Commonwealth of Kentucky
Commonwealth of Kentucky
Commonwealth Office of Technology
New Paging Service
Vendor Information:
Check the box by the Vendor selected for order:
Satellink Contract Number: C-02334788
Appalachian Wireless Contract Number: C-02402473
Accounting Information: Internal Tracking# (Optional):
Agency:
Order Number (yy/mm/dd/##): yy: mm: dd: ##:
Billing Address:
Line 1:
Line 2:
City: State: Zip:
Billing Contact:
Name:
Telephone:
Email:
Ship To Address:
Line 1:
Line 2:
City: State: Zip:
Ship To Contact
Name:
Telephone:
Email:
Account Group/Existing Account# (for adding units under account only):
Funding Information:
|Fund |Agency# |ORG |PBU |Activity |Minor Object |
| | | | | | |
Tax ID (Needed on new accounts only):
User Information:
Assigned User Name:
Office Location – (County):
Counties Assigned / Work Area:
Training Needed - YES NO
Requested Training Date (please allow 7 business days)
Contact Number for Training – ( ) -
Service Information:
Coverage Plan:
Voice Mail: YES NO
Optional Features (available contract optional features):
Equipment Information:
Pager Equipment (Numeric, Alphanumeric, FM or 2-way):
Accessories:
Additional Comments:
To be completed by Vendor:
Delivery Date (If it is FedEx – Tracking #):
Assigned number: ( ) -
Assigned Cap Code:
Pager Frequency:
Please allow 48 Hours for delivery
Supervisor Signature:
Exec Director Signature:
To be completed by User upon receipt:
Training accepted? Training declined?
Signature line:
................
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