New Customer — Mountain Top Telecom

Account name

Full name of customer paying for this account

First Name

Last Name

Address

Physical address of equipment

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Engineer's Name

Engineer(s) that performed the installation

Radio Name

Name of radio. Should be the customer's full name. If the radio belonged to someone else, make sure to log into the radio and change to the current customer's name.

Radio's prior name

If this radio belonged to another customer and you are changing the name to the current customer- please state the old name here.

Radio IP

IP you assigned to the customer's radio. IPs can be obtained from Mike DeCota.

Tower assigned

Tower radio connects to

Tower AP

Select the AP the station is connected to

Service Plan Notes

Speed Test Results after install

Run a speed test after install. Record results.

CCQ% at time of Install

Transmit CCQ% you recorded at the time of install.

Signal dBm at install

The Station and AP signal dBm at the time of install.

Frequency of radio

Frequency the customer's radio is set to

Equipment installed

List all equipment used for the install.

Router

Our managed cube router

Customer provided router

Service Plan

Choose the service plan the customer chooses after you let them know what their speed capabilities are

Basic Plan $54.95 5/5

Standard Plan $64.95 10/10

Premium Plan $74.95 20/20

Business Plan $84.95 Uncapped

Other (Specify below)

Travel Time & Hours

Log how long your travel time was to get to the client site. Log hours worked for this install.

NOTES

Anything else you need to explain

Date of Install

YYYY

Static IP?

Yes

Static IP

If you chose yes for static IP, list static IP address here