TELEPHONY SITE SURVEY FORM

GENERAL SITE INFORMATION What are the hours of operation at location? Building style Tower Campus Office Bldg.

Customer occupies which floors of building? Customer space is Office/Professional Yes No Retail Store Is there a: Institutional/School Elevator Factory/Industrial Freight Elevator

Strong Union presence? DMARC/MPOE location:

Loading dock

Humidity and temperature properly controlled by HVAC? Ceilings are: Floor is: Furniture is: Drop tile Rasied tile Desks Lock tile Concrete Modular Permanent

Yes

No Ceiling height

Exposed beam/trussels

PBX room is located on which floor?

Is it secure?

Yes

No

Dimensions of PBX room (HxWxL) Condition of PBX room: Type and location of spare electrical outlets in PBX room Is there a #6 grounding bar in PBX room PBX is mounted on: Floor Wall Yes Shelf No Plywood on walls 19" rack 25" rack Yes Other No

How much space exists to add additional equipment? Type of wallfield (PBX) Type of wallfield (Station) Wallfield is mounted on 66 Blocks 66 Blocks Plywood 110 Blocks 110 Blocks 19" Rack Patch Panels Patch Panels 25" Rack Other Other Other

How much space exists to add more wallfield? Number of station cables How are the station cables labeled? PBX cables run: PBX cables length on floor Pairs per cable Cable # Number of feed cables Extension # Not labeled under raised floor Yes Other No Pairs per cable

on wall

on overhead ladder

Are the spare slots cabled out to the wallfield?

Where is the data network located? How many available network connections exist near PBX Are there data racks near PBX? Racks are floor-mount Yes wall-mount No

Distance from PBX Connections are Jack/Patch Panel Yes 19" No 25" Hub

If no, is there room to add a rack In cabinets 2-post 4-post

How much room exists on racks near PBX Number of spare pairs

How many available electrical outlets near racks Yes No Conduit? Yes No

Do riser cables exist between floors?

Page 1 of 1

EXISTING PBX SYSTEM/PBX EQUIPMENT INVENTORY PBX Manufacturer Software Release Software/backup method: Flash Card Tape Drive PBX Model Modem # Floppy Drive CD Drive Network

Please list all information on flash card or tape: System has: Maintenance Terminal 120V/20A Printer 120V/50A Signalling Server 208V/30A -48VDC Media Server Other Shelves per cabinet

PBX Input Power

Total number of cabinets

Cabinet dimensions (HxWxL)

Total number of Digital Telephone ports Total number of CO Trunk ports Is the PBX on a UPS? UPS Manufacturer UPS Input Power UPS is 120V/20A 208V/30A Yes No

Total number of Analog Telephone ports Total number of T-1/PRI ports Remaining UPS capacity UPS Model Other Floor mounted UPS estimated weight Wall mounted Rack mounted <25% 25-50% 51-75% >75%

Hardwired to panel

Hardwired to PBX

UPS dimensions (HxWxL) Spare receptacles on UPS Yes No

If yes, quantity and type Yes No If yes, how many?

Does the UPS have external batteries/battery packs? Battery Manufacturer Cabinet # Location of Cabinet Carrier/shelf #

Battery type/rating Carrier/shelf type

Vintage or Slot # Circuit Pack/Power Supply Revision Type of Card Type of connector

I it

m Na

c: ffi IE ra / T e?) T h t ce ot si oi / B at V l h of ca w s Lo e to pe / ti Ty LD (if

rv Se

e ic

i ov Pr

r de

r de v i or t o Pr upp e ic h S ne rv c o Se Te Ph

Cu

o er om st

r be m u tN cc A

on , d ck ie lo .) tif o u b 6 tc en n irc (6 e id s / e 1x, rC d ye p de an ck ty J2 vi d le blo ro el on k, R i e P at oc od e ab RC l in l M ic U rv rm 0 b T1 A Se Is DM Te 11 CS

s es cc rier h a r t l : : ne s S Au am Ca es pe S el RI an gr or 8Z ur ce de P t h o l T y DM B nn n o , I C a : / ea h / pr ita ha g: ink st C DAN g: F ng C itc 0 0 ill l F om in Di ss e in / S w es V di w 10 50 ia aC ed al -W nd S S S ec eg co ar tiv ng ce am F ho d gn M ba Fr ES En Si E& Lo Ac W co Sp M Sh Ac In CO DM DM

M /A

io at riz o

m to us /C

: ts gi di

o, fs

ho

w to IS S DN NI r D 0 be m 80 e Nu ut 0 80 Ro

/ I ed 0 NI2 ls s? 25 S / pu e: de t S c o ? C ts? rs ou 5E en ge be of ard ss igi qu le an m e 3 1 Id ber nd ce d S t ? ,R Nu Ac any nt to 2 to as um sta 0 Ds so Hu 1 23 Le N is LD m DI If 80

CARRIER Name

Trunk or Station?

Carrier Repair No.

Billing Telephone Number

Number

Destination

DMARC location & Block

Termination type (66 block, 110 block, RJ21x, etc.)

DID

Type

In-building Location

PBX or PSTN

Hunt Group member

Loop Start Ground Start E&M

Purpose

PIC

Incoming Outgoing Both

First Name

Last Name

Set Type/Model

User ID

Main Extension

2nd Extension

Outside Caller ID

Fwd-Busy Voice Mail or Extension

Fwd-No Answer Voice Mail or Extension

Class of Service Phone: Internal, Local, Local/LD, etc

Pick Up Group

Assigned Services Paging, Ext Mobility, Fast Dials, etc

SIDE CAR

Long Handset Cord?

