Service Configuration Request
SatCom
VoIP
Date:
Request #
Contact Information
Company:
Email:
**
(required field ) - Use comma(,) to separate multiple emails
Contact Name:
Phone:
Company Address:
Mobile:
Company 2:
Fax:
City:
State:
Zip:
Country:
Salesperson:
Remote Installation Location:
Name:
Latitude:
Address:
Deg:Min:Sec:
Address 2:
OR
Decimal:
City, State, Zip:
Country:
Longitude:
Phone:
Deg:Min:Sec:
Phone 2:
OR
Decimal:
Remote Contact Email:
Action Request
Choose One
New
Change
Delete
Temporarily Suspend
Reactivate
Move
Requested Satellite
Choose One
SatMex 6 Hemi Beam
Amazonas 2
Galaxy 28
Telstar 14R US Beam
Telstar 11N US Beam
Telstar 11N Sub-Saharan Africa Beam
Telstar 11N European Beam
Other
Other:
Link Data Rate:
Band:
Choose One
Ku-Band
Outbound / Inbound:
Choose One
256 / 64
256 / 128
256 / 256
512 / 128
512 / 256
512 / 384
512 / 512
768 / 192
768 / 256
768 / 384
768 / 512
1024 / 128
1024 / 192
1024 / 256
1024 / 384
1024 / 512
1024 / 1024
1544 / 256
1544 / 384
1544 / 512
1544 / 768
2048 / 128
2048 / 256
2048 / 384
2048 / 512
2048 / 768
2048 / 1024
3072 / 1024
4096 / 1024
Kbps
Requested Access Level:
Choose One
Standard / No CIR
Standard / Added VoIP (at Additional Cost)
Upgraded Access / CIR (List Required CIR In Comments)
Corporate Continuity
Public Safety
Metered Service
Custom Access
Contention Rate:
Choose One
20:1 (Standard)
4:1 (Not Available With All Packages)
10:1
IP Address Required:
Choose One
Public /29 (5 Usable)
Public /30 (1 Usable)
VLAN
Private (NAT)
Equipment Parameters
Antenna:
Choose One
Supplied by IsoTropic
Skyware Global
Patriot
Prodelin
Other
Other:
Antenna Size (meters):
Choose One
Ku-Band
C-Band
Choose One
1.2
1.5
1.8
2.4
3.0
3.7
3.8
Other
Other:
Remote Mobile:
Choose One
AVL
C-Com
Winegard
MotoSat
SeaTel
KNS
Intellian
Other
Other:
Modem:
Choose One
Infinity 3100
Infinity 3100-NB
Infinity 5100
Infinity 5150
Infinity 5300
Infinity 5350
Infinity 7350
Infinity 8350
Evolution X5
NetModem II+
Serial Number:
Block Up-Converter (BUC):
Choose One
2 Watt Ku
3 Watt Ku
4 Watt Ku
6 Watt Ku
8 Watt Ku
2 Watt C-Band
5 Watt C-Band
10 Watt C-Band
Other
Other:
Manufacturer:
Model:
Serial Number:
LNB:
LNB:
Choose One
DRO
PLL
Manufacturer:
Model:
Serial Number:
Have a Sales Expert Contact Me
Have a NOC Technician Contact Me
Additional Notes:
Date:
VSR #
Contact Information
Company:
Email:
**
(required field ) - Use comma(,) to separate multiple emails
Contact Name:
Phone:
Company Address:
Mobile:
Company 2:
Fax:
City:
State:
Zip:
Country:
Salesperson:
Remote Installation Location:
Name:
Modem Serial Number:
Remote Contact Email:
VoIP
Area Code:
Did quantity:
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Caller ID:(max 15 chars)
Extension Quantity:
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Fax:
YES
Fax Quantity:
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Call Group Configuration:
E911 Address:
Address:
City
State
Zip Code
ATA:
ATA Model:
NONE
Linksys WRP-400-G1
Linsksys SPA2102
ATA Quantity:
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Phones:
Phone Model:
NONE
Grandstream GXP-2000
Cisco 7940
Phone Quantity:
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Phone Options:
NAT:
YES
Voicemail:
YES
Have a Sales Expert Contact Me
Have a NOC Technician Contact Me
Additional Details:
