Information
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Document No.
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Project Title
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Client / Site
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Site Address
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Conducted on
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Prepared by
- Bill Aziz
- Bassam Bashouri
- Greg Robinson
- Andrew Aziz
- Joe Bakutis
- Mark James
- Graham Rioux
- Codie Davis
- Todd Phillips
Survey
Background Information
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Primary Contact
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Phone
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E-Mail
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Facility Contact
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Accounts Payable Contact
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Proposal Due Date
Site Information
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Parking Accommodations
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Access Hours
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Distance To Site
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Loading Dock
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Freight Elevator
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Security Issues
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Access To Other Tenants Required
Qualifying Questions
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Project Type
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Project Timeline
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Other Approvals Needed
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How many rooms
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
Room Details
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Room Purpose
- Boardroom
- Conference Room
- Classroom
- Training Room
- Operations Center
- Other
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Room Name
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Other Discription
Room Environment
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Length
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Width
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Height
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Room Photos
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Ceiling Type
- 2' x 2' Lay-In
- 2' x 4' Lay-In
- Sheetrock / Hard Lid
- Open
- Spline
- Wood
- Other
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Ceiling Photos
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Distance To Structure Above Ceiling
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Structure Type
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Noise/Acoustical Concerns
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Ambient Lighting Concerns
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Wall Types
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Potential Interference
- Light Fixtures
- Air Ducts
- Architectural Features
- Sprinkler Heads
- Doors
- White Boards
- Windows
- Alarm Sensors
- Other
Room Layout
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Is Floor Track Needed
- Yes
- No
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How Many Feet
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Draw Room Layout
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Supporting Photos
Notes
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Notes
Equipment Requirements
Screen Requirements
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Screen Needed
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Add Screens As Needed
Screen
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Format
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Projection Type
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Mount Type
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Motor Type
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Tab Tensioned
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Screen Surface
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Depth Of Projection Room
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Desired Screen Height
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Ceiling Height In Projection Room
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Photo Of Rear Projection Space
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Floor To Bottom Of Screen Distance
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Notes
Projector Requirements
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Projector Needed
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Add Projectors As Needed
Projector
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Mount Type
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Mounting Structure
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Available Throw Distance
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Projection Light Obstructions
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Owner Furnished
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Notes
Large Format Display Requirements
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Displays Needed
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Add Displays As Needed
Displays
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Display Orientation
- Landscape
- Portrait
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Mount Type
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Mounting Structure
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Mount Obstructions
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Interactive
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Owner Furnished
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Notes
Video Sources
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Video Sources Needed
Source
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Source Name
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Input Type
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Wall Plate Input
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Table Top Input
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Owner Furnished
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Notes
Audio Sources
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Audio Only Sources Needed
Audio Source
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Source Name
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Wall Plate Input
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Table Top Input
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Owner Furnished
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Notes
Speakers
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Ceiling Mounted
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Wall Mounted
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Voice Lift
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Room Combining
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Multizone
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Notes
Control System
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Control System Required
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Type
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Other Description
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Touch Panel
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Touch Panel Type
- Table Top
- Wall Mount
- Wireless
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Keypad
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Notes
Conferencing
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Audio Conferencing
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Analog / POTS
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VOIP
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PBX Manufacture
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Video Conferencing
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Preferred Manufacture
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Notes
Cabling
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Conduits In Place
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Conduit Size
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Notes
Equipment Mounting
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Rack
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Owner Furnished
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Rack Location
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Rack Location Photo
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Cabinet
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Cabinet Photo
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Lectern / Podium
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Owner Furnished
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Lectern Photo
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Finish And Requirements
Labor
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Estimated Hours In Shop
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Estimated Hours On-Site
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Estimated Programming Hours
Miscellaneous
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Notes