FTTH Fiber Splicing Contractor Information Form
Thank you for your interest in partnering with us for upcoming FTTH fiber optic projects.
Please complete the information below. This information will be used to evaluate your
company's qualifications and experience.
Company Information
1. Company Name
2. Primary Contact Name
3. Title/Position
4. Phone Number
Format: (000) 000-0000.
5. Email Address
example@example.com
6. Company Address
7. Website (if applicable)
8. Years in Business
9. Number of Full-Time Employees
10. Number of Fiber Splicing Crews Available
Business Qualifications
11. Is your company insured?
Yes
No
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FTTH Experience
12. How many years of FTTH fiber splicing experience does your company have?
13. Which types of fiber projects have you completed?
FTTH
FTTx
Backbone
Distribution
Feeder
Drop Fiber
MDU
Enterprise
Other
14. Which splice enclosure manufacturers have you worked with? (Check all that apply)
Corning
CommScope
AFL
PLP
Dura-Line
Other
15. Which testing equipment do your crews use? (Check all that apply)
OTDR
Power Meter
Light Source
Fiber Identifier
Ribbon Fusion Splicer
Single Fiber Fusion Splicer
Other
16. Which splicing equipment do you currently use? (Examples: Fujikura 90R, Fujikura 90S, Sumitomo T-72C+, INNO View Series, etc.)
17. Are your technicians experienced with:
Ribbon Splicing
Single Fiber Splicing
Mid-Sheath Access
Fiber Restoration
Emergency Outages
Fiber Testing & Certification
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Safety & Compliance
18. Do your crews follow OSHA safety standards?
Yes
No
Project Capacity
19. How many splice crews are currently available?
20. Can your crews perform fiber testing and documentation?
Yes
No
21. Earliest available start date
-
Month
-
Day
Year
Date
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References & Previous Work
22. Please provide two client references.
Additional Information
Certification
"I certify that the information provided is accurate and complete to the best of my knowledge."
Authorized Representative Name
Title
Date
-
Month
-
Day
Year
Date
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