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Dealer Name:

Customer:

Date:

Salesman's Name:

Phone Number:

Expected Close Date:

Email:

How many buildings are involved?

		1
		2
		3
		other

What type of facility is it?

Will you use CAT5 or is SIAMESE accepted?

		CAT5
		SIAMESE (recommended)

Longest cable run (Approx):

# Days Expected To Keep Stored Video On DVR:

How many cameras inside?

Describe environment (ex: wall or ceiling mount, drop ceiling, warehouse, etc...)

How many cameras outside?

Describe environment (ex: wall or ceiling mount, drop ceiling, warehouse, etc...)

Considerations for lighting:

Considerations:

If so, what?

Will anything stay?

Notes:

Please describe any additional requirements, camera views, special needs, etc.

Dealer Name:

Customer:

Date:

Salesman's Name:

Phone Number:

Expected Close Date:

Email:

How many buildings are involved?

What type of facility is it?

Will you use CAT5 or is SIAMESE accepted?

Longest cable run (Approx):

# Days Expected To Keep Stored Video On DVR:

How many cameras inside?

How many cameras outside?

Considerations for lighting:

Considerations:

If so, what?

Will anything stay?

Notes:

For More Information

Name

Email Address

Phone Number

Questions or Comments

Dealer Name:

Customer:

Date:

Salesman's Name:

Phone Number:

Expected Close Date:

Email:

How many buildings are involved?

What type of facility is it?

Will you use CAT5 or is SIAMESE accepted?

Longest cable run (Approx):

Analog:

IP:

POE:

Frame Rate Desired Per Camera:

# Days Expected To Keep Stored Video On DVR:

RAID/REDUNDANCY REQUIRED:

PTZ:

PTZ Keyboard:

How many cameras inside?

How many cameras outside?

How many channels on DVR?

Is there good lighting on inside cameras?

Is there good lighting on outside cameras?

Considerations for lighting:

Will low light work or is infared needed?

Considerations:

DVR Type:

Rackmountable:

Audio:

Is there internet connectivity at the location?

Is there any existing surveillance equipment?

If so, what?

Will anything stay?

Notes:

For More Information

Name

Email Address

Phone Number

Questions or Comments