Request for Circuit Move, Addition, or Change
Brief Service
Description:
Site Name Site ID
Customer
Address Room #
Zip
(Include Building Name, Floor, etc.)
Site Contact: Alternate Contact:
Name: Name:
Phone: Phone:
Mobile/Pager: Mobile/Pager:
E-mail: E-mail:
‘B’ Side Information (CTC Branch Campuses must complete this section)
Address: Name:
Phone:
Zip Mobile/Pager:
E-mail:
New Circuit Data? Video? Shared? DS0 Assignments:
Circuit Move w/in Building Who will move equipment?
Disconnect Circuit # CDR #
Other – explain
** for circuit move to different bldg., please provide one request for new circuit and one request to disconnect old circuit**
Requested NIU Date Requested Time
Requested Ext. Date (if move or coordinated change)
Will this require equipment reconfiguration? no yes – explain:
Comments:
To be completed by K-20 Program Office:
Signal: Contract #1 T02-TSD-315 DS1 SUMMARY BILL # 206 Z02-0189 Extend Demarc? no yes
B8ZS/ESF Contract #2 Termination: RJ48X
Channel Assignments: DS3 (UW) Path - Channel -
DS3 (WSU) Path - Channel -
DMS250 DTCI -
Router/IMUX Router - Channel - Port -
G3R
To be completed by Provisioning: PORT SUMMARY BILL# COCC SUMMARY BILL#
CDR#: Circuit #: Circuit tags provided? yes no
Circuit # (B)
de1e8beb-d40f-40c1-ae9e-346a516e2449.doc
Extended Demarc Information (main campus)
Telco Entrance Facility:
Is Telco entrance inside? no yes if yes, Bldg. Floor Room
If Telco entrance is outside, provide Bldg. Name:
New Construction? no yes Remodel? no yes
Comments:
Data Circuit Information:
Router Location: Building Floor Room
Telco Entrance Facility to Router Location:
Is there any existing infrastructure (conduits, cable trays, cable, etc)? no yes
Is there existing cable plant available between the rooms? no yes
Total distance between the Telco entrance facility and the router location? Ceiling height?
Equipment & Room Information: (for NEW sites only!!)
Is power available? no yes Where will equip. be installed? rack shelf Is space available? no yes
Comments:
Video Circuit Information: (if not shared circuit)
Video Location: Building Floor Room
Telco Entrance Facility to Video Equipment Location:
Is there any existing infrastructure (conduits, cable trays, cable, etc)? no yes
Is there existing cable plant available between the rooms? no yes
Total distance between the Telco entrance facility and the video equip. location? Ceiling height?
Comments:
Video Circuit Information: (if shared circuit)
For shared T1, K-20 will extend demarc to location of router equipment. Any extension from router to video equipment will be at
institution’s expense.
Video Location: Building Floor Room
Router Location to Video Equipment Location:
Is there any existing infrastructure (conduits, cable trays, cable, etc)? no yes
Is there existing cable plant available between the rooms? no yes
Total distance between the router location and the video equipment location? Ceiling height?
Comments:
** Please provide a site map with work location clearly identified**
de1e8beb-d40f-40c1-ae9e-346a516e2449.doc
Extended Demarc Information (branch campus)
Telco Entrance Facility:
Is Telco entrance inside? no yes if yes, Bldg. Floor Room
If Telco entrance is outside, provide Bldg. Name:
New Construction? no yes Remodel? no yes
Comments:
Data Circuit Information:
Router Location: Building Floor Room
Telco Entrance Facility to Router Location:
Is there any existing infrastructure (conduits, cable trays, cable, etc)? no yes
Is there existing cable plant available between the rooms? no yes
Total distance between the Telco entrance facility and the router location? Ceiling height?
Equipment & Room Information: (for NEW sites only!!)
Is power available? no yes Where will equip. be installed? rack shelf Is space available? no yes
Comments:
Video Circuit Information: (if not shared circuit)
Video Location: Building Floor Room
Telco Entrance Facility to Video Equipment Location:
Is there any existing infrastructure (conduits, cable trays, cable, etc)? no yes
Is there existing cable plant available between the rooms? no yes
Total distance between the Telco entrance facility and the video equip. location? Ceiling height?
Comments:
Video Circuit Information: (if shared circuit)
For shared T1, K-20 will extend demarc to location of router equipment. Any extension from router to video equipment will be at
institution’s expense.
Video Location: Building Floor Room
Router Location to Video Equipment Location:
Is there any existing infrastructure (conduits, cable trays, cable, etc)? no yes
Is there existing cable plant available between the rooms? no yes
Total distance between the router location and the video equipment location? Ceiling height?
Comments:
** Please provide a site map with work location clearly identified**
de1e8beb-d40f-40c1-ae9e-346a516e2449.doc