Network Checkout Form General InformationStreet AddressApartment, suite, etcCityState/ProvinceZIP / Postal CodeDate/TimeDateTravel TimeHoursMinutesStart TimeHours-120102030405060708091011Minutes-000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859AMPMStop TimeHours-120102030405060708091011Minutes-000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859AMPMInstaller/Tech InformationInstaller(s) / Tech(s)Please list each team member on siteName *PhoneEmail AddressSelect RoleInstallerLeadPMITContractorOtherProject DetailsSelect Location *SelectMooyah BurgerRusty TacosMr GattisGood2GoCiCi'sOtherOtherPurpose of VisitInstallationTroubleshootingSite SurveyBreak/FixOtherOtherWork CompletedSelect Works CompletedInfrastructure - CablingInfrastructure - Network TerminationsInfrastructure - Network Testing & LabelingInfrastructure - Rack InstallationInfrastructure - JHook InstallationInfrastructure - Pathway InstallationInfrastructure - Ladder tray installationInfrastructure - Other Network Equipment InstallPlum - Time Clock InstallationPlum - POS Terminal Bundle Installation - Terminal/RP/CD/CCPlum - KDS InstallationPlum - Device/Connectivity TroubleshootingPlum - Site ConfigurationIT - Networking ConfigurationIT - Network TroubleshootingIT - Device Removal / CleanupIT - New Device Installation(s)Mako - Router InstallationMako - 24/48 Port Switch InstallationMako - 8 Port Switch InstallationMako - New Site SetupMako - Device/Connectivity TroubleshootingCameras - InstallationCameras - TroubleshootingSite SurveyProject PhotosYesNoDid we take site photos?URLCeiling Heights8'10'12'15'15 +Please notate multiple ceiling heights where cabling may be required.Areas of Interest - Please inspect for any potential issues. Take photos of these areas, and notate any specific call outs.Detail/Pictures - Locate DEMARCDetail/Pictures - Entrances and Exit. Please take wide shots of all areasDetail/Pictures - Ceilings and WallsDetail/Pictures - Locate All existing networking equipmentDetail/Pictures - Existing cabling pathwaysDetail/Pictures - Existing networking Rack? If Not please determine suitable location for 9/12u rack.Detail/Pictures - Please take pictures from within the ceiling in at least 2 location(s) where pathways may be requied.Question - Will any exterior penetration be required? If so - take picture(s) of the exterior where penetration will be requiredQuestion - Is plenum required?Question - Ceiling Height(s)Question - Will any drops exceed 300ft?Site Pictures and Areas of InterestCall outs / and specificsParts ProvidedSelect Product TypeCat 6 (Plenum)Cat 6 Riser)Cat 5e (Riser)Cat 5e (Plenum)Keystone Jack(s)RJ45(s)Pull StringJ-HookCut in Rings - single/dualWall Plate - Single/DualWall Plate - Quad/SixPatch Cable(s) - 1ftPatch Cable(s) - 2ftPatch Cable(s) - 5ftPatch Cable(s) - 7ftPatch Cable(s) - 14ftUPSRocker PanelPatch Panel(s) - 24 PortPatch Panel(s) - 48 PortPatch Panel - PassthroughCable ManagmentMounting HardwarePlywood Backer BoardRack ScrewsNetwork Rack ShelfNetwork Rack Fans6u Network Rack9u Network Rack12u Network Rack16u Network RackCat 6 Cabling FootageCat5e Cabling FootageKeystone JacksRJ45sPull String QtdJ-Hook QtdsCut-In-Rings QtdSingle/Dual Wall Plate QtdsQuad/Six Port - Wall Plate Qtds1ft Patch Cables - Qtds2ft Patch Cables - Qtds5ft Patch Cables - Qtds7ft Patch Cables - Qtds14ft Patch Cables - QtdsUPS - QTDsRocker Panel QTDs24 Port Patch Panel - QTDs48 Port Patch Panel - QTDsPassthrough Patch Panel - QTDSCable Management - QTDsNetwork Rack Shelves - QTDNetwork Rack 6u - QTDsNetwork Rack 9u - QTDsNetwork Rack 12u - QTDsNetwork Rack 16u - QTDsPriceIs additional work required at this location?YesNoPlease describe the reason for additional work or why work was not completed on this trip *Additional Comments and NotesConsent *Confirm that all information provided is accurate and agree to the terms.NumberSignature Required?YesNoSignatureStart signing your signature hereYour browser does not support e-Signature field.Submit OrderSave as Draft
and then Add to Home Screen