https://www.safaricom.co.ke/images/Downloads/Terms_
upon depletion of the monthly allocation. Any applicable deposit shall be paid during service activation and will and_Conditions/C1_Safaricom_Data_Privacy_Statement.pdf . Any update or amendment to these Terms and
be refundable at service termination upon settlement of all due bills. Where service is activated in the course Conditions including privacy terms will be available on the Safaricom website www.safaricom.co.ke and will
of the month, prorated usage from date of activation to end of the month will be billed and included in the take effect from the date of notification of the update or amendment.
1st months invoice. You shall pay all amounts due within thirty (30) days from the date of invoice to the bank 8.6 Governing Law; Dispute Resolution. The interpretation, validity and performance of this Agreement shall
account designated by Safaricom from time to time or through the Safaricom MPESA. Unless otherwise specified be governed by and construed in accordance with the laws of Kenya. Any dispute or difference be¬tween the
in an Order Form, all amounts shall be invoiced and paid in Kenya Shillings. Parties relating to the rights or obligations of the Parties under this Agreement which cannot be settled amicably
4.4 Withholding Tax if you deduct withholding tax from your payments to Safaricom, you will: shall be brought before Kenyan courts.
4.4.1 where the Service is provided in Kenya or a DTA Country, provide Safaricom with a withholding tax 8.7 Severability; Waiver. In the event any provision of this Agreement is held by a court of competent juris¬diction
certificate in such format as may be prescribed by the Kenya Revenue Authority from time to time. to be invalid, void or unenforceable, such offending provision(s) shall be stricken and the remainder of this
4.4.2 where the Service is provided outside of Kenya or in a non-DTA Country, gross up your payments to Agreement shall remain legal, valid and binding. The failure by either Party to exercise or enforce any right
Safaricom so that the net amount Safaricom receives is equal to the amount it would have received had there conferred by this Agreement shall not be deemed to be a waiver of any such right nor to operate so as to bar
been no deduction or withholding. the exercise or enforcement of any such or other right on any later occasion.
4.4.3 indemnify Safaricom in full including for any interest, fines and penalties charged by the taxing author¬ity 8.8 Assignment. You may not assign this Agreement without first obtaining Safaricom’s prior written con¬sent.
and any costs to defend the claim where Safaricom receives a claim from a taxing authority that it has not Safaricom may assign this Agreement [to its Affiliate] without your prior written consent but you will be notified
received withholding tax deducted. of the assignment.
4.5 Disputed Bills. In the event that you dispute any portion of a Safaricom invoice then you will be required to 8.9 Notice. Any notice or communication required to be given hereunder may be delivered by hand or email
pay the undisputed portion of the invoice and submit a written claim for the disputed amount, documenting the (with confirmation of delivery) at in the case of Safaricom, to Safaricom House, Waiyaki Way c/o the CEO and
basis of your claim. All claims must be submitted to Safaricom within seven (7) days of receipt of the invoice for in your case to the address you provide in the Order Form or at such other address as may be subsequently
those Services. communicated by either party by notice in writing.
4.6 Unauthorized Use of Services. You will be solely responsible for all charges incurred in respect of the 8.10 Entire Understanding. This Agreement (including the Service Schedules, any Order Form and to the extent
Services even if such charges were incurred through or as a result of unauthorized use of the Services unless applicable the Price List), constitute the entire understanding of the Parties related to the subject matter hereof.
such unauthorized use is proven to have been occasioned by a willful default by Safaricom. You will not resell, All prior written or oral agreements, understandings, communications or practices between you and Safaricom
duplicate, transfer, give access to, copy or distribute any part of the Service in any medium without Safaricom’s are hereby superseded insofar as they relate to the Services hereunder. This Agreement may be amended only
prior written authorization. in writing signed by a duly authorized representative of each of the Parties. In the event of any conflict between
4.7 Equipment Provided and Configured by you. Safaricom will not be responsible for the operation or the documents comprising this Agreement, precedence shall be given to the documents in the following order:
maintenance of any equipment provided or configured by you and neither will Safaricom be responsible for the (i) this Agreement; (ii) the applicable Service Schedules; (iii) the Order Form.