Customer Information Form

Billing Information

Your Name

Client Information

Name of Person Using Device(Required)
Legal Decision Maker(Required)
MM slash DD slash YYYY
Gender(Required)
Address(Required)
If an emergency, call my 911 emergency center before any emergency contact?(Required)
If no voice contact, contact 911 emergency center before any emergency contact?(Required)
Allow forced entry?(Required)

Emergency Contacts

Emergency Contact 1: Name(Required)
Has Key?(Required)
Must Notify?(Required)
Emergency Contact 2: Name
Has Key?
Must Notify?
Emergency Contact 3: Name
Has Key?
Must Notify?
Emergency Contact 4: Name
Has Key?
Must Notify?

ASSISTED LIVING TECHNOLOGIES, INC. SUBSCRIBER AGREEMENT TERMS, CONDITIONS, WAIVER & RELEASE OF LIABILITY AGREEMENT

Subscriber Agreement

1. PARTIES AND SERVICES: The undersigned (hereinafter “SUBSCRIBER”), hereby contracts with Assisted Living Technologies, Inc. (hereinafter “ALT”), for the purchase or rental, and installation of, limited training on and limited monitoring of, one or more __________________________ devices (hereinafter “UNIT,” regardless of whether one or more devices is purchased or rented by SUBSCRIBER). ALT is in the business of providing the UNIT for sale or rental to, installation of, limited training on and limited monitoring of services provided to SUBSCRIBER, for the purpose of the UNIT’S installation and SUBSCRIBER’S subsequent use on their person and/or premises. ALT will receive notices from a third party monitoring service and/or the UNIT when an alarm is triggered on the UNIT. ALT will monitor the UNIT upon receiving such notice from a third party monitoring service and/or the UNIT and will take reasonable and appropriate action, as limited by the scope of services under this Agreement, to ensure the UNIT’S continued operation, or to correct an error encountered by the UNIT. ALT is NOT in the business of, and does not provide, medical care, medical advice, first-hand telephone monitoring service, emergency response monitoring or in-person emergency response, and SUBSCRIBER acknowledges and agrees that no such epresentations or warranties have been made to it and that it does not rely upon ALT to provide anything beyond the services defined in this Subscriber Agreement (hereinafter “Agreement”). SUBSCRIBER acknowledges and understands that ALT may obtain services of one or more third parties to perform monitoring services required for the SUBSCRIBER’S intended use of the UNIT. SUBSCRIBER understands that ALT must at all times be provided with current information about the SUBSCRIBER as required by ALT, as well as other emergency response information necessary to enable ALT to attempt to contact emergency responders when agreed and that it is SUBSCRIBER’S sole obligation to provide current information to ALT in the appropriate form and through the appropriate means. SUBSCRIBER acknowledges that it has received and completed the Customer Information Form (hereinafter “CIF”) and has provided accurate and current information to ALT there in, and that ALT, in its performance under this Agreement, will rely solely on the information provided by SUBSCRIBER. SUBSCRIBER understands and acknowledges that under the terms of this Agreement, ALT’S obligations under this Agreement are limited to installation, provision of limited training services on the UNIT to SUBSCRIBER, limited maintenance of the UNIT as defined and limited herein and to receive notices from a third party monitoring service and/or the UNIT when an alarm is triggered on the UNIT, and thereafter monitor the UNIT upon receiving such notice from a third party monitoring service and/or the UNIT and take reasonable and appropriate action, as limited by the scope of services under this Agreement, to ensure the UNIT’S continued operation or to correct an error encountered by the UNIT. It is understood that one or more third parties will perform monitoring of signals received by means of the UNIT located on SUBSCRIBER’s person and/or premises and initiate a response thereto, as defined and limited by this Agreement. Upon actual receipt of a signal from the UNIT, if appropriately and reasonably notified, ALT will make every reasonable effort to transmit notification promptly to authorized persons identified in the current CIF, emergency responders and/or other authorities as appropriate in ALT’s discretion, unless ALT, in its sole and reasonable discretion, has reason to believe that an emergency condition does not exist and/or a false alarm has occurred. SUBSCRIBER’S use of ALT’S products and services, including any and all UNIT(S), evidences SUBSCRIBER’S receipt, understanding, acknowledgement and acceptance of the complete terms and conditions contained in this Agreement. 