Please complete the form below:
Customer Name
*
Customer Connectivity Address
*
Installation Type
*
DIA
IPLC Local LOOP
IPVPN Local Loop
MPLS Local Loop
Contact Person
*
Contact No (Mobile/LandLine)
*
Contact Email
*
Commissioning Date
*
Billing Date
*
Site Address
*
Internet Bandwidth (Applicable for DIA & IPVPN)
*
Number of IP Required
*
Managed Service Router
*
Cisco 881 Sec k9
1921 Sec K9
Mikrotik Router
SMART Hand service One Call is inclusive (Upto 4 Hours) and beyond that per call upto 4 hours USD $100
*
Yes
No
Setup Charge (OTC)
*
Recurring Charge (MRC)
*
Advanced Amount
Work Order
*
Name of the Account Manager in AirTel
*
Contact No (Mobile)
*
Contact email
*
Comments
Security Code
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