FleetBoard initial startup, form · of8285b300002a · Mercedes-Benz WIS

OF82.85-B-3000-02A

FleetBoard initial startup, form

Telematics products Mercedes-Benz do Brasil

FLEETBOARD

Send copy of this form, by "e-mail", correctly completed with the information required below and properly signed to start the activation request for the FleetBoard system.

If necessary, for further information, please contact Mercedes-Benz do Brasil on the telephone: 55 (019) 3725 2121 option 0 (zero) 4 and 6.

E-mail: [email protected]

Note: The safety code will only be offered for use in the StarDiagnosis, after the documents receipt:

 Sda - completed and signed by the customer.

 SdFR - completed by the dealer and signed by the customer and dealer - use the OF82.85-B-3000-02B.

By the completion and signature of the current document, the Customer, Fleet Owner, qualified in the item V below, requires the activation of the FleetBoard services for the vehicle(s) specified in the item III below for the commercial and professional activities development.

Please complete the required fields and send a copy by Fax / Email to start the request. The original document, with the signatures, needs to be sent up to 10 calendar days from the request, by E-mail or Fax, to Mercedes-Benz do Brasil address, indicated at the end of the document.

I. Fleet Name:

II. Agreement number

III. Vehicle(s) data

Chassis number	License Plate / Name	Model	Number	Service provider	Field for internal
					A	R	C	D / M
					¨	¨	¨	___/___
					¨	¨	¨	___/___
					¨	¨	¨	___/___
					¨	¨	¨	___/___
					¨	¨	¨	___/___
					¨	¨	¨	___/___
					¨	¨	¨	___/___
					¨	¨	¨	___/___
					¨	¨	¨	___/___
					¨	¨	¨	___/___
					¨	¨	¨	___/___
					¨	¨	¨	___/___
					¨	¨	¨	___/___
					¨	¨	¨	___/___

IV. Customer's contact person

Full name	Position	E-mail	Telephone

V. Intervening dealer

Dealer name	Consultant name	E-mail	Telephone

¨We declare that we agree with all the terms and conditions of the FleetBoard Service Agreement, as well as the general sales conditions from MBBras and thereafter the agreement of the FleetBoard Support order.


Location, date	Customer Signature	Signature witness 1	Signature witness 2

Location, date	Signature Sales FB	Location, date	Signature 0800-FB

E-mail: [email protected]

Tel: 0800 970-9090

Website: www.fleetboard.com.br

Mercedes-Benz do Brasil Ltda.

FleetBoard Area (V / FB)

CIP B 054 1 S, Av. Alfred Jurzykowski, 562

São Bernardo do Campo, São Paulo, CEP 09680-900