Verizon Wireless - Georgia Technology Authority
Verizon Wireless - Georgia Technology Authority
Contract GTA-000187-010
Wireless Service & Equipment Inquiry
Please complete the information requested below and fax the document to: 678-868-2083. A Verizon Wireless Government Account Manager will contact you within 24 hours to discuss you needs.
Today’s Date:___________________________________
Agency Name:______________________________________________________________
Street Address:______________________________________________________________
City:_______________________________________ State: GA ZIP:_______________
Authorized Contact Person:____________________________________________________
Title:___________________________________ Telephone:_________________________
E-mail address: _____________________________________________________________
We Are Interested in information on the following wireless services (check all that aply):
|θ |Voice Service | |θ |Automatic Vehicle Locator Systems |
|θ |Push-to-Talk | |θ |Interoperable Communications |
|θ |Wireless e-mail | |θ |PDA/Smartphone |
|θ |Public Safety Applications | |θ |Internet Billing & Reporting |
Other Interest:_______________________________________________________________
Is your agency already a Verizon Wireless Customer? (Y/N) _____
Account Number:________________________________________
Is this inquiry in conjunction with a formal Request for Proposal (RFP)? ________________
If you answer “Yes,” Please fax the RFP document with this form.
Who is your existing carrier: _______________________ How Many Lines: ____________
Federal Tax ID:_________________________ D&B:_______________________________
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