Network Site Survey Sales Rep Serial Number Delivery Date Network Print/Scan Fax Board Account Information Account Name Street Address City/State/Zip Contact Phone Email Address Network Administrator Please Fill in Completely Please Note: Howard D. Happy Companies 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 New Field YesNo Phone Email Address Is there a Live Network Drop and Patch Cable for Copier? YesNo If "No", ETA? For copiers about 45 Copies per Minute is t here a 20amp (NEMA 5 - 20) outlet? YesNo If "No", ETA? Is (Protocol / Toplogy / Media) other than (TCP / IP / Ethernet / 10 / 100 Based-T) being used? YesNo If "Yes", please list List Server Version being used How Many Workstations Will Connect To Copier? List quantity of each below: Win XP Win Vista Win 7 Mac Other (name and quantity) IP Address For Copier Controller IP (Copier) Subnet Mask Gateway Will You Be Utilizing? Scan to FileScan to EmailScan to E-filingScan to FTPFax Forwarding (To Network Destination)Desktop Faxing (From Client) Δ