Headset Required?

Shoulder Rests needed?

Wall Mount Required?

ACD Agent: Yes Call Center Group or No? (by area)

NOTES

e S TE NO

rs Fi

am tN

s La

tN

am

el od

D rI

n io ns e xt

tC

d? or

t Se

M e/ yp T

e Us

D rI

n ai

Ex

n io ns te

d 2n

t Ex

n io ns e

le al

e ds an

ut O

de si

t , : as n ne l/LD s ,F io o a s ce y er en Ph oc vi ilit sw E xt er ob etc sy E ce l , L S M s, u vi a An r up B r er oc etc o lo ed xt ial ro d- l o - N ai G w ai f S l, L gn , E D AR d M F M o a si g C Up Fw ice ss ern As gin E ce i a ck D Cl Int Pa Vo Pi SI Vo

ng Lo

e ds ea H

tR

d? re ui eq

es

ts

d? de e ne

ire qu e

d?

r de ul o Sh

al W

lM

R nt ou

Ye

No or

: nt ge A

ll Ca

up ro ) r G ea te ar en y C (b

x, fa

e S

c vi De

. i.e m pe de Ty mo e

am

am tN rs Fi

tN as L

D rI se U

n ai

Ex

n io ns te

e id ts u O

le al

D rI

n io ns e xt

, : n ne l/LD io r ns ho ca e P w te y e Lo ns r Ex v ic al, us r E A up B o l o Ser oc etc ro d- l o - N ai G w ai f l, L d M F M o a Up e Fw ice ass ern k ic l nt o o ic C I V P V

TE NO

OPERATOR CONSOLES Qty Manufacturer Model Color # of feature buttons

How many operator consoles/phones have adjunct devices?

Power source:

Local

Bulk

How many have headsets?

Long hand cords?

Long base cords?

Headset type/model:

For all wireless phones listed, where is the base/antenna located?

For all IP phones listed, what is the power source?

Individual power supplies

Power over ethernet

Are the workstation's network connection wired through the IP phones?

Yes

No

Are there any conference room phones?

Yes

No

If yes, how many?

Conferencing phone model

Video Conferencing?

Yes

No

Voice jacks are

RJ11

RJ45 Color

Labeled

Yes

No

All pairs terminated

Yes

No

# of voice jacks at each location

Type of plate

Single

Duplex

Quad

Other

# of data jacks at each location

Color

Data jacks are

RJ45 Other

TELEPHONY ADJUNCTS Music on hold MOH Manufacturer Media type: Tape CD Radio Muzak Yes No Connects to PBX how? MOH Model Satellite Phone line download mp3

Overhead Paging Paging Manufacturer

Yes

No

Connects to PBX how? Paging controller model Input Output

Paging Amplifier model Paging dimensions (HxWxL)

How many zones can a user page?

Call Accounting CAS manufacturer CAS includes:

Yes

No

Connects to PBX how? CAS Model

Monitor

Printer

Buffer box

Network connection

UPS Other

CAS dimensions (HxWxL) ACD/Call Mgmt system Manufacturer System includes Announcements are: Call Recording? Network connection internal to PBX Yes No UPS Yes No

CAS estimated weight Connects to PBX how? Model Wallboard Operating software CD/Tape/Disks provided by external announcer

provided by VM

Call recording manufacturer/model: Calls are recorded on: CD Tape Server Workstation Other:

TELEPHONY ADJUNCTS FAX Server? Manufacturer Yes No Connects to PBX how? Model

VOICE MAIL Manufacturer VM dimensions (HxWxL) Modem # Voice ports are: Analog extensions

Model VM estimated weight Number of voice ports connected to PBX Digital extensions Line side T-1 Internal to PBX

Are there any spare voice ports available Connection to PBX: Distance from PBX UPS Manufacturer UPS dimensions (HxWxL) VM is mounted on: VM system includes: PBX Floor Voice ports only

Yes

No

If yes, how many? Patch cord Through customer's network Is the VM on a UPS? Yes No

Serial cable

Distance from Customer's network UPS Model

UPS estimated weight Wall Monitor Table Printer 19" rack 25" rack Other External Tape drive

Tower PC

External CD drive

Are the following on-site:

Operating software CD/Tapes/disks

Backup tapes/disks

E911 Onsite Server or Hosted Service? If onsite server how is it connected? Manufacturer If hosted service how is it routed?

Yes

No

Model

DID INFO/CALL FLOW What are the hours of operation?

How are calls answered during normal business hours? How are calls answered during off hours? Is there an auto-attendant? Yes No If yes, is it internal to PBX VM External device

Is there toll-free #'s routing through the system? Is there a night-bell or ringer? Yes No If yes, where is it located?

Can callers dial direct to an individual telephone (DID)?

Yes

No Yes No # of locations

Can users dial another location by dialing just an extension number? Digits sent by the PBX send?

Location DID ranges:

What is the outbound caller-id shown? Are there any E911 requirements? Are CAMA trunks being used?

Remote users/Mobility features

Is there any remote workers? Is any softphone clients used? Additional mobility features used? Yes Yes No If yes, is any special equipment used? No If yes, what version/rls.?

VOIP
Is there a vlan? Yes No Is there QOS? Yes No

Is there SIP trunks?

Yes

No

ADDITIONAL COMMENTS