Colo Company Worksheet - Excel by hmp10394

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									                                                                                    1101 W. Lake St., 6th Floor
                                                                                    Chicago, IL 60607-1640
                                                                                    Tel: 888-450-2100 Fax: 773-326-0892
                                                                                    www.nitelusa.com
Service Order Form
                                                                     ORDER TYPE
      NEW         UPGRADE               CANCELLATION               DISCONNECT               CHANGE              MOVE                               RENEWAL

                                                                   ATTACHMENTS
      IP JUSTIFICATION                  TECH QUESTIONNAIRE                                 COS WORKSHEET                                           CFA / LOA


                                          COMPANY ORDER CONTACT INFORMATION
CONTACT                                                                      ACCOUNT#
EMAIL                                                                        COMPANY
PHONE                                                                        ADDRESS
FAX                                                                          CITY/STATE
MOBILE                                                                       ZIP/COUNTRY

                                        CUSTOMER BILLING CONTACT INFORMATION
CONTACT                                                                      COMPANY
EMAIL                                                                        ADDRESS
PHONE                                                                        CITY/STATE
FAX                                                                          ZIP/COUNTRY


                                      CIRCUIT INSTALLATION LOCATIONS (location A & Z)
                         LOCATION A                                                         LOCATION Z
END USER NAME
COLO FACILITY NAME
STREET ADDRESS
ADDRESS2/FLOOR/STE
CITY/STATE/ZIP
MAIN LISTED PHONE
ON-SITE CONTACT
ON-SITE PHONE
ON-SITE ALT PHONE
TECH CONTACT
TECH PHONE
TECH EMAIL
CFA
BLDG CLLI CODES
JACK TYPE
CONNECTOR TYPE                 RJ48      RJ45     FC          LC        SC        BNC             RJ48          RJ45         FC          LC       SC           BNC

INTERFACE TYPE                 CAT5             SMF            MMF              COAXIAL           CAT5                 SMF                  MMF              COAXIAL

REC & TRANS LEVEL        RX:                                 TX:                            RX:                               TX:
CARD/PORT PROTECT              2-WIRE                          4-WIRE                             2-WIRE                           4-WIRE

DS3 FRAMING                    C-BIT                   M13                        M23FC           C-BIT                      M13                           M23FC

T1 CODING/FRAMING              B8ZS                    AMI                        Other:          ESF                        D4/SF                         Other:

IP ADDRESS REQUEST                                                                                        Blocks larger than 16 IPs require IP Justification Form
                                                                                                                                  Nitel Service Order Form Page 1 of 2
                                                                           1101 W. Lake St., Chicago, IL 60607
                                                                           Tel: 888-450-2100 Fax: 773-326-0892

                                          PRODUCT & SERVICES INFORMATION
    CUSTOMER PON:                                                  CARRIER                        TOTAL
                                                                                        UNIT NRC/  NRC/                       TOTAL       BURST
QTY PRODUCT                               TYPE       BANDWIDTH INFO                      INSTALL INSTALL       UNIT MRC        MRC         RATE




                                               EQUIPMENT & OTHER CHARGES
          CARRIER / SUPPLIER                                                              DELIVERY DATE
                                                                                                    TOTAL
                                                                                        UNIT NRC/    NRC/
QTY PRODUCT                               DESCRIPTION                                    INSTALL INSTALL       UNIT MRC          TOTAL MRC




                                           SPECIAL INSTRUCTIONS/ COMMENTS




Service Use Certification: Where Customer is ordering private line or multipoint metro Ethernet services from Nitel on a standalone basis, the
end points for which are located in the same state, Customer certifies to Nitel that less than 10% of Customer’s traffic utilizing such services
will be deemed interstate traffic. Where Customer is ordering private line services from Nitel on a standalone basis, the end points for which
are located in different states, or any MPLS service, Customer certifies to Nitel that more than 10% of Customer’s traffic utilizing such
services will be deemed interstate traffic. Where Customer is ordering transport services which are terminated to a Nitel-provided IP port,
Customer certifies to Nitel that more than 10% of Customer’s traffic will be originated or terminated outside of the state in which the port is
located.

