(A Govt. Of India Enterprises)UNDERTAKING

I/We ______________________________ (name/companys name) have subscribed to

BSNLs leased line service for the circuit between __________________________ and

_________________________ . For the said service BSNL has provided NTUs to both

ends of the circuit (NTU Model No. ___________________ ).

I undertake to pay to BSNL insurance charges on the said NTUs subsequently as and

when informed by BSNL w.e.f date of subscription of service.

Signature._____________________

Name & Address of the Subscriber.

______________________________

______________________________

______________________________

Note: an authorized signatory in case of a registered has signed the undertaking Company.

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