2. TIMING OF AGREEMENT: This Agreement shall be effective upon execution of this Agreement, SUBSCRIBER’S provision of accurate and current CIF, and installation of the UNIT by ALT. This Agreement will remain in effect until cancelled by any party thereto upon thirty (30) days written notice. ALT may cancel this Agreement, with or without cause, at any time. Upon violation of any of the terms and conditions of this Agreement by SUBSCRIBER, or upon default of any of its obligations or duties hereunder, as well as upon a failure by SUBSCRIBER to make payment of any monies payable to ALT pursuant to this Agreement and services rendered by ALT, or upon a declaration that SUBSCRIBER is insolvent or bankrupt, ALT’S obligations under this Agreement shall terminate immediately without the need for written or oral notice and ALT may claim and obtain full damages for such violation or default, including, without limitation, compensatory, consequential and, if appropriate, punitive damages. ALT may in its sole discretion elect to continue this Agreement between the parties despite such a violation or default by SUBSCRIBER. 3. SUBSCRIBER’S OBLIGATIONS: SUBSCRIBER herein agrees to duly perform and comply with all of the following obligations and duties: A. Provide, and be responsible for the maintenance of, suitable and constant electrical, telephone, cellular telephone and/or broadband internet service, necessary for the installation and continuous operation of the UNIT. B. Make no alterations or repairs to the UNIT. C. Any movement of the UNIT must comply with ALT’S installation instructions, which SUBSCRIBER hereby acknowledges it has received. D. Allow ALT access to inspect the UNIT, provide maintenance to the UNIT and to remove and return the UNIT after termination of the Agreement or upon default by SUBSCRIBER. E. Prevent and avoid inadvertent false alarms of the UNIT and ensure that no willful or intentional false alarms occur. In the event of a false alarm, SUBSCRIBER agrees to immediately notify ALT that such alarm was false and an emergency situation does not exist. F. Provide persons identified by SUBSCRIBER in the CIF, emergency responders and/or other appropriate authorities with access to SUBSCRIBER’s person and/or premises for the purpose of responding to alarms. G. Keep the CIF and SUBSCRIBER information provided to ALT accurate and current at all times. H. Periodically test the UNIT for operation and cooperate with ALT in testing of the UNIT that ALT determines in its sole discretion to be necessary. SUBSCRIBER will be responsible for securely storing, managing and deploying, when required, encryption keys or passwords which are generated to protect data or to provide SUBSCRIBER access, and which may be required from time to time to ensure continuity, upgrading and reconfiguration of the UNIT, equipment and/or service, and in particular but without limitation, restoration of data. I. Take reasonable care of the UNIT and equipment installed by ALT and must not tamper, damage, improperly move or remove or attempt to repair. SUBSCRIBER will be responsible for all damages to or loss of the UNIT and equipment and/or software installed by ALT, unless said loss or damages is caused by ALT. Damaged or malfunctioning UNIT and equipment will be replaced by SUBSCRIBER at the market cost, plus technical service charge of Sixty Dollars ($60.00) per hour. J. Not use the UNIT, or services provided by ALT, for any illegal or improper purpose or in a manner that constitutes violation or infringement of rights of any entity or person. K. SUBSCRIBER shall advise all persons who may be the subject of any monitoring about the existence, nature and extent of such monitoring and shall obtain the consent from all such persons. In executing this Agreement, SUBSCRIBER represents that such notice has been provided to such persons and said persons have provided their consent to the services to be provided by ALT. L. SUBSCRIBER is fully and completely responsible for correctly implementing and maintaining UNIT settings and preferences after initial installation and limited training by ALT. It is agreed that ALT has no responsibility for maintaining UNIT settings or preferences after said initial installation and limited training. Further, SUBSCRIBER will abide by all safety and regulatory guide instructions of the UNIT manufacturer and/or distributor. M.If SUBSCRIBER has two (2) or more telephone line extensions on the premises that use the same telephone number, and if one (1) of these telephones is actively being used, the receiver is “off the hook,” the off button has not been pressed or the telephone is otherwise in use, the UNIT will not operate without installation of an RJ31X connection by the telephone company. SUBSCRIBER understands and acknowledges that it is SUBSCRIBER’S sole responsibility to have this device installed. SUBSCRIBER understands that signals are transmitted using electrical power and over telephone company lines, cellular telephone networks and/or broadband internet service, which are not owned by ALT and are wholly and completely beyond the possession, maintenance, control and jurisdiction of ALT, and in the event that electrical or telephone and/or broadband internet service is inoperative, unavailable, interrupted or disconnected, for whatever reason, the UNIT will not operate. SUBSCRIBER further understands and acknowledges that ALT is not capable of, and not responsible for, providing any services during periods of time when ALT’S electrical or telephone service is inoperative, unavailable, interrupted or disconnected, for whatever reason, or under any condition that would make it impossible for ALT to place a telephone call in the regular course of business, nor is ALT responsible for any such event affecting a third party monitoring service provider. 