                                                 NITEL CONTACT INFORMATION
 SALES REP      - PLEASE SELECT FROM DROPDOWN -                                      AGENT        - PLEASE POPULATE UNLESS NO AGENT -

  BUS DEV       - PLEASE SELECT FROM DROPDOWN -

                                            SERVICE TERM & TOTAL CHARGES
                                           Sign and fax order form to nitel 773-326-0892

                    WAIVED INSTALL FEES                            TERM                                      DATE
                                                              CUSTOMER
                       ONE-TIME CHARGES                       SIGNATURE
                                                                 PRINTED
                      MONTHLY CHARGES                              NAME

                                                                   TITLE
                                                                COMPANY
                                                                   NAME
                                                                                                                Nitel Service Order Form Page 2 of 2
Carrier / Suppliers   Products                   TYPE    BANDWIDTH

NITEL                 IP PORT                     T1     1.54Mbps
AT&T                  IP PORT W/ MANAGED ROUTER N x T1   2Mbps
LEVEL 3               PRIVATE LINE                E1     3Mbps
GLOBAL CROSSING       METRO ETHERNET MULTIPOINT DS3      4.5Mbps
VERIZON               MPLS PORT                   OC3    5Mbps
SAVVIS                MPLS PORT W/ MANAGED ROUTER OC12   6Mbps
QWEST                 LOCAL LOOP                  OC48   7.5Mbps
TIME WARNER           LOCAL LOOP A                FE     9Mbps
XO                    IXC                         GigE   10Mbps
INTERNAP              LOCAL LOOP Z                2.5G   10.5Mbps
SPRINT                VOICE - LOCAL LOOP          10G    12Mbps
                      VOICE - 8XX GEO ROUTING            15Mbps
                      VOICE - TERMINATION OVERFLOW       20Mbps
                      EXPEDITE                           25Mbps
                      CROSS-CONNECT                      30Mbps
                      MUX                                35Mbps
                      DEVICE MONITORING                  40Mbps
                      MANAGED ROUTER                     45Mbps
                      BUILD / CONSTRUCTION               50Mbps
                      INTERNET PROTECT                   55Mbps
                      DDOS                               60Mbps
                      IP BLOCK                           65Mbps
                      MAC FEE                            70Mbps
                      NOC FEE                            75Mbps
                      CPA FEE                            80Mbps
                      CANCELLATION                       85Mbps
                      EARLY TERMINATION LIABILITY        90Mbps
                                                         95Mbps
                                                         100Mbps
                                                         120Mbps
                                                         125Mbps
                                                         150Mbps
                                                         155Mbps
                                                         200Mbps
                                                         250Mbps
                                                         300Mbps
                                                         400Mbps
                                                         500Mbps
                                                         600Mbps
                                                         622Mbps
                                                         1000Mbps
                                                         1500Mbps
                                                         2500Mbps
                                                         5000Mbps
                                                         10000Mbps
INFO        SPECIAL SERVICES

NA          EQUIPMENT PURCHASE
BURSTABLE   EQUIPMENT LEASE
CAPPED      ROUTER CONFIGURATION
            SHIPPING & HANDLING
            LIMITED WARRANTY - 1 YEAR
SALES REPS                                                TERMS
- PLEASE SELECT FROM DROPDOWN -
BOB SCHWARTZ, 773-661-5538, BSCHWARTZ@NITELUSA.COM        12 MONTHS
BRIAN CARNEY, 773-661-5541, BCARNEY@NITELUSA.COM          18 MONTHS
BRIAN ROWE, 773-661-5547, BROWE@NITELUSA.COM              24 MONTHS
CLAY HULEN, 773-770-1355, CHULEN@NITELUSA.COM             36 MONTHS
DAVE ZILCH, 773-661-5549, DWILLIAMS@NITELUSA.COM          48 MONTHS
DAVID BOLAND, 773-661-5529, DBOLAND@NITELUSA.COM          60 MONTHS
JASON PARA, 773-770-1352, JPARA@NITELUSA.COM
JIM HESSMER, 773-770-1366, JHESSMER@NITELUSA.COM
JOE BARTOSZ, 773-661-5532, JBARTOSZ@NITELUSA.COM
JONATHAN ERLICH, 773-770-1358, JERLICH@NITELUSA.COM
LISA KAMINS, 773-770-1381, LKAMINS@NITELUSA.COM
LORI DALESANDRO, 773-770-1380, LDALESANDRO@NITELUSA.COM
MARK WILLIAMSON, 773-770-1354, MWILLIAMSON@NITELUSA.COM
PAUL ASQUINI, 773-770-1351, PASQUINI@NITELUSA.COM
RON GRASON, 773-770-1350, RGRASON@NITELUSA.COM
RYAN SCHENKEL, 773-770-1353, RSCHENKEL@NITELUSA.COM
TIM BASA, 773-770-1353, TBASA@NITELUSA.COM
WOOJIN HWANG, 773-770-1369, WHWANG@NITELUSA.COM
IP Address Options BUS DEV
                    - PLEASE SELECT FROM DROPDOWN -
/30=4 IPs          NONE
/29=8 IPs          BRIAN ROWE, 773-661-5547, BROWE@NITELUSA.COM
/28=16 IPs         DAVE ZILCH, 773-661-5549, DWILLIAMS@NITELUSA.COM
/27=32 IPs         LISA KAMINS, 773-770-1381, LKAMINS@NITELUSA.COM
/26=64 IPs
/25=128 IPs
/24=1 Class C
/23=2 Class Cs
/22=4 Class Cs

								
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