Communications Network Services
Telecommunications Project Request for Estimate 


A. General Information

1.  Department Name:    ___________________________________________________

2.  Customer Account Code:  _______________________________________________

3.  Project Title:      ___________________________________________________

4.  Contact Person:     ___________________________________________________

5.  CP's Telephone and E-mail Address: ____________________________________

6.  Department's Communications Liaison:   ________________________________________

7.  Communications Liaison's Telephone and E-mail Address: ________________________________



B.  Project Information  

1. Scope of Project:




2. Location of Project:
        
    
			
  1. Building:
    
			
  2. Room Number(s):
    
			
  3. Estimated Total Number of Voice Connections (include fax machines):
    

			
  4. Estimated Total Number of Data Connections (include network printers):
    
			
  5. Estimated Total Number and Description of Special Connections such as 
    VTEL, NET.WORK.VA, or other High Speed [100MHz]):
    6. 
		
  


        



3.  Description of  any known special conditions:




4. Estimated Date of Completion:  ______________________________________________


5. Department Head Signature: _________________________________________________