@if($package->name != '1' && $package->contract == '24' && ($created >= '2020-08-12' && $created < '2020-11-01'))
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PROMOTION (RM 10 off for 24 months)
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@else
@endif
|
ALLO TECHNOLOGY SDN BHD
Cyberview Garden Villas, Persiaran Multimedia, Cyber 7
63000 Cyberjaya, Selangor Darul Ehsan
Tel: 03-8800 5222 Fax 03-8800 5221
E-mail:customerservice@citybroadband.my
Website:www.citybroadband.my
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BROADBAND INTERNET ACCESS SERVICE APPLICATION FORM
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|
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| Please write in CAPITAL LETTERS and tick(/) where required |
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| APPLICATION: |
|
@if($form->Form->type_service == "New")
 }})
@endif
|
New |
|
@if($form->Form->type_service == "Upgrade")
@endif
|
Upgrading/Downgrading |
|
@if($form->Form->type_service == "Relocation")
@endif
|
Relocation(RM150) |
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@if($form->Form->type_service == "Rectification")
@endif
|
Rectification |
|
|
APPLICATION INFORMATION
|
|
| Full Name |
{{ $form->name }} |
|
| NRIC/Passport No. |
{{ $form->ic }} |
Gender |
{{ $form->gender }} |
|
|
| Primary Contact No. |
{{ $form->phone1 }} |
Secondary Contact No. |
{{ $form->phone2 }} |
|
|
| Citizenship |
{{ $form->citizen }} |
E-mail |
{{ $form->email }} |
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INSTALLATION ADDRESS
|
|
| Unit.No |
{{ $form->unit_no }} |
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| Building |
{{ $form->building_name }} |
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| Street |
{{ $form->street }} |
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| City/State |
{{ $form->city }} / {{ $form->state }} |
Postcode |
{{ $form->postcode }} |
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|
|
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SERVICE DETAILS
|
|
| 1. Subscription/Contract Period : |
@if( $package->contract == "12")
@endif
|
|
12 months |
@if( $package->contract == "24")
@endif
|
|
24 months |
|
|
| 2. Required For Service : |
{{ $package->rfs }} |
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| 1. Standard contract period is 24 months unless otherwise stated |
| 2. Required For Service (RFS) is subject to the avaiability of required infrastructure and/or equipment |
| 3. Early termination will subject to RM 500 penalty. |
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PACKAGE DETAILS
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| 1. City Broadband Residental (Best Effort Bandwith) |
|
|
@if(strpos($created_at, '2018') !== false)
|
@if( $package->name == '100')
@endif
|
|
100Mbps |
|
RM 109 ( RM 115.54 ) |
|
|
@if( $package->name == '300')
@endif
|
|
300Mbps |
|
@if(strpos($created_at, '10') !== false || strpos($created_at, '11') !== false || strpos($created_at, '12') !== false)
RM 149 ( RM 157.94 ) |
@else
RM 169 ( RM 179.14 ) |
@endif
|
|
@if( $package->name == '500')
@endif
|
|
500Mbps |
|
@if(strpos($created_at, '10') !== false || strpos($created_at, '11') !== false || strpos($created_at, '12') !== false)
RM 239 ( RM 253.34 ) |
@else
RM 259 ( RM 274.54 ) |
@endif
|
|
@if( $package->name == '1')
@endif
|
|
|
|
@if(strpos($created_at, '10') !== false || strpos($created_at, '11') !== false || strpos($created_at, '12') !== false)
RM 379 ( RM 401.74 ) |
@else
RM 399 ( RM 422.94) |
@endif
|
@else
@if((($package->montly_fee == '1 Month FREE' && $package->contract == '24') || ($package->name == '500' && $package->contract == '24')) && ($created >= '2019-12-12' && $created <= '2020-01-31'))
@foreach($product as $p)
|
@if( $package->name == $p->speed )
@endif
|
|
{{ $p->package_name }} |
|
@if( $p->promotion_price != '0' && $package->contract == "24")
RM {{ $p->retail_price }} ( RM {{ number_format(floatval($p->retail_price) * 1.06, 2) }} )
RM {{ $p->promotion_price }} ( RM {{ number_format(floatval($p->promotion_price) * 1.06, 2) }} )
|
@elseif($p->promotion_price == '0')
@if($p->speed == '500')
RM {{ $p->retail_price }} ( RM {{ number_format(floatval($p->retail_price) * 1.06, 2) }} )
RM 127 ( RM {{ number_format(127 * 1.06, 2) }} )
|
@else
RM {{ $p->retail_price }} ( RM {{ number_format(floatval($p->retail_price) * 1.06, 2) }} ) |
@endif
@endif
|
@endforeach