4. CHANGES TO CUSTOMER INFORMATION FORM: ALT will accept changes to the CIF, from individuals authorized to make changes thereto, in writing or by telephone. SUBSCRIBER understands and acknowledges that telephone calls placed to ALT may be recorded. ALT shall implement authorized changes to the CIF within a reasonable amount of time of ALT’S actual receipt thereof in light of the date, time and manner in which the authorized changes to the CIF are provided to ALT. SUBSCRIBER hereby releases ALT from liability, and agrees that it will not bring any suit, claim or action for money damages for personal injury or property damage sustained by SUBSCRIBER, as a result of a delayed response, failed response or inability of a third party monitoring service to respond to a signal due to the passage of time in between actual receipt of the requested authorized changes to the CIF by ALT and an event resulting in personal injury or property damage to SUBSCRIBER. ALT shall act in good faith in implementing authorized changes to the CIF within a reasonable amount of time of actual receipt thereof. 5. FAILED RESPONSE: ALT shall not be responsible for personal injury, property damage or any other manner of losses or damages sustained by SUBSCRIBER due to a delay in response time, or a failure to respond, by any person or entity, including, but not limited to, authorized persons identified in the current CIF, emergency responders and/or other authorities notified by any third party monitoring service according to SUBSCRIBER’S instructions or in ALT’S discretion. 6. INTERRUPTION OF SERVICE: SUBSCRIBER acknowledges and agrees that ALT shall not be liable in any way for failures of the UNIT or interruption of monitoring services by third parties, as identified herein, due to causes beyond ALT’S control, including, but not limited to, acts of God, acts of federal, state or municipal government, fire, flood, earthquake or other natural disasters, strikes, riots, labor disputes terrorism, war, famine, pestilence, acts or omissions of utility companies, electric companies, telephone and/or cellular telephone companies, broadband internet service providers or satellite failure, or of any other cause beyond ALT’S control, including, without limitation, the acts or omissions of SUBSCRIBER or any third party. It is agreed that any third party monitoring service obtained by ALT is not required to supply monitoring services to the SUBSCRIBER during which the interruption of the services identified herein, due to any such cause, may continue, and that ALT is not responsible for any failure of same. 7. FALSE ALARMS: In the event that an excessive number of false alarms, as deemed excessive in ALT’S sole and reasonable discretion, are caused by SUBSCRIBER’S or a third party’s negligence, carelessness or accidental use, ALT may deem same to be a material breach of the contract on the part of the SUBSCRIBER, and at its discretion and option, in addition to all legal remedies available to it, be excused from any further performance of its obligations under this Agreement upon giving ten (10) days written notice to SUBSCRIBER. If false alarms are caused by SUBSCRIBER’S malfeasance or intentional or malicious use of the UNIT, ALT may elect in its sole and reasonable discretion to deem same to be a material breach of the contract on the part of the SUBSCRIBER, and at its option, in addition to all legal remedies available to it, be immediately excused from any further performance of its obligations under this Agreement and without written notice to SUBSCRIBER. In the event that any fine, penalty or other fee is assessed or taken against ALT by any governmental or municipal agency as a result of any alarm originating from SUBSCRIBER’S person and/or premises, SUBSCRIBER agrees to fully and promptly reimburse ALT in that amount within thirty (30) days of receipt of such fine, penalty or other fee. SUBSCRIBER acknowledges and agrees that the acts or omissions of any and all persons acting at the direction or in the interest of SUBSCRIBER will be treated as the acts or omissions of the SUBSCRIBER. 8. PAYMENT: SUBSCRIBER agrees to pay a monthly service fee to ALT on or before the thirtieth (30th) day after the date of invoice. If service is provided for any part of a month, the fee for the entire month is due and payable. All late payments shall be charged interest computed on a daily basis from the due date, until paid in full, at the rate of one and one-half percent (11⁄2%) per month or the maximum rate permitted by law, whichever is less. SUBSCRIBER also agrees to pay all collection and attorney’s fees for costs of collection of all monies due to ALT. Should SUBSCRIBER’S account become more than thirty (30) days past due, service may be suspended until SUBSCRIBER pays a twenty five dollar ($25.00) reactivation charge and brings the account current. In the event that amounts due by SUBSCRIBER to ALT hereunder are not paid in full within thirty (30) days of the date upon which such payment is due, ALT may terminate this Agreement and all services provided thereunder, by written notice, which termination shall be effective upon mailing of the notice. 