SBG Contract
--- PAGE 1 ---
Date:
SERVICE TYPE
Permanent
Temporary
Unarmed
Armed
Patrol
CLIENT SERVICE ADDRESS
Name:
Street:
City, State, Zip :
Contact Name/Title :
Telephone :
Email :
Billing Address Same as Service Address
CLIENT BILLING ADDRESS
Name:
Street:
City, State, Zip :
Contact Name/Title :
Telephone :
Email :
CONTACT DETAILS
EMERGENCY CONTACT(S) NAMES #1:
EMERGENCY CONTACT(S) NAMES #2:
HOME PHONE NUMBER #1:
HOME PHONE NUMBER #2:
CELLULAR PHONE NUMBER #1 :
CELLULAR PHONE NUMBER #2 :
SERVICE RATES PER HOUR
Unarmed
Regular:
Overtime:
Armed
Armed Regular:
Armed Overtime:
Patrol
Regular :
Overtime :
GUARD & TIME DETAILS
SECURITY BASE GROUP WILL PROVIDE _______ SECURITY OFFICER(S) FROM:
Additional Information:
Days:
Monday
Tuesday
Wednesday
Thursday
Friday
From (Regular):
AM
PM
To (Regular):
AM
PM
Saturday
Sunday
From (Overtime):
AM
PM
To (Overtime):
AM
PM
Security Services shall commence on:
Title:
Date :
--- PAGE 3 ---
CLIENT DETAILS
Company Name:
Street:
City, State, Zip :
Attn Name :
Phone :
Email :
--- PAGE 4 ---
Security Services shall commence on:
Day Name:
Date:
Month:
Year:
SIGNATURES
Authorized Representative #1
Authorized Representative #2
DATES
Date #1:
Date #2:
--- PAGE 5 ---
CREDIT CARD INFORMATION
Card Type:
Visa
MasterCard
American Express
Discover Card
CREDIT CARD:
CVV :
Expiry Month :
Expiry Year :
CUSTOMER’S INFORMATION
FIRST NAME :
MIDDLE NAME :
LAST NAME :
STREET ADDRESS :
CITY :
STATE :
ZIP :
PHONE NUMBER :
EMAIL ADDRESS :
AMOUNT AUTHORIZATION GIVEN FOR :
DATE AUTHORIZATION GIVEN :
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