Northeast Cable Logo and Menu MapData - Voice - Video
This form is for basic informational quotes only.  This will give you and us an idea of your scope of work.  We will then take this information as background reference when we talk in person or by phone. If you only want an estimate, please state within the Comments Section that you would like to receive your estimate back as email.  Thank you.


- CUSTOMER INFORMATION -


FIRST NAME:
LAST NAME: 
PHONE NUMBER:

FAX NUMBER:

EMAIL ADDRESS:

TYPE OF BUSINESS:

CAMPUS ENVIRONMENT:

YES NO
COMPANY NAME:
STREET ADDRESS:

CITY:

STATE:

ZIP CODE:

HOW DID YOU HEAR ABOUT US:

- CURRENT NETWORK INFORMATION -


TYPE OF NETWORK IN PLACE:

NUMBER OF CLIENTS:

FIBER BACKBONE IN PLACE:

YES NO
NOT RELATED
NETWORK SOFTWARE:

BRAND OF ELECTRONICS IN PLACE NOW (EX. 3COM):

PHONE SYSTEM IN PLACE:

- PROJECT INFORMATION -


TYPE OF SERVICE NEEDED (SELECT ALL THAT APPLY):
  • VOICE
  • DATA
  • VIDEO
  • CONSULTING
  • ENGINEERING
WILL YOU NEED AS-BUILT DRAWINGS:
YES NO
NOT SURE


WILL THIS COMPRISE OF INSIDE OR OUTSIDE WORK:

INSIDE OUTSIDE
BOTH

PLEASE DESCRIBE THE INTENDED PROJECT AS MUCH AS YOU CAN.  THE MORE DETAILS, THE BETTER WE CAN PROJECT THE SCOPE OF WORK:

{Company&Services}--{Our Work}--{Contact Us}
{Desk Reference}--{Website Extras}--{Home}

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Northeast Cable Networks, Inc
Copyright 1997-2007

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