CVI Site Survey Template 102014

• CVI Job Number

• Client Room Name

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Type of Room

• Type of Room

  Select Boardroom Conference Room Classroom Training Room Teleconference Room Auditorium Other

  • Boardroom
  • Conference Room
  • Classroom
  • Training Room
  • Teleconference Room
  • Auditorium
  • Other

• Specifiy:

Room Dimensions (Enter Dimensions ft and inches)

• Room Width ("Display Wall")

• Room Length ("side wall")

• Room Height (Floor to Ceiling)

• Plenum Height (Ceiling to Structure)

• Picture of Display Wall

  Media

• Picture of wall to right of display wall

  Media

• Picture of opposite of display wall

  Media

• Picture of wall to the left of the display wall

  Media

• What Type of Ceiling

  Select T-Bar and if so: Open Rafter Open Grid (T-Bar No Tiles) Concealed Spline Cathedral (slanted) Corrugated Metal Dry Wall and if so:

  • T-Bar and if so:
  • Open Rafter
  • Open Grid (T-Bar No Tiles)
  • Concealed Spline
  • Cathedral (slanted)
  • Corrugated Metal
  • Dry Wall and if so:

• What type?

  Steel

  Wood

• What size T-Bar Grid

  2X2

  2X4

• Is it Cottage Cheese Texturing?

  Yes

  No

• Add Ceiling Photos

  Media

• Add Ceiling Photos

  Media

• Wall Construction At least one wall (where the wall plate installs) must be hallow, such as Dry Wall, Lath & Plaster, Wood Paneling over Dry Wall or Acoustically Treated, Fabric Covered over Dry wall

  Select Dry Wall Wood Paneling over Dry Wall Lath & Plaster Acoustically Treated Fabric covered over Dry Wall Concrete Block Glass Brick All Walls Have Insulation and Fire Block inside them

  • Dry Wall
  • Wood Paneling over Dry Wall
  • Lath & Plaster
  • Acoustically Treated Fabric covered over Dry Wall
  • Concrete Block
  • Glass
  • Brick
  • All Walls Have Insulation and Fire Block inside them

• If All Walls are non-hallow, such as the type you selected, system cabling will need to be surfaced mounted using Wiremold.

• Construction

  Concrete Slab

  Wooden Joist

• Floor Covering

  Carpet

  Hardwood

  Sheet Vinyl

  Tile

• On Which Floor of the Building is this Room

  Basement

  First Floor

  2nd Floor or Above

• Specify:

• Any other floors above this floor

  Yes

  No

  N/A

• Furniture Present in Room

  Select Conference Table Instructor's Desk Installed Seating Lectern Wall Unit

  • Conference Table
  • Instructor's Desk
  • Installed Seating
  • Lectern
  • Wall Unit

• Additional Furniture Not Listed:

• Floor Utliities

  Select Electrical Power Voice/Data Jacks Conduit(s) Mic Jack(s)

  • Electrical Power
  • Voice/Data Jacks
  • Conduit(s)
  • Mic Jack(s)

• Add Floor Photo(s) Note Floor Boxes

  Media

• Select Type of Structure Above Ceiling (Note Insulation is not a type of structure)

  Steel Beam

  Pan (corrugated metal)

  Wood Beam

  Concrete and if so:

  Other

• Specifiy

• Is it Pre/Post Tensioned Slab?

  Yes

  No

  N/A

Pre-Installation Electric Runs

• Power for equipment:

  Client will Arrange

  Power is Already In Place

• Cable Path

  Conduit

  Stub-Outs

  Wire Tray

  Wiremold

• Select Options the Customer Would Like in Their System

  Select DVD Player Blu-Ray Player Electronic Whiteboard Lectern Audio Conferencing Video Conferencing Apple TV or Similar Device Wireless Mouse and Keyboard Document Camera Control System Projector Lift Wireless Microphone(s) Wired Microphone(s) Surround Sound

  • DVD Player
  • Blu-Ray Player
  • Electronic Whiteboard
  • Lectern
  • Audio Conferencing
  • Video Conferencing
  • Apple TV or Similar Device
  • Wireless Mouse and Keyboard
  • Document Camera
  • Control System
  • Projector Lift
  • Wireless Microphone(s)
  • Wired Microphone(s)
  • Surround Sound

• Enter Other Devices Desired but not listed above

• Will a Projection System Be Used in this Application?