9. UNIT INSTALLATION, SERVICE AND REPAIR: All delivery and installation dates are approximate and are based upon ALT’S prompt receipt of all necessary information from SUBSCRIBER, including that contained in the CIF, to properly process the SUBSCRIBER order. ALT will generally conduct installation during its usual business hours but may, on reasonable notice, require SUBSCRIBER to provide access to the person and/or premises at other times. SUBSCRIBER agrees to allow ALT access to the premises to install electrical wiring, cable and sensors as necessary, and SUBSCRIBER further agrees to allow ALT to install such equipment or devices as required, including affixing materials to walls or other structures and related structural modification required for same. ALT agrees to act reasonably in performing such installation and to create as minimal amount of structural change as is reasonable. ALT shall provide limited training to SUBSCRIBER at the time of installation of the UNIT. This limited training may include training on setting of UNIT preferences, alerts and settings. If available and provided by ALT, SUBSCRIBER acknowledges that it has received and read any Safety and Regulatory Guide literature for the UNIT and will abide by the provisions of same. SUBSCRIBER acknowledges and understands that it is responsible for maintaining and updating preferences and alerts at all times following the initial installation and limited training by ALT, and that ALT is in no way responsible for maintain or updating same after installation and limited training. If the UNIT malfunctions, SUBSCRIBER agrees to notify ALT immediately and deliver the UNIT to ALT. In the event that the UNIT is within the service area of ALT, ALT may, at its option, obtain the UNIT at ALT’S then-current service fee or send a courier for pickup of the UNIT. All repairs shall be performed in a timely and workmanlike manner unless ALT is prevented from performing same due to circumstances beyond its control. Services charges may be required when a problem that cannot be resolved through telephone support necessitates on-site visit from ALT. On-site service and repair by ALT, including travel time, is invoiced at the rate of sixty dollars ($60.00) per hour. 10.WAIVER, RELEASE OF LIABILITY AND INDEMNIFICATION: In consideration of the services provided by ALT under this Agreement, SUBSCRIBER agrees to hold ALT and its officers, directors, shareholders, employees, agents, parent companies, subsidiaries, successors, assigns, attorneys and other representatives harmless from, and to defend and indemnify ALT and its officers, directors, shareholders, employees, agents, parent companies, subsidiaries, successors, assigns, attorneys and other representatives against, any suits, claims, settlements, judgments, costs or expenses of any kind, including attorney’s fees, contribution, and/or indemnification, whether in contract, common law or by statute, by any person or organization (or for subrogation by an insurer of such person or organization), including, without limitation, claims by authorized persons, emergency responders, appropriate authorities and persons whose property is under the possession, control or in custody of the SUBSCRIBER, including claims for personal injury, property damage or death, product defect, product liability, loss of business profits, business interruption, loss of business information, loss of goodwill, loss of opportunity, corruption of data, infringement or violation of any copyright, patent or intellectual property right, nonpayment of taxes, withholdings and other government required amounts on the SUBSCRIBER’S income or wages, as well as any related liens, medical or otherwise, on account of any claim asserted as a result of, or in relation to, SUBSCRIBER’S use or control of the UNIT, even if due to the NEGLIGENCE of ALT or its officers, directors, shareholders, employees, agents, parent companies, subsidiaries, successors, assigns, attorneys or other representatives. SUBSCRIBER agrees to indemnify and hold harmless ALT against any claim of invasion of privacy, unauthorized disclosure of medical or personal information or conditions, or similar claims. SUBSCRIBER understands and acknowledges that that the UNIT has a strictly limited intended use and that SUBSCRIBER should not and may not reasonably rely upon the UNIT for anything beyond the scope of the intended use described herein. Moreover, SUBSCRIBER understands and acknowledges that there are factors inherently beyond the control of ALT that may prevent or affect the intended use of the UNIT, including, but not limited to, the loss of electricity, telephone service, broadband internet service, satellite service, cellular telephone service, inclement weather and/or superseding or intervening acts of third parties, including all causes beyond ALT’S control, including, but not limited to, acts of God, acts of government, fire, flood, earthquake and other natural disasters, strikes, labor disputes, riots, terrorism, war, famine, pestilence, acts or omissions of utility companies and of