Title Page
Document identification
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Document Classification
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RAV Project number
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DSMS Reference Number
Location
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Facility
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Room Name/Number
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Exact Address
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Conducted by: (RAV contact)
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Phone: (RAV contact
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Conducted on
Contact Details
Unisys Point of Contact
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Name:
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Phone Number:
Delivery Point of Contact
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Name:
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Phone Number:
Alternate Point of Contact
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Name:
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Phone Number:
Faulty Equipment
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Add items and fill in descriptive information below:
Item
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Manufacturer
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Serial number
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Model Number
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Description
Faults/Issues Adressed
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Insert Faults below
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Description
(Option 1) Replacement Equipment
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Add items and fill in descriptive information below:
Item
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Manufacturer
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Model Number
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Description
(Option 2) Recommended System Upgrade (If Required)
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Add Item
Item
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Quantity
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Description
Justification Brief (Engineering Only)
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Description
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Take image of Illustration of issue or:
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Sketch Illustration of Issue
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Before and/or After images of Room
Checklist
Room Details
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Wall Type
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Ceiling Type
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Ceiling Access
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Detail
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Cable Access
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Detail
Equipment Details
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PROJECTOR
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Throw Distance detail
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Screen Size Detail
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FLAT SCREEN DISPLAY
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Detail
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VIDEO CONFERENCING
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Detail
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AUDIO
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Detail
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SPEAKERS
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Detail
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LIGHTING
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Detail
Source Requirements
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ROOM PC
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Detail
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LAPTOP
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Detail
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VIDEO
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Detail
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DVD
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Detail
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TV
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Detail
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VIDEO CONFERENCING
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Detail
Control Equipment
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AMX/CRESTRON
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Detail
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TOUCH SCREEN
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Detail
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Location
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Site Notes