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  • Many questions in this Form have the option to not be answered.

  • Not answering a YES question is the same as saying NO.

  • Any questions that have a NO answer will have a FOLLOW-UP question.

  • All mandatory fields must be completed prior to submission.

  • An entry may be filled as you progress and submitted at the end of the job or day.

Work Ticket Information

  • Job Date

  • Enter Tech ID

  • Call ID.

  • Please enter ticket information as seen on fieldlink.

  • Please enter the last 6 digits of the Call ID.

  • Your entry is invalid. Please check that you have entered a 6 digit number.

  • Circuit Number

  • Alberta Area Code

  • British Columbia Area Code

  • Please enter the last 7 digits of the Circuit Number.

  • Your entry is invalid. Please check that you entered only 7 digits.

  • Deemed Rate

  • Invisilight?

  • Quarter hour increments.

  • Job Remarks

Billable Ads-Ons

  • # of additional Wired STB installed?

  • # of additional Wireless STB installed.

  • Was it necessary to wire ANY of the Wireless STB?

  • Please submit verification photo.

  • Installation of ONT?

  • Was it required that you run a Clear Curve run greater than 6' on the exterior of the premise?

  • Please submit verification photo.

  • Bonded Copper? (COPPER ONLY)

  • Voice Overline (SMB ONLY)

Fibre Drop Add-ons

  • Did you install a New Drop?

  • Drop Type

  • Aerial Fibre Drop Installed?

  • Additional Aerial Spans?

  • Number of additional A Spans?

  • Conduit Fibre Drop Installed

  • Additional Conduit Spans?

  • # of Additional C Spans.

  • Aerial/Conduit Span Installation?

  • Additional A/C Spans?

  • NAP#

  • MPT/BP#

  • Suite

  • Building Number

  • Did you install a NIB/FTB?

  • Please submit photos of before and after NIB/FTB installation.

drop down test select

  • Test

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.