  Yes

  No

  N/A

• Select all items that could interfere with the projection system

  Select Air Duct Sprinkler Head Fire Enunciator (strobe) Fluorescent Light Fixture Motion Sensor Fan Cable Tray Asebestos Structural Column Air Register Sprinkler Pipe Smoke Detector Incandescent Light Fixture Loudspeaker Insulation Type specify type: Other

  • Air Duct
  • Sprinkler Head
  • Fire Enunciator (strobe)
  • Fluorescent Light Fixture
  • Motion Sensor
  • Fan
  • Cable Tray
  • Asebestos
  • Structural Column
  • Air Register
  • Sprinkler Pipe
  • Smoke Detector
  • Incandescent Light Fixture
  • Loudspeaker
  • Insulation Type specify type:
  • Other

• Specify:

• I have looked up in the ceiling and there are no obstructions in an area 4'X4' above the projector.

  Yes

  No

  N/A

• Will a projection screen be used in this application?

  Yes

  No

  N/A

• Check all Items that could be obstrucitons.

  Select Air Duct Sprinkler Head Fluorescent Light Fixture Exit Sign Cable Tray White/Blackboard Map Rail Wall Unit/Shelving Air Register Sprinkler Pipe Incandescent Light Fixture Electrical Conduit(s) Wall Clock Window Framed Picture/Mirror Other

  • Air Duct
  • Sprinkler Head
  • Fluorescent Light Fixture
  • Exit Sign
  • Cable Tray
  • White/Blackboard
  • Map Rail
  • Wall Unit/Shelving
  • Air Register
  • Sprinkler Pipe
  • Incandescent Light Fixture
  • Electrical Conduit(s)
  • Wall Clock
  • Window
  • Framed Picture/Mirror
  • Other

• Specify:

• Is there Existing AV Equipment in this room?

  Yes

  No

  N/A

• List Equipment Projector, Screen, Sound System

• Will the Equipment be Removed? Leave? or Used in System? Describe

• Add Photo of existing equipment

  Media

• Add Photo of existing equipment

  Media

• Add Photo of Existing Equipment

  Media

• Wall Plate(s) can be installed on a hollow, non-insulated wall.

• Notes:

• There will be no obstructions (fans, lights,etc.) along the light path of the projector

• Notes:

• Electrical Power is available near location of Smart Panel/Rack

• Notes:

• There is a clear 4' X 4' area above the ceiling where the projector will be mounted

• Notes:

• Any ceiling mounted obstructions to projector installation will be moved by the client prior to installation of system

• Notes:

• Room Drawings is attached, and location for screens, projector, wall plate and (if applicable) rack and speakers are noted

• Notes:

• If the system is using a ceiling mounted screen: there is at least 12 inches of space above the ceiling tile along the entire width of the screen case.

• Notes:

• There will be no obstructions present at the locations specified for control panel, wall plates, rack and speakers

• Notes:

• Room Lights can be dimmed in the vicinity of the projection screen

• Notes:

• Building/Room Construction

  New

  Existing

• Renovation?

  Yes

  No

  N/A

• Are Hard Hats Required?

  Yes

  No

  N/A

• Installation Vehicle Parking

  Select Open Parking in Main Lot Special Parking for Service Vechile Pay Lot: Validated by Clien Pay Lot: Not Validated Street

  • Open Parking in Main Lot
  • Special Parking for Service Vechile
  • Pay Lot: Validated by Clien
  • Pay Lot: Not Validated
  • Street

• Meter

  Free

• Hours of Room Availability

  Mon-Fri 7am to 6pm

  Nights Only

  Weekend Only

  Special Hours

• Specify

• Security

  Select Visitors Must Obtain and Wear Badges Visitors Must Be Escorted to Destination Visitors Must Show Identification Visitors Must Show Proof of Vehicle Insurance Visitors Must Show Proof of Citizenship Other

  • Visitors Must Obtain and Wear Badges
  • Visitors Must Be Escorted to Destination
  • Visitors Must Show Identification
  • Visitors Must Show Proof of Vehicle Insurance
  • Visitors Must Show Proof of Citizenship
  • Other

• Delivery Informaiton

  Loading Doc

  Freight Elevator

  Receiving Department

  Main Entrance

  Side or Special Entrance

• Type of Labor Working at Job Site Now

  Non-Union

  Union

  Prevailing Wage