Work Request
Requestor Info
Date:
-
Month
-
Day
Year
Requester's Name:
*
First Name
Last Name
Requester's Email:
*
example@example.com
Requester's Phone Number:
*
-
Area Code
Phone Number
Metasolv Order #
Type of work requested:
*
Please Select
Project
Complex Install
Site Survey
Internal Maintenance
Service type:
Managed Voice
Managed WiFi
Managed LAN
Other
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Work Request
Site & POC
Site Information
Site #1
Business Name
Site Name
Site Acronym
Address
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Access Requirement
No special requirements
needs active customer badge/clearance
must be escorted
Special hours of access
Badges Required
Providence Badge
BP Badge
TWIC badge
JBER
Alyeska Pipeline
GCI Badge
GCI Pin
Access Information
Escort Information
Business Hours
Time Open
Time Closed
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Site #2
Business Name
Site Name
Site Acronym
Address
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Access Requirement
No special requirements
needs active customer badge/clearance
must be escorted
Special hours of access
Badges Required
Providence Badge
BP Badge
TWIC badge
JBER
Alyeska Pipeline
GCI Badge
GCI Pin
Access Information
Escort Information
Business Hours
Time Open
Time Closed
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Site #3
Business Name
Site Name
Site Acronym
Address
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Access Requirement
No special requirements
needs active customer badge/clearance
must be escorted
Special hours of access
Badges Required
Providence Badge
BP Badge
TWIC badge
JBER
Alyeska Pipeline
GCI Badge
GCI Pin
Access Information
Escort Information
Business Hours
Time Open
Time Closed
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Site #4
Business Name
Site Name
Site Acronym
Address
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Access Requirement
No special requirements
needs active customer badge/clearance
must be escorted
Special hours of access
Badges Required
Providence Badge
BP Badge
TWIC badge
JBER
Alyeska Pipeline
GCI Badge
GCI Pin
Access Information
Escort Information
Business Hours
Time Open
Time Closed
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
POC
Point of Contact Information
Contact #1
Company Name
Contact Type
*
Primary
Maintenance, IT
Outage
Building Owner
Business Owner
Property Manager
Emergency
Name
*
First Name
Last Name
Phone No. 1
*
-
Area Code
Phone Number
Phone No. 2
-
Area Code
Phone Number
Email
example@example.com
Can grant site access?
*
Yes
No
Contact #2
Company Name
Contact Type
Primary
Maintenance, IT
Outage
Building Owner
Business Owner
Property Manager
Emergency
Name
First Name
Last Name
Phone No. 1
-
Area Code
Phone Number
Phone No. 2
-
Area Code
Phone Number
Email
example@example.com
Can grant site access?
Yes
No
Contact #3
Company Name
Contact Type
Primary
Maintenance, IT
Outage
Building Owner
Business Owner
Property Manager
Emergency
Name
First Name
Last Name
Phone No. 1
-
Area Code
Phone Number
Phone No. 2
-
Area Code
Phone Number
Email
example@example.com
Can grant site access?
Yes
No
Contact #4
Company Name
Contact Type
Primary
Maintenance, IT
Outage
Building Owner
Business Owner
Property Manager
Emergency
Name
First Name
Last Name
Phone No. 1
-
Area Code
Phone Number
Phone No. 2
-
Area Code
Phone Number
Email
example@example.com
Can grant site access?
Yes
No
Site/POC Comments
Other information/comments regarding site(s) and/or the Point of Contact(s).
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Work Request
Project
Customer Cut Date:
-
Month
-
Day
Year
Date
Expected Start Date:
-
Month
-
Day
Year
Date
Expected End Date:
-
Month
-
Day
Year
Date
Estimated number of technicians needed:
Estimated number of work hours per day, per technician:
Estimated total hours for project:
Are there pre-deployment meetings:
Single Meeting
Recurring Meetings
No
Meeting Information
One Time meeting:
-
Month
-
Day
Year
Date
00
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
:
Hour
00
10
20
30
40
50
Minutes
Recurring meeting- First Meeting
-
Month
-
Day
Year
Date
00
01
02
03
04
05
06
07
08
09
10
11
12
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20
21
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23
:
Hour
00
10
20
30
40
50
Minutes
Meetings occur every
Last meeting
-
Month
-
Day
Year
Date
Travel?
Is Travel required?
Yes
No
Travel Billing Code
Conditional
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Work Request
Site Survey
When does the site survey need to be completed by?
-
Month
-
Day
Year
Date
When can the site survey be performed?
-
Month
-
Day
Year
Date
00
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
:
Hour
00
10
20
30
40
50
Minutes
Do we need to schedule with the customer?