any other cause beyond ALT’S control, and SUBSCRIBER fully assumes all risks associated with the use of the UNIT and the potential failure of the intended use of the UNIT, even if due to the NEGLIGENCE of ALT or its officers, directors, shareholders, employees, agents, parent companies, subsidiaries, successors, assigns, attorneys or other representatives. SUBSCRIBER specifically agrees to hold ALT and its officers, directors, shareholders, employees, agents, parent companies, subsidiaries, successors, assigns, attorneys and other representatives harmless from, and to defend and indemnify ALT and its officers, directors, shareholders, employees, agents, parent companies, subsidiaries, successors, assigns, attorneys and other representatives against, any claim or suit initiated by or on behalf of SUBSCRIBER. SUBSCIBER acknowledges that upon being provided the UNIT at installation by ALT, it will be in possession of, and have control over, the UNIT while on its person and/or premises or otherwise, until the termination of this Agreement and the return of the UNIT to ALT with written receipt provided to evidence same. SUBSCRIBER’S waiver of any liability of ALT and its officers, directors, shareholders, employees, agents, parent companies, subsidiaries, successors, assigns, attorneys and other representatives, as well as SUBSCRIBER’S agreement to defend and indemnify ALT and its officers, directors, shareholders, employees, agents, parent companies, subsidiaries, successors, assigns, attorneys and other representatives, shall apply to all claims, regardless of cause, including claims arising from or related to ALT’S performance under this Agreement, acts or omissions in providing services, claims arising from or related to defects or negligence in installation, service, operation or non-operation of the UNIT, claims arising from or out of signal transmission and/or receipt and claims arising from or out of any NEGLIGENCE by ALT or its officers, directors, shareholders, employees, agents, parent companies, subsidiaries, successors, assigns, attorneys and other representatives, or any third party monitoring service utilized by ALT for the UNIT. SUBSCRIBER shall notify ALT of any claim, complaint or notice of damage or loss within the scope of this paragraph ten (10) and immediately take such action as may be necessary or appropriate to protect the interests of ALT. 11. ACKNOWLEDGEMENT OF WAIVER, RELEASE OF LIABILITY AND INDEMNIFICATION AGREEMENT: In addition to SUBSCRIBER’S below cknowledgement contained in paragraph twenty-two (22), SUBSCRIBER herein acknowledges that it has read the Waiver, Release of Liability and Indemnification Agreement contained in paragraph ten (10) and fully understands its terms. SUBSCRIBER further understands that by signing this Agreement it is giving up substantial legal rights. SUBSCRIBER warrants and acknowledges that it has not been induced to sign this Agreement by any promise or representation by ALT or any person or entity affiliated with or acting on behalf of ALT. SUBSCRIBER signs this Agreement voluntarily and of its own free will. SUBSCRIBER acknowledges and agrees that it has had the opportunity to consult with legal counsel on this Agreement in general and specifically on this Waiver, Release of Liability and Indemnification Agreement. The provisions of this paragraph eleven (11) shall survive cancellation, termination or expiration of this Agreement and until all matters within the scope of this Agreement are fully and finally barred by applicable law. 12. CHOICE OF COUNSEL: Pursuant to SUBSCRIBER’S agreement to the waiver, release of liability and to defend and indemnify ALT, as defined in paragraph ten (10) and acknowledge in paragraph eleven (11), in the event that a legal claim of any nature or kind whatsoever is made against ALT or its officers, directors, shareholders, employees, agents, parent companies, subsidiaries, successors, assigns, attorneys or other representatives, arising out of or related to SUBSCRIBER’S use or control of the UNIT, or ALT’S services provided under this Agreement, SUBSCRIBER agrees that pursuant to its duty to defend, indemnify and hold harmless ALT, ALT may, in its sole and reasonable discretion, choose the legal counsel that will represent and defend ALT in any such action or claim. Any and all fees and expenses of counsel for ALT shall be paid by SUBSCRIBER, or if already paid by ALT then reimbursed by SUBSCRIBER, as part of its indemnity and defense obligation under this Agreement and specifically with respect to its indemnity and defense obligation under paragraph ten (10). 