ProntoTrak Agency_Form 4

ProntoTrak Agency_Form 4

PRONTOTRAK, INC.

FINANCIAL AND LIABILITY FORM AGREEMENT

Name
Name
First Name
Last Name

The Participant whose name appears above (referred to herein as “I” or “me or my”) acknowledges receiving the equipment listed in the Rules Form and/or Attachment A attached hereto and incorporated herein by this reference. I will be legally and financially responsible for this equipment while on the court ordered electronic monitoring program. I acknowledge I will be held legally and financially responsible for this equipment if it is lost, stolen, or damaged, and that civil action or a criminal complaint may be initiated against me by ProntoTrak in connection therewith.

I will not tamper with or attempt to fix or allow anyone else to tamper with or attempt to fix, said equipment. All equipment will be returned to ProntoTrak on the first to occur of the due date listed in the rules and conditions provided to us, upon termination of the program, upon instruction of an ProntoTrak representative or upon the order or instruction of the sentencing court or supervising agency. If I do not return the equipment on the due date listed and in good working order, I could be charged with theft or vandalism and a warrant may be issued in my name. I understand that I will be liable for any fees and/or charges associated with the recovery and repair and/or replacement of said equipment.

I understand and agree that if I comply with the terms, covenants and conditions of this agreement, I will promptly return the monitoring equipment to ProntoTrak in a timely manner and in good working order on the due date.

If I fail to comply with the rules of GPS Monitoring, Electronic Monitoring and/or Alcohol Monitoring established by the court and I am taken off the system due to a violation (termination), it will be my responsibility to make arrangements to have all monitoring equipment immediately returned to ProntoTrak. I will pay the daily equipment rate for each additional day the equipment is not in our possession past the termination date.

I understand and agree that should ProntoTrak be required to appear in court to testify concerning me or the transactions contemplated hereby, I hereby acknowledge that ProntoTrak may provide all reports and information about me, and my program as requested by the court, and such reports and information shall be admissible in a court of law.

I agree to pay the reasonable attorneys’ fees and costs of ProntoTrak whether or not an action is brought, for the services of counsel employed to collect any amounts owed under this agreement, to recover the equipment, to recover damages to the equipment, or to enforce the performance of any other agreement contained herein, including, without limitation, past due fees, late fees at a rate of 1.5% of the unpaid balance per month and the costs and attorneys’ fees on any appeal, or in any proceedings under the United States Bankruptcy Code or in any post judgment proceedings.

I acknowledge that on the date indicated below I received equipment for monitoring as outlined in the Rules Form. I understand that if at any time during the period of monitoring said equipment identified fails to work properly, I shall notify a ProntoTrak representative and may be given replacement equipment. I understand that if replacement equipment of similar value is given to me, I shall sign Attachment A.

We hereby authorize, permit, and/or allow PRONTOTRAK, at its sole discretion and at any time, to release, disclose, and/or disseminate all information in its possession regarding the Participant’s location, the length of time the Participant spends at any location, and/or the Participant’s current whereabouts to any employee, representative, official, and/or designee of any town, city, municipal, county, state, local, federal, and/or national law enforcement agency or administrative agency for the purpose of locating the Participant at any given time and/or place while PRONTOTRAK monitors the Participant pursuant to this agreement. We hereby knowingly, consciously, and voluntarily waive any right we may possess to keep this information from the above-listed persons and/or entities. We further acknowledge and agree our consent to the release, disclosure, and/or dissemination of this information is entirely voluntary and without any coercion, duress, threats, and/or undue influence by PRONTOTRAK or any of its employees, representatives, and/or designees.

I have read and understand the above statements and agree to accept full financial and legal responsibility for the monitoring equipment assigned as stated in the Rules Form and/or Attachment A and to be bound by all of the terms and conditions set forth in this Agreement.