Contract forPROVIDING SERVICES OF electronic communication
viaGIAInternet access service/ viaTVdigital cable TV service / viaPhonetelephone service
* All fields marked with an asterisk are required.
viaGIAcontract no.: / viaTVcontract no.: / viaPhonecontract no.:Customer no.:
Operator
T-Mobile Czech Republic a.s.,having its registered office atTomíčkova 2144/1, 148 00 Prague 4; company reg. no.:64949681, tax reg. no.: CZ64949681, registered in the Commercial Register administered by the Municipal Court in Prague, Section B, File 3787Customer
Surname / Business name: / * / Name: / * / Title:Permanent residence1)/ Registered office: / *
ID doc. no. / Reg. no.: 2) / * / Birth ID no. /Passport no.: 2) / * / Citizenship / *
Date of birth: / * / Tax reg. no: 2) / *
Mobile phone: / * / E-mail: 3) / *
1) To be filled in if the address is not the same as the installation address or the billing address. This is the address stated in a valid identity document that needs to be provided for the purposes of the verification of the data stated herein.
2) The registration number (andthe tax registration number) must be specified by a legal entity or a self-employed natural person (entrepreneur); other natural personsonly specify their ID document number and birth ID number. The passport number must only be filled in in the case of foreign nationals.
3) This field needs to be filled in for the purposes of the delivery of Statements of Services and information regarding the status of services. We will also send information and updates regarding the activated services to this e-mail address.
Service installation address
Location (name): / Building: / Floor:Street: / Conscription no. / Street no.: / / / Flat no.:
Community: / Postal code:
Billing address and payment method
Street: 4) / House no. / Street no.: 4) / /Community: 4) / Postal code: 4)
Payment method: / direct debit5)bank transfer / Statements sent: / electronically6)by post (charged, see the Price List)
Bank: 5) / Account no. / Bank code: 5) / /
4) To be filled in only if the billing address is different from the service installation address. If this section is left blank, the information contained in the section “service installation address” will be used.
5) If choosing direct debit as the payment method, you must first arrange for a consent to direct debit at your bank and specify the number of the account from which direct debit will be made.
6) Statements of Services are sent electronically by default – this service is free of charge.
Service specifications(only specifications of the services ordered are to be completed)
viaGIA –Internet access service
viaGIA plan: / Mini10/10Mbps / Light50/50 Mbps / Comfort100/100 Mbps / Ultra300/300 Mb/sContract term: / indefinite period / 12M fixed period / 24M fixed period / Requested activation date: 7)
Public static IP address: / yes(optional–subject to a fee) / Router – purchase (optional): 8) / D-link DIR-600 Mikrotik RB951G
7) If this field is left blank, the service will be activated as soon as practicable.
8)The router is not necessary for the use of the viaGIA service but the Operator recommends its purchase. For more detailed information, please visit ,section“viaGIA / Supplementary Devices. The router can be ordered for the full price (if the contract is entered into for an indefinite period) or for a special price(if the contract is entered into for a fixed term); more information is available in the Price List. Please select the type of the device in the box, the price will be set automatically depending on the contract term.
viaTV –digital cable TV service
viaTV plan: / ZákladStandard Premium / Requested activation date: 7)Set-top box: 9) / Lease:basic price12M fixed term 24M fixed term
Purchase: set-top box is purchased by the customer / Set-top box (type) / Arris VIP 1113
9) A set-top box can be rented or purchased, fees according to a valid Pricelist. The set-top box is a necessary device for usage of viaTV service.
viaPhone –telephone service
viaPhone plan: / Standard Combi (only in combination with the viaGIA / viaTV service)Combi Plus (only in combination with the viaGIA / viaTV service)
Contract term: / indefinite period 24-month fixed period / Requested activation date: 7)
Purpose of the telephone connection: / private usebusiness and other purposes / Itemised List of Calls10) / activate
Number porting (optional)11) / yes / Terminal(optional) / Siemens C590 Cisco SPA 303 Cisco SPA 112 adapter
10) Itemised lists of outgoing calls are sent by e-mail (once a month) free of charge.
