Let's get you up to speed. We would love to hear from you. Please enable JavaScript in your browser to complete this form.Date *Arrival Time *Completion Time *Customer Name *FirstLastUser Name *Address *City *State, Zip Code *Phone *Technician *Kyle JohnsonBrandon SmithRoscoe Williams IVFrank LozanoConsultantCall Type *Basic Residential InstallCustom Residential InstallBasic Commercial InstallCustom Commercial InstallService CallMove ServicePick UpLine Of SightMBPS / Plan Amount Monthly *5/2 Up $34.997/3 Up $49.998.5/4 Up $69.9910/5 Up $89.9912.5/6 Up $124.9915/7 Up $149.9918/8 Up $199.9920/10 Up $275.0025/10 Up $325.0030/10 Up $375.0040/20 Up $500.00Not ApplicableCommercial Plan Monthly *Router *Luxul Router $250.00Cambium Router $250.00Line Of Sight *LOSNo LOSRadio Type *MAC *Mac 1/Product DescriptionMac 2/Product DescriptionMac 3/Product DescriptionMac 4/Product Description Radio S/N *Job Complete *YesNoItems Pending *Additonal Services Requested *Target Date *ChargesCommerical Monthly Plan Charge *Monthly Plan Charge *Monthly Plan Charge 7/3 Up *Monthly Plan Charge 10/5 Up $89.99 *Monthly Plan Charge 12.5/5 Up $124.99 *Monthly Plan Charge 15/5 Up $149.99 *Monthly Plan Charge 18/8 Up $199.99 *Monthly Plan Charge 20/10 Up $275.00 *Monthly Plan Charge 40/20 Up $500.00 *Equipment Charge *Radio/Router Management $15.00 Equipment Protection Plan $29.99Router Charge *Large Radio Surcharge $75.00 *Subtotal *Additional Charges– Installed repaired and added cable run $99, Acess Point $200 ECT.Total *PaymentsPayment Method *CashCheckCredit CardPaid OnlineBill To Existing AccountNo ChargeCard Type *Master CardVisaDiscoverAMEXMonthly Auto Pay *YesNoName on the Card *Billing Address *Credit Card Number *Expiration Date *MM/YYSecurity Code CVC *Cash Payment Amount *Credit Card Payment Amount *Check Payment Amount *Check Number *Total Paid *Total Paid *Total Paid *Please NOTE: A custom install is an installation requiring 2 hours or more to complete. Custom installs start at $350 plus $150 an hour for each additional hour. Examples of custom installs include running wiring through the attic or through a specific room, through crawl space, relocating radio or equipment, or setting up access point, etc. *This list contains examples only is not inclusive of all types or specifics for custom installs.Issues / Messages/ NotesUpload Pictures *NoYesWire Run Click or drag a file to this area to upload. Radio Click or drag a file to this area to upload. Mount Click or drag a file to this area to upload. AP (Showing Location) Click or drag a file to this area to upload. POE Click or drag a file to this area to upload. Exterior Wire Penetration Click or drag a file to this area to upload. Interior Wire Penetration Click or drag a file to this area to upload. Other Click or drag a file to this area to upload. Non LOS -360 picture 1 Click or drag a file to this area to upload. Non LOS -360 picture 2 Click or drag a file to this area to upload. Non LOS -360 picture 3 Click or drag a file to this area to upload. Non LOS -360 picture 4 Click or drag a file to this area to upload. Non LOS -360 picture 5 Click or drag a file to this area to upload. NameSubmit