Yes
No
Site survey is scheduled for
-
Month
-
Day
Year
Date
00
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
:
Hour
00
10
20
30
40
50
Minutes
Is Travel required?
Yes
No
Travel Billing Code
Conditional
Change Management
Is an IPAC required for this work?
Yes
No
Link to IPAC
Browse Files
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Project Code
Labor code
Materials code
Change Management Required
No Change Management Required
NCSR
Change Net
Other
Is the NCSR approved?
Yes
No
NCSR #
NCSR Scheduled Start
-
Month
-
Day
Year
Date
00
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
:
Hour
00
10
20
30
40
50
Minutes
NCSR Scheduled End
-
Month
-
Day
Year
Date
00
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
:
Hour
00
10
20
30
40
50
Minutes
Is the Change Net approved?
Yes
No
Change Net #
Other Details:
Change Net Scheduled Start
-
Month
-
Day
Year
Date
00
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
:
Hour
00
10
20
30
40
50
Minutes
Change Net Scheduled End
-
Month
-
Day
Year
Date
00
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
:
Hour
00
10
20
30
40
50
Minutes
Survey Details
Is there confluence page built?
Yes
No
Copy a link to the "Scope of Work" confluence page.
Is there any specific non-standard details needing to be captured?
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Work Request
Capitol Project
Is there confluence page built?
Yes
No
Copy a link to the "Scope of Work" confluence page.
Detailed Project Scope of Work:
Is this a new install or refresh?
New
Refresh
All hardware is due to site/anchorage by?
-
Month
-
Day
Year
Date
Is hardware being removed?
Yes
Hardware disposal instructions:
Design Engineer
First Name
Last Name
Implementation Engineer
First Name
Last Name
Is special testing required"?
Yes
No
Special Testing Notes:
Network or construction drawings
Browse Files
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Is the tech responsible for ordering ANY materials?
Yes
No
What materials is the tech responsible for?
PO's associated with the project:
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Work Request
CPE
Hardware to be installed
Juniper
Adtran
ethernid
Switch
Iperf
Other
All hardware is to be configured and ready by:
-
Month
-
Day
Year
Date
Hardware Procurement- Juniper
Available at the 4901
Will be delivered to F/O
Tech to pick up from IE
Hardware is to be shipped to:
Other
Hardware Procurement- Adtran
Available at the 4901
Will be delivered to F/O
Tech to pick up from IE
Hardware is to be shipped to:
Other
Hardware Procurement- Ethernid
Available at the 4901
Will be delivered to F/O
Tech to pick up from IE
Hardware is to be shipped to:
Other
Hardware Procurement- Iperf
Available at the 4901
Will be delivered to F/O
Tech to pick up from IE
Hardware is to be shipped to:
Other
Hardware Procurement- Switch
Available at the 4901
Will be delivered to F/O
Tech to pick up from IE
Hardware is to be shipped to:
Other
Hardware Procurement- Other
Available at the 4901
Will be delivered to F/O
Tech to pick up from IE
Hardware is to be shipped to:
Other
Hardware was shipped on:
-
Month
-
Day
Year
Date
Hardware was shipped to:
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Work Request
Internal Maintenance
What is the type of work being requested?
Please Select
VTC- Room maintenance
Add/ move/ change- cabling
Other
Select the room
Please Select
SADC- Hawaii
SADC- Lanai
SADC- Oahu
SADC- TAC
SADC- Maui
SADC- DSC
SADC- Death Star
SADC- Millennium Falcon
SADC- Voyager
SADC- Enterprise
DT- 6th floor
DT- 6th floor studio
DT- 7th floor Birch
DT- 7th floor Aspen
DT- 7th floor Cotton Wood
DT- 7th floor Spruce
DT- 8th floor middle
DT- 8th floor corner
DT- 10th floor
DT- 11th floor
DT- 12th MBS
DT- 12th accounting
DT- 13th- Dorn
DT- 13th- Winterfel
DT- 13th- Kings Landing
DT- 14th- Daytona
DT- 14th Bristol
DT- 14th Martinsville
DT- 15th IT conference room
DT- 16th HR
DT- 16th JL
DT- 10- Chapados
DT- 10- Duncan
3000C - Chugach
3000C- DeHavilland
AOC- Kinik
AOC- Kobuk
AOC- Deshka
AOC- Chena
AOC- Yukon
AOC- Montague
AOC- Attu
Polaris- Polaris
36th- CSC
Room Issue
Please Select
Room Non-functional
Room Damage
Describe the issue:
Scope of work
Location:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Work Request
Submission
Specify any other emails that need to receive this information below.
Recipient #1
example@example.com
Recipient #2
example@example.com
Recipient #3
example@example.com
Final comments/Information
Attach any number of files here:
Browse Files
Cancel
of
Save
Submit
Should be Empty: