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© 2010 DIVERSITYCOM, INC. ALL RIGHTS RESERVED.
© 2010 DIVERSITYCOM, INC. ALL RIGHTS RESERVED.
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Thank you for contacting us. Please fill out the information below. Please note that the more information you provide, the better we are able to find a solution that best suits your needs. (*Required field)

Service/Quote Request

First Name*
 Last Name*
Title
 Email*
Direct Phone*
 FAX Phone
Company Name*
Company Street Address*
 Company Phone*
Company City*
 Company State*
 Company ZIP*
Type of Business*
 Number of Locations*
 Number of Employees*
Remote Workers?* (Select one)Yes   No
Site Contact Name (if different)
Site Contact Phone
 Site Contact Email
Site Address (if different)


Type of Service Needed (Check all that apply, then answer the corresponding questions below)

New System Installation (Click to skip to New System Installation Section)
 Move System and/or Equipment (Click to skip to Move Section)
 Add Equipment(Click to skip to Add Section)
Repair (Click to skip to Repair Section)
 Programming Changes (Click to skip to Changes Section)
 Wiring (Click to skip to Wiring Section)
 Other (Click to skip to Other Section)

New System Installation

1. How would you best describe your current phone system needs? (Check all that apply)

 We are looking to replace our current system
 We are looking for a phone system for a new office or location
 We are looking to expand our current system

2.  How many simultaneous calls or "lines" do you want your phone system to handle?
Enter number of lines

Note: Each call, including people in queue or on hold, uses a "line." Be sure to consider both your current and future needs as some system have more expansion capability than others.

3. How many individual users or "extensions" will you need?
Enter number of extenstions
 
This is basically a total of the number of users the system will have. Remember, each individual user and/or common area phone will require a unique "extension."

4. Are you interested in receiveing information on service and/or maintenance contracts?

Yes, we are interested in a service contract
 No,  we are not interested in a service contract
 Unsure, please advise us of the costs and benefits

5. Are you interested in receiveing information on leasing options?

Yes, we are interested in leasing options
 No,  we are not interested in a leasing options
 Unsure, please advise us of all available leasing/purchasing options

6. What is your estimated budget for this purchase?
Enter budget estimate
 
7. When do you intend to have this system installed?

 ASAP
 Within 0 to 3 months
 Within 3 to 6 months

8. Would you prefer new equipment or refurbished equipment (refurbished equipment is generally lower in cost)?

 Please give me quotes for both new and refurbished systems
 I am only interested in a brand new system
 I am only interested in a refurbished system
9. What features do you want with your phone system? (Check all that apply)

 Automated Attendant (automatic answering and call routing)
 Call centers
 Advanced call routing and tracking features (typically for call centers)
 Music or advertising on hold (callers hear messaging/music while on hold)
 Caller ID
 Overland paging
 Voicemail
 Call accounting
 Wireless solutions
Other (please note)  

10. Please describe in detail any additional requirements you may have for this phone system:

Moves, Adds, Changes, Repairs (Enter as much information as possible)
System Manufacturer
 Model/Type of System
Software Version/Release
 Date of purchase/Last upgrade (if known)
(mm/dd)
Number of TDM Ports (non-IP)
 Number of IP ports (if applicable)
 Number of Voicemail ports
Voicemail Manufacturer
 Type/Name of Voicemail
Voicemail Software Version/Release
 Date of purchase/Last upgrade (if known)
 (mm/dd)
Number of end users/phones
 		Phone types/models (list all)
Number of attendant consoles
 Number of application servers (voicemail, UM, and/or storage servers)
Number of CSUs
 Number of CSU/DSUs

Check all that apply and provide quantities for checked items:

Paging/Loudspeakers / QTY
Softphones / QTY
Wireless / QTY
UPS (battery backup) / QTY (Note: Batteries are wearable items and not covered under any service agreements)

Please describe in detail the issues requiring repair (if applicable):

Wiring/Other

Please describe in detail your wiring needs and/or any other services you require:
Thank you for providing us with this information.
Please press the submit button to send your request. One of our staff will contact you within 24 hours.