13. DISCLAIMER: It is understood and agreed that ALT is not an insurer and that the requisite insurance shall be obtained by and be the sole responsibility of SUBSCRIBER and that the amounts payable to ALT hereunder are based upon the value of property located on SUBSCRIBER’S person and/or premises. The parties hereto agree that it is impractical and extremely difficult to repair the actual damages, if any, that may proximately result from failure on the part of ALT to perform any of its obligations hereunder, specifically including, without limitation, any act or omission relating to downloading technology monitoring goods or services. SUBSCRIBER agrees that ALT shall be exempt from liability for loss or damage due to occurrences, or consequences therefrom, whether directly or indirectly, which the service or system is designed to detect or divert, and that if ALT shall be found liable for loss or damage due to a failure to or of service in any respect, its liability shall be limited to replacement or repair of any defective equipment or to a sum equal to one-half (1/2) of the annual service charge paid by the SUBSCRIBER, or two hundred and fifty dollars ($250.00), as liquidated damages and not as a penalty, whichever is greater, the determination of which will be at the sole discretion of ALT. As the exclusive remedy, the provisions of this paragraph shall apply, if loss or damage, irrespective of cause or origin, results directly or indirectly to person or property from performance or non-performance of obligations imposed under this Agreement, or from negligence, active or passive, of ALT, its employees or agents, provided, however, that in no event shall ALT be liable for consequential or incidental damages of any kind or nature. SUBSCRIBER understands and acknowledges that it is waiving any legal right to a claim arising out of, or related to, ALT’S installation and limited training for, the UNIT, including any deficiency or NEGLIGENCE in ALT’S installation of the UNIT, including installation of sensors, electrical wiring, phone line, equipment, cable, setting of alerts, preferences or connectivity, as well as a claim arising out of or related to the limited training and maintenance provided by ALT on the UNIT. SUBSCRIBER agrees it is responsible for implementing and maintaining UNIT settings and preferences after initial installation and limited training by ALT and that ALT is not responsible or liable for errors or omissions in changes or modifications to those settings made by SUBSCRIBER or third parties. SUBSCRIBER agrees it is responsible for maintaining adequate telephone service, cellular telephone service and network coverage and/or broadband internet service, and waives any and all claims against ALT for interruptions or deficiencies in same. The UNIT and any instructions or maintenance by ALT is provided “as-is.” The UNIT may have or result in errors and may produce unexpected results that are not under the control of ALT. It is specifically understood that ALT disclaims any implied warranty of merchantability and any implied warranties of fitness for a particular purpose with respect to the UNIT, installation of the UNIT, its use, operation or support. SUBSCRIBER agrees that its use of the UNIT shall be entirely at SUBSCRIBER’S own risk. ALT, third party monitoring service(s) and the UNIT utilize communication networks of other carriers over which ALT has no control whatsoever. SUBSCRIBER is aware that the UNIT is dependent upon the availability and functionality of those carrier networks. SUBSCRIBER further acknowledges that it is aware that the UNIT contains electronic parts that may cease to function properly or at all without any fault of ALT. SUBSCRIBER understands and agrees that ALT makes no warranties, whatsoever, other than those expressed in writing by ALT and that no employee, agent or representative of ALT has any authority to make any additional express warranties or otherwise vary the terms of this Agreement. ALT does not adopt or endorse representations made by any other entity concerning or related to the services provided by ALT as defined herein, including as to speed of signals and communications or the security of same. SUBSCRIBER understands and agrees that no warranties are made with respect to any third party monitoring service utilized in furtherance of this Agreement and the UNIT. Except as specifically provided in this Agreement, there are no other warranties, express or implied, and SUBSCRIBER acknowledges by executing this Agreement and using the UNIT. 14. RETURN OF UNIT (RENTAL ONLY): If SUBSCRIBER elects to rent the UNIT, SUBSCRIBER hereby agrees to be liable for liquidated damages in the amount of the present monetary retail cost of replacement of the same, or if not reasonably available, the current UNIT model, until it is returned to ALT’S service center, documented by issuance of a written receipt. SUBSCRIBER shall promptly return the UNIT to ALT upon termination of this Agreement and in any event within seven (7) business days. 15. EVIDENCE OF INSURANCE (RENTAL ONLY): If SUBSCRIBER elects to rent the UNIT, SUBSCRIBER hereby acknowledges and certifies that it carries sufficient insurance to protect the UNIT from damage due to fire, water, theft and any damage beyond that which is encountered in normal use, in an amount equal to or greater than the monetary retail cost of replacing the UNIT at the time that it was originally placed on SUBSCRIBER’S person or premises. SUBSCRIBER further agrees to name “Assisted Living Technology, Inc.,” as an additional insured on a policy of insurance obtained by SUBSCRIBER for this purpose or where such policy of insurance covers such loss or damage. 