I hereby affirm that I have the authority to authorize, and I authorize Smile Business Products, Inc. dba Smile Network Services (Smile) to connect the above multifunctional print device and/or printers, scanning software and our automated meter collection tool to our network, based on the network information provided in this site survey. I agree that the installation can be done on our company server(s) and workstation(s) by your staff with my authorization. I agree to indemnify Smile for any post-installation issues that may arise regardless of their origin, and will resolve, or contract with a third party to resolve, any maintenance, repair or support issue that arise after the installation of the multifunctional device. An appointment will be scheduled for installation/connectivity of the equipment by our Connectivity Specialist. All fields marked with an asterisk (*) are required. Who is your Account Manager* Don't Know... Denise Reyna Ezequiel Lua INTERDEALER Ivan Dietz Jason Richmond Kevin Kurtz Kevin Magiera Matt Frederick Ned Bressler Ryan Reeves Scott Harvey Steven Howe Tim Devencenzi Vincent Devencenzi Wayne OHara Company* Last Name* First Name* Phone Number* No dashes Email address* Address* City* State* California Nevada Postal Code* Fax Number No dashes Your IT Support Staff* Always Onsite Offsite Available By Appointment 3rd Party No IT Support Does this equipment replace a current Smile machine?* Yes No Do you have a dedicated outlet for your new MFP(s)? It's a requirement for all MFPs* Yes No Does this installation require Account Codes (tracking) setup? Yes No What physical connection will you be using for the equipment? * CAT5 USB Wireless Is there an Active Data Port within 6 feet of the equipment? Yes No If Not 6ft, how far? What is the IP address to the equipment being installed? * What is the Subnet of the equipment being installed? * What is the Gateway of the equipment being installed? * What type of Printer Driver installation is required?* Local PC Print Server Other How many workstations would you like setup to printer?* None 1-10 11-20 21+ Workstation Operating Systems* Macintosh Windows 7 Windows 8 Windows 10 Server Operating System* Windows Server 2008 Windows Server 2012 Windows Server 2016 Windows Server 2019 I Do Not Have A Server Mail Server Type Microsoft Exchange POP3/Hosted (I.e. GoDaddy, Surewest) Lotus iMap Scanning* Network Folder E-Mail FTP None Faxing* Analog Line Digital Line No Fax Using VOiP to send and receive faxes would be inconsistent with fax requirements and may cause concern. I would like my Printer Driver to default for? Black and White (Print Driver will print Black and White, unless I choose Color) Automatic (Print Driver will select depending on the file being printed, unless I choose Color or Black and White specifically) Auto Meter Collection Tool Contact: Name, and Email or Phone #* Please provide the name of the person who we should contact to install our Meter Reading Software. Technical Contact Name* Technical Contact Phone Number or Email Address No dashes By typing in my name, I hereby confirm the above information to be accurate and agree to the above terms and conditions. Authorized Digital Signature* This field should be left blank Send Please wait...
