Contact Information

First Name

Last Name

Company

E-mail Address

Address Line 1

Address Line 2

City, State, Zip

TimeZone

Eastern Central Mountain Pacific

Primary Phone Number

Alternate Phone Number

Subscription Service

Quantity

Approx GB Each

Windows Desktops

MacOS Desktops

Windows Servers

UNIX Servers

Add-On Modules (Profession Edition Only)

 Microsoft Exchange Server

Qty:

 Exchange Mailboxes

Qty:

 Microsoft SQL Server

Qty:

 Oracle Database Server

Qty:

 MySQL Database Server

Qty:

 Onsite installation service?

 Local backup copy to USB drive for local restores?

 Local Backup Server with Offsite Replication?

What kind and speed of Internet Service do you have?

Preferred Payment Method, if you signed up

PayPal Check/Cash Visa MasterCard

Where did you hear about us?

Special Requests or Requirements

Terms and Conditions

1. All Software provided by Tier3Backup is on an "as is" basis with no warranties of any kind and Tier3Backup will not be liable for any damages of any kind arising from the use. Tier3Backup further disclaims all warranties, express and implied, including without limitation, any implied warranties of merchantability or fitness for a particular purpose.
2. Tier3Backup shall not be liable for any indirect, special, incidental or consequential damages (including damages for loss of business, loss of profits, loss of backup data, or the like), whether based on breach of contract, tort (including negligence), product liability or otherwise, even if Tier3Backup or its representatives have been advised of the possibility of such damages and even if a remedy set forth herein is found to have failed of its essential purpose.
3. In consideration of the use of this Software to provide services to any third parties, the buyer hereby undertakes to indemnify and hold Tier3Backup harmless from and against all claims, suits, losses, liabilities (including the Company’s reasonable attorney’s fees), damages, cost and expenses from or in connection to this Software and/or these services for whatever reason.
4. A license key and account can only be used on one computer at any given time. The use of a single license key on multiple computers is not permitted. Violation to this restriction will be subjected to a penalty of fulfilling the legitimate license requirement at five times the nominal licensing rate.

I / We have read and understood the Terms and Conditions above and agree to be bound by them.