16. DEPOSIT (RENTAL ONLY): ALT agrees to return SUBSCRIBER’S deposit when all equipment, including the UNIT, is returned to ALT’S service center in good working condition, as determined by ALT, and documented by issuance of a written receipt. 17. PROHIBITION AGAINST MODIFICATION OF OR CHANGE TO UNIT: The transmitter carried by the SUBSCRIBER and the receiver located within the UNIT are required to comply with FCC Rules and Regulations as Part 15 Devices. As such, the transmitter and the receiver have limited transmitted power and therefore limited range. A received cannot respond to more than one transmitted signal at a time and may be blocked by radio signals that occur on or near their operating frequencies, regardless of code settings. Infrequently used radio links should be tested regularly by SUBSCRIBER to protect against undetected interference or fault. SUBSCRIBER hereby understands and acknowledges that ALT is not responsible for any interruption or loss of use of the UNIT, or the consequences thereof, due to the UNIT being moved outside of its limited range. Any changes or modifications to the device may void FCC compliance and render the UNIT inoperable. SUBSCRIBER shall comply with all applicable federal, state and local laws, ordinances, statutes, rules and regulations relating to its obligations under this Agreement and its use of the UNIT. SUBSCRIBER understands and acknowledges that any tampering, changes or modifications to the UNIT results in an immediate default by SUBSCRIBER under this Agreement. ALT reserves the right to demand adequate assurance with respect to SUBSCRIBER’S obligations under this Agreement. 18. NOTICES: Any notice(s) required to be provided by SUBSCRIBER to ALT shall be in writing and sent certified mail, return receipt requested, addressed to the address identified on this Agreement. Any change of address by SUBSCRIBER must be promptly identified to ALT in writing and sent certified mail, return receipt requested. 19. ASSIGNMENT: This Agreement may not be assigned by the SUBSCRIBER to any person or entity without such a request for assignment being submitted in writing to ALT and without the prior express written consent of ALT in response to such a written request. SUBSCRIBER understands and agrees that ALT is under no obligation whatsoever to agree to assign this agreement to any person or entity and further that ALT need not provide the basis for refusing consent to such consent. 20. LIMITATION ON DAMAGES: To the maximum extent permitted by law, ALT shall not be liable to SUBSCRIBER for indirect, punitive, double/treble, exemplary, incidental, indirect, consequential or special damages, including any damages sought as part of a claimed violation of the Connecticut Unfair Trade Practices Act, General Statutes § 42-110a et seq., arising out of this Agreement or any services or obligations construed under this Agreement, or arising out of the use or inability to use the UNIT, or the transactions or relationship between the parties to this Agreement, even if ALT has been advised of the possibility of such damages. Each UNIT includes a communicator that sends signals to a third party monitoring center via telephone service or an internet service provider, over which ALT has no direct and immediate control. If SUBSCRIBER’S telephone service is disconnected or out of order, or if SUBSCRIBER makes modifications to the cellular telephone network service or telephone service, such as adding DSL service, VOIP service or changing the telephone service provider, signal transmission to the monitoring center may be interrupted. Likewise changes in internet service may also impact communication to the monitoring center. ALT may, on SUBSCRIBER’S behalf, request services or equipment from any telecommunications company or internet service provider providing signal transmission services or facilities under this Agreement. SUBSCRIBER acknowledges that there may be times when third party monitoring service centers’ electronic systems will be unable to acquire, transmit, or maintain an alarm signal, and that transmissions may be impaired or interrupted by a variety of conditions and circumstances beyond the control of such third party monitoring services or ALT, including, but not limited to, storms and power failures. If the UNIT is configured by ALT to communicate over SUBSCRIBER’S broadband internet service, whether Cable, DSL or otherwise, signal transmission may likewise be interrupted by irregularities in that service or by power outages. ALT is not responsible for SUBSCRIBER’S telephone, cellular or internet service in any manner. Moreover, SUBSCRIBER specifically agrees that ALT shall not be liable for any act, omission, negligence, product defect, liability or contractual violation caused by, or resulting from, a manufacturer or distributor of the UNIT. SUBSCRIBER specifically agrees that its sole remedy or recourse for claimed negligence, product defect, liability, damage or contractual violation lies with the manufacturer or distributor of the UNIT. SUBSCRIBER acknowledges and agrees that its remedy for a claimed breach of this Agreement by ALT shall be limited to return of UNIT and repair and/or replacement of the UNIT, as appropriate in ALT’S discretion. If it should be found by a court of competent jurisdiction that