On Site Installation Questionnaire

1.*Company Name

2.*Address

3.*City, State & Zip

4.*Point of Contact

5.*Phone

6.*email

7.*Hours of Operation

8.Notes

9.Is there an Existing Network?

Yes No

10.If yes, Is network access ready at the POS station location?

Yes No Not Sure

11.What Internet Connection is Available?

T1 Cable DSL Wireless Dial Up None

12.Who is the Internet Service Provider?

13.Internet Service Provider number

14.Internet Service Provider Technical Support

15.Where is the location for gaining access to the router / switches / active drop?

16.Notes

17.Is there a drop ceiling throughout the facility?

Yes No Unsure

18.If Yes, what is the height of the drop ceiling?

19.If No, Which of these ways are available to run cable

Crawl Space Moldings Conduit Carpet Wall-Mount Other

20.If Unsure, nn on-site survey of the facility maybe required prior to installation. List any network devices in already in place or any site specific

21.Check the Install Type

Single Station Install Single Station w. Back office Multiple Station Install Multiple Station with Back office

22.What is the distance between the POS stations?

23.Is there a back office POS or a plan to add one in the near future?

Yes No

24.If Yes, what is the distance from the POS stations to the Back office?

25.What is the distance from the Internet Access Point to the back office?

26.Notes

27.*Are Additional Network Devices or Peripherals going to be installed at this location?

Scale Prep Printers DVR Inventory Scanner Report Printer Caller ID Modem Other None

28.Please give a brief description of the location of the hardware & distances between them relative to the POS and back office.

29.Has electrical power at each POS station, and back office been confirmed? If No You MUST have confirmed electrical power installed at each POS station & back office before work can begin.

Yes No

30.Date of completion of electrical power installation