11) To be filled in only if the subscriber of another operator wishes to terminate his/her contractual relationship with that operator, keep his/her existing national telephone number and use it also in relation to the Operator’s services. A document entitled “Geographic Number Porting” must be filled in if subscribers wish to port their number. If no number is ported to the Operator, the Operator will automatically allocate a new number to the Customer free of charge.
Telephone directory–form of publication of the Customer’s data in the telephone directory:12)standard release – name, surname, academic degree (for natural persons), trade name or name; or e-mail address / not to publish the data
E-mail: / Alias:
Prohibition to use data for the purposes of direct marketing pursuant to Section 95 of Act No. 127/2005 Coll.: / yes
12) Detailed information regarding the purpose of the telephone directory and the related rights of the Customer are specified in the Terms and Conditions for Processing of Subscribers’ Personal, Identification, Traffic and Location Data.
viaGIA, TV, Phone – device delivery (if a device is ordered)
Device delivery13) / personal pick-up delivery to the installation address (by courier – subject to a fee according to the Price List in force)13) Collecting the device in person at the Operator’s address is free of charge; the deliveryto the installation address is subject to a fee according to the Price List, regardless of the number of devices (the exact date needs to be agreed in advance).
Contractual stipulations:
1.1.The Operator and the Customer hereby enter into a contract for the provision of electronic communications services (the “Contract” or the “Subscriber Contract”) on the basis of which the Operator will provide to the Customer electronic communications services and related services in the scope on which the parties will agree (together the “Services”), and the Customer undertakes to pay the price agreed for the Services in a due and timely manner.
1.2.The contractual relationship established on the basis of this Contract is governed by the laws and regulations of the Czech Republic.The following documents form the content and inseparable parts of the Contract: the terms and conditions specified on this form, the Business Terms and Conditions Applicable to theviaHome Electronic Communications Services of T-Mobile Czech Republic a.s.in force (the “viaHome Terms and Conditions”), the General Terms and Conditions ofT-Mobile Czech Republic a.s.in force (the “General Terms and Conditions”), the Terms and Conditions for Processing of Subscribers’ Personal, Identification, Traffic and Location Data in force,the Number Porting Terms and Conditions in force,Specifications of the viaPhone Supplementary Services (optional), Specifications of the Geographic Number Porting Service in Relation to the viaPhone Service (optional) andthe viaHome Price List in force (the “Price List”).In the case of any discrepancy between the viaHome Terms and Conditions and the General Terms and Conditions, the viaHome Terms and Conditions will prevail.By signing this Contract, the Customer confirms that he/she is familiar with all these documents and that he/she agrees with them without reservations. The Operator points out to the Customer that certain documents specified above contain provisions that could be considered surprising. Such provisions are always marked in the documents (particularly in the form of underlining). The Customer confirms that he/she has carefully read these provisions and that he/she agrees with them without reservations. The Customer undertakes to read the terms and conditions of all Services that he/she will activate during the term of the Contract; the terms and conditions applicable to the activated Services will become an integral part of the Contract upon the activation of the particular Service.
1.3.The Services will be activated as close as possible to the requested activation date, usually within fourteen (14) daysfrom the requested activation date. If no requested activation date is specified, the Services will be activated usually within fourteen (14) days from the date on which the Contract is signed by the last party, though no later than thirty (30) days from the date on which the Contract is signed by the last party.
1.4.The Customer confirms that he/she is the owner of the property (usually the flat) in which the Services will be installed or entered into a valid lease agreement with the owner of the property or a valid sub-lease agreement with the lessee of the property, as applicable. If this condition is not fulfilled, the Customer is obliged to provide, together with this Contract, an express consent of the owner or the lessee of the property to the activation of the Service, which must bear a notarised signature of the owner or the lessee of the property.
1.5.The Customer further confirms that he/she has no outstanding debts owed to the Operator, which arise from the previous or any other concurrent contractual relationship. The prices for the Services and the related activities and price conditions are specified in the Price List as in force on the date of the provision of the Service. The Customer undertakes to pay the prices for the provided Services by the due dates that will be specified by the Operator in the relevant Statements of Services.
