Imaging Systems of LA Site Survey
First Name
(required)
Last Name
Your Title
Company
(required)
Email
(valid email required)
Phone Number
FAX Number
IT Contact
IT Phone
Street Address
City
ZIP/Postal Code
Message
Model
Select
240W
2400W
MP161
MP2510
MP3500
MP4500
MP4000
MP5000
MP5500
MP6500
MP7500
MPC2500
MPC3000
MPC3260
MPC3500
MPC4500
MPC5560
MPC6000
MPC7000
SPC210
CL7200
CL410
CL411
Do you have industry specific software?
Do not know
Yes
No
On which server OS will the printer driver be installed?
None
Windows 2003
Windows 2000
Windows NT
UNIX/LINUX
NOVELL
Peer to Peer
Windows 2008
What Operating Systems will the imager be installed on?
Windows Vista
Windows XP
Windows 2000
Windows NT
Windows 98
UNIX/LINUX
NOVELL
MAC
Do not know
What is the IP address for the Imager/Printer:
(required)
What is the subnet mask for the Imager/Printer:
What is the Gateway for the Imager/Printer:
Is there an open working network jack within 6ft?
Do not know
Yes
No
If no, what is the distance to the jack?
Do all computers have working CD ROM drives?
Yes
No
No, but has USB port
Do not know
How many stations will be set up to print by Allfax?
Select
1
2
3
4
5
6
7
8
9
10
Do wish to SCAN TO EMAIL?
Do not know
Yes
No
The next 2 fields must be filled out in order to set up SCAN TO EMAIL.
What is the address of the SMTP server?
What is the email address to be given to the Imager?
What is the DNS server IP address?
If mail server requires authentication, please put username and password in notes below.
How many email addresses will be set up by Allfax?
Select
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Email addresses to be set up:
Do you wish to be able to FAX from the PC?(Requires the Fax Expansion Kit)
Do not know
Yes
No
If yes, how many stations for PCFax?
Select
1
2
3
4
5
6
7
8
9
10
Do you wish to use Inbound Fax Routing?
Do not know
Yes
No
If yes, what is the email address to be routed to?
Sales Representative
Select
Steve Collura
Mac McElroy
Hope Landry
Kevin Clew
Notes:
Network installations and reconfigurations are performed free of charge within the first 30 days of imager install. Any network configurations after the 30 days are subject to charge unless Connectivity Contract is purchased.
Would you be interested in the Connectivity Contract?
Select
Yes
No, not interested
No, have own IT support
Maybe, need more information
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