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Network Site Survey

Network Site Survey

Sales Rep:

Product:

Serial Number:

Delivery Date:

Network Print/Scan:

Fax Board:

Account Information

Account Name:

Street Address:

City / State / Zip:

Contact:

Phone:

Network Administrator Please Fill in Completely

Please Note: Dean’s Technicians will NOT install software on a Customer’s server without the Network Administrator or a representative of the Customer’s IT Department present.

Network Administrator:

Phone:

Email Address:

If "No", ETA?

If above is answered "Yes", please list:

List Server Version being used:

How many Workstations will connect to copier?

List quantity of each Client below: NOTE: Above 3 units, a fee of $35.00 per unit MAY apply. Misc. fees may also apply for services rendered beyond the normal networking responsibilities.

Win 95 / 98:

Win ME:

Win NT:

Win 2k:

Win XP:

Win Vista:

Other (name and quantity):

IP Address for Copier:

Controller IP (Copier):

Subnet Mask:

Gateway:

Will you be utilizing?

Scan to File

Scan to Email

Scan to E-filing

Scan to FTP

Fax Forwarding (To Network Destination)

Desktop Faxing (From Client)