Information
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Client
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Building or Room Number
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Location
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Conducted on
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Anticipated Installation Timeframe
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Prepared by
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Site Survey #
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Sales Order #
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Sales Order Due Date
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Client P.O. #
Room Type
Type of Room
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Type of Room
- Boardroom
- Conference Room
- Classroom
- Training Room
- Teleconference Room
- Auditorium
- Other
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Specify
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Notes
Room Dimensions
Room Dimensions (Enter Dimensions ft and inches)
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Room Width ("Display Wall")
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Room Length ("side wall")
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Room Height (Floor to Ceiling)
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Plenum Height (Ceiling to Structure)
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Picture of Display Wall
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Picture of wall to right of display wall
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Picture of opposite of display wall
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Picture of wall to the left of the display wall
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Notes
Ceiling Type
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What Type of Ceiling
- T-Bar and if so:
- Open Rafter
- Open Grid (T-Bar No Tiles)
- Concealed Spline
- Cathedral (slanted)
- Corrugated Metal
- Dry Wall and if so:
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What type?
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What size T-Bar Grid
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Is it Cottage Cheese Texturing?
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Add Ceiling Photos
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Add Ceiling Photos
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Notes
Wall Type
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Wall Construction At least one wall (where the wall plate installs) must be hollow, such as Dry Wall, Lath & Plaster, Wood Paneling over Dry Wall or Acoustically Treated, Fabric Covered over Dry wall
- 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
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If All Walls are non-hollow, such as the type you selected, system cabling will need to be surfaced mounted using Wiremold.
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Notes
Floor Construction
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Construction
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Floor Covering
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On Which Floor of the Building is this Room
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Specify:
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Any other floors above this floor
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Furniture Present in Room
- Conference Table
- Instructor's Desk
- Installed Seating
- Lectern
- Credenza
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Additional Furniture Not Listed:
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Floor Utliities
- Electrical Power
- Voice/Data Jacks
- Conduit(s)
- Mic Jack(s)
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Add Floor Photo(s) Note Floor Boxes
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Notes
Type of Ceiling Structure
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Select Type of Structure Above Ceiling (Note Insulation is not a type of structure)
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Specifiy
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Is it Pre/Post Tensioned Slab?
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Notes
Pre-Installation Electric Runs
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Power for equipment:
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Cable Path
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Notes
Options Desired
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Select Options the Customer Would Like in Their System
- 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
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Enter Other Devices Desired but not listed above
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Notes
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Even More Notes
Ceiling Obstructions in area of Projector Installation
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Will a Projection System Be Used in this Application?
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Select all items that could interfere with the projection system
- 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
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Specify:
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I have looked up in the ceiling and there are no obstructions in an area 4'X4' above the projector.
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Notes
Wall or Ceiling Obstructions
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Will a Display Monitor or Monitors be used in this application?
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Number of Monitors:
- One
- Two
- Three
- Four
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Specify:
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Check all Items that could be obstrucitons.
- 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
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Specify:
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Notes
Existing Installed AV Equipment In Room
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Is there Existing AV Equipment in this room?
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List Existing Equipment, Projector, Screen, System
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List existing equipment locations. If equipment rack is in a closet, measure doorway , height and depth of closet.
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If the equipment resides in a credenza make sure to measure the opening and depth of the millwork
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If there is an existing Projector and Screen, measure H&W of screen surface. Record model # of Projector. Measure Throw Distance from front of Projector to Screen.
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If there are existing Microphones and Speakers, record quantities and if possible model #'s.
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List existing infrastructure in the floor and in the rack locations.
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Will the Equipment be Removed? Leave? or Used in System? Describe
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Add Photo of existing equipment - Get Close Ups Of Model Number If Possible
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Add Photo of existing equipment- Get Close Up Of Model Number If Possible
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Add Photo of Existing Equipment - Get Close Up Of Model Number If Possible
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Notes
Verifications
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Wall Plate(s) can be installed on a hollow, non-insulated wall.
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Notes:
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There will be no obstructions (fans, lights,etc.) along the light path of the projector
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Notes:
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Electrical Power is available near location of Smart Panel/Rack
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Notes:
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There is a clear 4' X 4' area above the ceiling where the projector will be mounted
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Notes:
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Any ceiling mounted obstructions to projector installation will be moved by the client prior to installation of system
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Notes:
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Room Drawings are attached, and location for screens, projector, wall plate and (if applicable) rack and speakers are noted
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Notes:
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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.
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Notes:
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There will be no obstructions present at the locations specified for control panel, wall plates, rack and speakers
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Notes:
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Room Lights can be dimmed in the vicinity of the projection screen
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Notes:
Job Site Details
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Building/Room Construction
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Renovation?
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Are Hard Hats Required?
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Installation Vehicle Parking
- Open Parking in Main Lot
- Special Parking for Service Vechile
- Pay Lot: Validated by Clien
- Pay Lot: Not Validated
- Street
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Hours of Room Availability
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Specify
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Security
- 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
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Delivery Informaiton
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Type of Labor Working at Job Site Now