SUBSCRIBER INFORMATION FORM

Camera 1 Type

Camera 1 Name

Camera 1 Audio

DVR 1 Type

Camera or DVR Model

IP Address

Port(s)

Device ID

Username

User Password

Notes

Camera 2 Name

Camera 2 Type

Camera Audio

DVR Type

Camera or DVR Model

IP Address

Port(s)

Device ID

User Name

User Password

Notes

Camera Type

Camera Name

Camera Audio

DVR Type

Camera or DVR Model

IP Address

Port(s)

Device ID

Username

User Name

User Password

Notes

Camera Type

Camera Name

Camera Audio

DVR Type

Camera or DVR Model

IP Address

Port(s)

Device ID

Username

User Name

User Password

Notes

CAMERA 8

Camera Type

Camera Name

Camera Audio

DVR Type

Camera or DVR Model

IP Address

Port(s)

Device ID

Username

User Name

User Password

Notes

CAMERA 10

Camera Type

Camera Name

Camera Audio

DVR Type

Camera or DVR Model

IP Address

Port(s)

Device ID

Username

User Password

Notes

Camera Type

Camera Name

Camera Audio

DVR Type

Camera or DVR Model

IP Address

Port(s)

Device ID

Username

User Name

User Password

Notes

CAMERA 14

Camera Type

Camera Name

Camera Audio

DVR Type

Camera or DVR Model

IP Address

Port(s)

Device ID

Username

User Name

User Password

Notes

CAMERA 16

Camera Type

Camera Name

Camera Audio

DVR Type

Camera or DVR Model

IP Address

Port(s)

Device ID

Username

User Name

User Password

Notes

Camera Type

Camera Name

Camera Audio

DVR Type

Camera or DVR Model

IP Address

Port(s)

Device ID

Username

User Name

User Password

Notes

CAMERA 20

Camera Type

Camera Name

Camera Audio

DVR Type

Camera or DVR Model

IP Address

Port(s)

Device ID

Username

User Name

User Password

Notes

CAMERA 22

Camera Type

Camera Name

Camera Audio

DVR Type

Camera or DVR Model

IP Address

Port(s)

Device ID

Username

User Name

User Password

Notes

Camera Type

Camera Name

Camera Audio

DVR Type

Camera or DVR Model

IP Address

Port(s)

Device ID

Username

User Name

User Password

Notes

CAMERA 26

Camera Type

Camera Name

Camera Audio

DVR Type

Camera or DVR Model

IP Address

Port(s)

Device ID

Username

User Name

User Password

Notes

CAMERA 28

Camera Type

Camera Name

Camera Audio

DVR Type

Camera or DVR Model

IP Address

Port(s)

Device ID

Username

User Name

User Password

Notes

Camera Type

Camera Name

Camera Audio

DVR Type

Camera or DVR Model

IP Address

Port(s)

Device ID

Username

User Name

User Password

Notes

CAMERA 32

Camera Type

Camera Name

Camera Audio

DVR Type

Camera or DVR Model

IP Address

Port(s)

Device ID

User Name

User Password

Notes

CAMERA 34

Camera Type

Camera Name

Camera Audio

DVR Type

Camera or DVR Model

IP Address

Port(s)

Device ID

Username

User Name

User Password

Notes

When there is human movement on site:

Protocol Standard

	Yes	No	Other
(1) Dispatch police first and then attempt to contact keyholders for verification until keyholder is reached?
(2) Contact keyholder first for verification and then dispatch only upon keyholder authorization?
(3) Do you want keyholders contacted on any human movement on a 24/7 basis?
(4) Dispatch police prior to contacting keyholders on obvious suspicious activity (i.e. damage to or removal of property, loitering)?
(5) Do you want Acadian to contact keyholders with status and resolution after the police have been dispatched to the site?

Protocol Standard

	When there is a contact/motion/fire alarm from alarm panel (without video verification):	-	-
(1) Dispatch police/fire first and then attempt to contact keyholders for verification?
(2) Contact keyholders first for verification and then dispatch upon keyholder authorization?

Protocol Standard

	When there is a contact/motion/fire alarm from alarm panel (with video verification):	-	-
(1) Dispatch police/fire first and then contact keyholders with description of video?
(2) Contact keyholder with description of video and dispatch upon keyholder authorization?

Protocol Standard

(1) If camera connection failure occurs and no keyholder can be contacted, do you want Acadian to dispatch the police and continue to attempt to make contact with keyholder until the alarm is resolved?When there is a service issue (connection failure, trouble signal from panel):

When there is a contact/motion/fire alarm from alarm panel (without video verification):

When there is a contact/motion/fire alarm from alarm panel (with video verification):

When there is a service issue (connection failure, trouble signal from panel):

(1) If camera connection failure occurs and no keyholder can be contacted, do you want Acadian to dispatch the police and continue to attempt to make contact with keyholder until the alarm is resolved?

(3) Contact primary contact

Do you want a supervised periodic test: YES NO If YES, how often:(4) Contact keyholder and primary contact:

(4) Contact keyholder and primary contact

Do you want a supervised periodic test: YES NO If YES, how often

When

Who

When

Who

FOR VIDEO SYSTEM: Please list any special requests, protocols or instructions not given above:

Alarm Panel Type

Dialer Type

Test Frequency

Zone Type

Associated Camera

Zone

Zone Type

Location

Associated Camera

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

From

To

Holiday

From

To

From

To

Holiday

From

To

From

To

Holiday

From

To

From

To

Holiday

To

From

To

Holiday

To

From

To

Holiday

From

To

From

To

Holiday

To

Special O/C Instructions

Type of Report

Report Method

Report Sent To (Name)

Report Frequency