@elseif ($created >= '2020-08-12' && $created < '2020-11-01')
@foreach($product as $p)
|
@if( $package->name == $p->speed )
@endif
|
|
{{ $p->package_name }} |
|
@if( $p->aug20_price != '0' && $package->contract == "24")
RM {{ $p->retail_price }} ( RM {{ number_format(floatval($p->retail_price) * 1.06, 2) }} )
RM {{ $p->aug20_price }} ( RM {{ number_format(floatval($p->aug20_price) * 1.06, 2) }} )
|
@elseif($p->aug20_price == '0' || $package->contract == "12" )
RM {{ $p->retail_price }} ( RM {{ number_format(floatval($p->retail_price) * 1.06, 2) }} ) |
@endif
|
@endforeach
@else
@foreach($product as $p)
|
@if( $package->name == $p->speed )
@endif
|
|
{{ $p->package_name }} |
|
RM {{ $p->retail_price }} ( RM {{ number_format(floatval($p->retail_price) * 1.06, 2) }} ) |
|
@endforeach
@endif
@endif
|
|
@if ($package->name != '1' && $package->contract == '24' && ($created >= '2020-08-12' && $created < '2020-11-01'))
|
RM 10 off for 24 months
|
@endif
| *All prices shown in the bracket include 6% Services Tax (ST) |
|
|
|
|
|
@if($package->voice_fee == "yes" || $package->voice_fee == "Yes" || $package->voice_fee == "YES")
@endif
|
|
Yes |
|
@if($package->voice_fee == "no" || $package->voice_fee == "No" || $package->voice_fee == "NO")
@endif
|
|
No |
|
|
| Advanced Payment |
@if($package->montly_fee == '1 Month FREE' && $package->contract == '24')
| 1 Month Fee : 1 Month FREE |
@else
| 1 Month Fee : RM {{ $package->montly_fee }} (including 6% ST) |
@endif
| Deposit Fee : RM {{ $package->deposit }} |
@if($package->voice_fee == "no" || $package->voice_fee == "No" || $package->voice_fee == "NO")
| Voice Fee : RM 0.00 |
@elseif($package->voice_fee == "yes" || $package->voice_fee == "Yes" || $package->voice_fee == "YES")
@if($created >= '2020-08-12')
Voice Fee : RM 21.20 (including 6% ST) |
@else
Voice Fee : RM 21.20 (including 6% ST) |
@endif
@endif
| One Time Charge Fee : RM {{ (float)$package->upfront_payment}} (including 6% ST) |
@if($package->montly_fee == '1 Month FREE' && $package->contract == '24')
| Total : RM {{ number_format(floatval($package->deposit) + floatval($package->voice_fee) + (float)$package->upfront_payment * 1.06, 2) }} |
@else
@if($package->voice_fee == "yes" || $package->voice_fee == "Yes" || $package->voice_fee == "YES")
| Total : RM {{ number_format(floatval($package->montly_fee) + floatval($package->deposit) + 21.20 + (float)$package->upfront_payment, 2) }} |
@else
Total : RM {{ number_format(floatval($package->montly_fee) + floatval($package->deposit) + (float)$package->upfront_payment, 2) }} |
@endif
@endif
| *Installation fee will be woved for permises with available of required infrastructure |
| **Deposit is refundable |
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|
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DOCUMENTS AND DECLARATION
|
|
| Documents Required: |
|
|
|
Photocopy of MyKad (front and back) or passport for Non-Malaysian (minimum 12 months validity) and visa (minimum 6 months validity) |
|
|
| Declarations: |
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| I hereby consent to the collection, use, disclosure of my personal information in accordance with the PRIVACY POLICY available on www.citybroadband.my |
|
| I hereby declare that the above information, documents and any appendices attached are true and valid. I have read and undertood the consent of this form and agreed to be bound by TERMS & CONDITIONS as stated on the next page of this form which accompany the subscription of product(s) and/or service(s). Allo Technology Sdn Bhd reserve the rights to refuse any application at any given time should any of the information is incorrect. |
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| By signing this document, I agree and accept TERMS & CONDITIONS stipulated herein. I declare that the information provided by me is true and valid. Allo Technology Sdn Bhd reserve the rights to refuse my application at any given time without any refund or whatever monies held by Allo Technology Sdn Bhd should any of the above informationis found to be incorrect. If the service is offered to me, I declare to be bound by the TERMS & CONDITIONS of the service herein |
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|
APPLICATION ACKNOWLEDGEMENT
|
@if($form->signature != "")
 }})
@endif
|
| Submitted Date: {{ $form->Form->created_at }} |
|
@if ($ext1 =="pdf" && $ext2 =="pdf" && $ext3 =="pdf" && $ext4 =="pdf")
@else
@if($form->back_ic != "" && $form->front_ic != "")