1.6.The Customer and the Operator have agreed on contractual penalties that may be charged in the event that the Customer breaches his/her duty to pay the price agreed for any provided Services in a due and timely manner. If the Customer delays the payment of any Statement of Services in relation to the provided Services by one (1) day, the Operator may charge acontractual penalty of CZK 150 to the Customer. If the Customer delays the payment of any Statement of Services in relation to the provided Services by twenty-one (21) days, the Operator may charge a contractual penalty of CZK 1,000 to the Customer. If the Customer fails to pay three consecutive Statements of Services in a due and timely manner or if the Customer delays the payment of any pecuniary debt owed to the Operator for a period exceeding ninety (90) days, the Customer is obliged to pay acontractual penalty equal to 20% of the sum of the monthly fees that remain to be paid until the end of the agreed contract term. The sum will be calculated for the period beginning on the first day of the suspension of services (i.e. the date on which the suspension or restriction of the Services pursuant to Article 3.4 of the General Terms and Conditions began), during which the right to claim the contractual penalty arose, and ending on the date of expiry of the agreed contract term. The decisive price is the basic list price incl. VAT applicable to the tariff plan that the Customer uses under the Contract; the right to claim this contractual penalty does not arise in the case of contracts that were entered into for an indefinite term. The Customer and the Operator have further agreed on a contractual penalty pursuant to Article 6.8 of the viaHome Terms and Conditions and Article 6.1 of the General Terms and Conditions. Contractual penalties may be applied simultaneously
If the Contract is terminatedfor a reason other than a delay in the payment of pecuniary debts, the Customer is obliged to pay to the Operator a financial compensation – a payment the amount of which equals to the costs associated with the device that was provided to the Customer under special terms,and at the same time a payment equal to 20% the sum of the monthly fees that remain to be paid until the end of the agreed contract term (the decisive price is the basic price incl. VAT applicable to the tariff plan, which was billed in the latest Statement of Services and which is stated in the Price List); such payment is deemed to represent a flat-fee compensation for the termination of the Contract prior to the expiry of the fixed term originally agreed upon between the parties. If the Operator claims the compensation of the costs associated with the device from the Customer, the Operator may bill this part of the compensation separately.
The Customer is obliged to pay the contractual penalties and financial compensation charged to him/her in a due and timely manner, by the due dates specified in the respective Statement of Services.
1.7.This Contract has been made in two counterparts havingthe legal force of an original; each of the parties will retain one counterpart.
1.8.The Contract comes into force on the date on which it is signed by the last party and into effect on the date on which the provision of the Service under this Contract begins.
1.9.If the viaTV service is ordered and provided, the Customer acknowledges that the TV channels marked as “adultsonly” are intended only for viewers older than 18 years and may contain scenes of violence, graphic sexual content or other content not admissible for persons younger than 18 years.
The Customer confirms that the data stated in this Contract is true and complete. If the Operator finds that the data stated herein is not true or is incorrect, it may terminate the provision of the Service(s) in accordance with the viaHome Terms and Conditions. Together with the acceptance of the offer, the Customer is obliged to indicate all provisions of all business and other terms and conditions of the Operator which the Customer could not have reasonably expected; if the Customer does so, a procedure similar to that as in the case of a non-binding offer will apply. If the Customer enters into the Contract as a consumer and if the Contract was concluded outside the usual business premises or using the electronic communications means, the Customer may withdraw from the Contract within fourteen (14) days following the date on which the Contract was concluded. To withdraw from the Contract, the Customer is required to send a notice of withdrawal to the following address: Kontaktní centrum viaHome (“viaHome Contact Centre”), T-Mobile Czech Republic a.s., Tomíčkova 2144/1, 148 00 Prague 4. The Customer hereby explicitly requests the Operator that it starts fulfilling its duties before the expiry of the above-mentioned contract withdrawal period.
Note: / Number of annexes:Please send two signed copies of the Contract by post or deliver them in person to the following address:
Kontaktní centrum viaHome, T-Mobile Czech Republic a.s., Tomíčkova 2144/1, 148 00 Prague4.
viaHome_smlouva_enT-Mobile Czech Republic a.s. Phone: 236 099 333 E-mail: 1/2