Repair

Novacom Telephone Company, Inc. Business Telephone Systems Installation & Service Since 1981

Customer Service/Additions/Upgrade & New Customers Quote Form

Please complete the following form and submit it to Novacom via the submit button. You will
have a dated confirmation after selecting the submit option. Before closing the screen, please print this form for your records.
Details of your requirements are very important. Please provide as much information you have to allow
us to maintain an up to date profile of your systems.
Please Email to Novacom to register for this Internet form and obtain a password.

Customer Log In

E-mail Address *

Date of This Form

Requested Service Due Date

Name of Your Organization *

Authorized Staff -First Name		Last Name		Your Title

Street

City

State

Zip Code

Authorized Local Contact*

Local Contact Telephone*

Local Extension Number

FAX Line

Current Telephone System. Quantity of Telephones Quantity of Lines

Purchase Order-Enter PO if needed.

Local Contact Name		Local Contact Location	Local Telephone

Current Call Cost Profile-Keep cost at market pricing via Novacom call managements plans.
Current Carrier Total Monthly Bill Total Minutes Local Total Minutes Long Distance

Overview of Needed Service(s)-Note specific concerns and details.

Repair-Please specify extension and outside line (exclude Area Code) numbers:

Needed Services                               Comment               Enter Your Detailed Response, Below
    No Ringing Specify Extension(s) or All
    No Ring on Line(s) for Above Extensions
    FAX Line(s) Dead
    Static On Line Specified Line(s)
    Telephone Ext(s) Problem Specify
    Telephone Ext(s) Specify Dead Ext
    Data Terminal Problem

Re-Program-Please specify extension and outside line (exclude Area Code) numbers:
    Change Ringing Specify Extension(s) or All
    Change Ring on Line(s) for Above Extensions
    Change Coverage Pick Up Other Ext(s)
    Change Display Features On Ext(s)

Add/Move-Please specify extensions & model numbers; model numbers on face or underside of telephone.
    Add New Extension(s) with New Number
    New/Move Telephone (specify model)
    Add New FAX Line
    Add/Move Line(s) or All
    Add New Line Carrier (Example Verizon)
    Add Conference Room Speaker
    Add New Paging
    Add New Voice Wires
    Add New Data Wires
    Add New Workstation (We sell Dell)
    Add File Server (We Sell Dell)
    Add Music or Announcement on Hold
    Add New FAX Mail System
    Add New Door Entry Intercom/Door Opener

    Add Call Accounting Reporting

Upgrade-Specify new enhancements to your voice and data management program.
    New Telephone System
    Upgrade to Faster Internet Access
    Upgrade Voice Mail
   Upgrade Data Firewall

Other Specify

Submit Specifics and Comments Below.
Please list names of staffers, extension number, location, manufacturer names and model numbers, and any related details.
Specific concern:

Other Current or Future Interests-Check all that apply. A no obligation proposal will be submitted.

If needed, for assistance in the use of this form, please click
Dedicated Novacom Account Manager for assistance.