SUBSCRIBER is entitled to money damages arising out of or related to this Agreement, to the extent permitted by law, it is hereby agreed that any such amount of recoverable money damages shall not exceed a sum equal to one-half (1/2) of the annual service charge paid by the SUBSCRIBER, or two hundred and fifty dollars ($250.00), as liquidated damages and not as a penalty, whichever is greater, the choice of which will be at the sole discretion of ALT. This limitation on damages is intended to apply and does apply without regard to whether such damages are claimed, asserted or brought in an action or claim in tort or in contract, or under any other law or form of action. SUBSCRIBER specifically acknowledges and agrees that any cause of action arising out of or related to this Agreement must be commenced within one (1) year of the event giving rise to the cause of action and otherwise such cause of action shall be permanently barred. This limitation is intended by the parties to apply to the fullest extent permitted by law and shall survive any termination, expiration or rescission of this Agreement until fully barred by applicable law and statute of limitations. 21. GOVERNING LAW: This Agreement, and any dispute occurring thereunder or arising therefrom, is to be governed by the laws of the State of Connecticut. SUBSCRIBER acknowledges and agrees that in the event of a lawsuit between the parties to this Agreement, SUBSCRIBER will not move for removal of such action to Federal District Court for the District of Connecticut if the action is filed in Connecticut State Superior Court, and SUBSCRIBER will not move to remand such action to Connecticut State Superior Court if the action is filed in Federal District Court for the District of Connecticut. Nothing in this paragraph twenty-one (21) shall prohibit ALT from moving for removal of any such lawsuit to Federal District Court for the District of Connecticut or moving to remand any such lawsuit to Connecticut State Superior Court. 22. ACKNOWLEDGEMENT: SUBSCRIBER hereby acknowledges and affirms that no promise or inducement which is not herein expressed has been made to the SUBSCRIBER, and in executing this Agreement, SUBSCRIBER does not rely upon any statement or representation made by ALT or any person or entity affiliated with or acting on behalf of ALT, concerning this Agreement or anything identified, referenced or related to the subject matter and contents of this Agreement, except for the representations made in this written Agreement. SUBSCRIBER acknowledges that ALT specifically reserves any and all rights they may have against all persons and entities, whether individual, corporate or otherwise, arising out of the subject matter of this Agreement in the event of a breach of this Agreement or default by SUBSCRIBER thereunder. SUBSCRIBER further acknowledges and agrees that it has carefully read the foregoing Agreement and knows and understands its contents and signs it as its own free act without inducement or duress of any kind or nature whatsoever. 23. SURVIVAL OF AGREEMENT: In the event that any portion of this Agreement is deemed unenforceable, void or against public policy by a Court of competent jurisdiction, the remainder of the Agreement shall remain in full force and effect and be binding on SUBSCRIBER until all matters within the scope of this Agreement are fully and finally barred by applicable law. 24. ENTIRE AGREEMENT: This Agreement contains the ENTIRE AGREEMENT, understanding and final expression of the binding agreement between SUBSCRIBER and ALT. Only those representations stated herein are binding upon SUBSCRIBER and ALT and no prior statements, writings or representations of any type, kind or nature may be used to vary the terms of this Agreement. Any conflict between this Agreement and any other document will be resolved in favor of this Agreement. In the event of a lawsuit arising out of this Agreement, it is agreed that any prior statements, writing or representations of any type, kind or nature existing between the parties have no evidentiary value whatsoever and that it is the parties’ intent that such documents shall not be submitted or received into evidence. The terms of this Agreement are contractual and not mere recital. This Agreement cannot and shall not be modified orally before or after the execution of the written Agreement, and any such claimed oral modification is hereby mutually agreed to be unenforceable. This Agreement may not be amended, waived, altered, modified, changed, rescinded or terminated except by a written instrument executed by both SUBSCRIBER and ALT, except as otherwise provided herein.

I, as SUBSCRIBER, have carefully read the foregoing Subscriber Agreement and the Terms and Conditions contained therein, including the Waiver, Release of Liability and Indemnification Agreement, and know and understand its contents and knowingly agree to the terms and conditions set forth herein on the date below, evidenced by my signature below. By typing your name in the boxes below, I agree to all the terms set forth in this agreement

Signature of Duly Authorized Representative of SUBSCRIBER(Required)
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