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)

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