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| Name (Required): |
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| Company: |
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| Address: |
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| City: |
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| State: |
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| Zip Code: |
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| Country: |
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| Phone # (Required): |
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| Fax #: |
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| E-mail address (Required): |
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| Total number of cameras needed: |
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| Cameras: | |
Indoor |
Outdoor |
| Number of
box cameras needed: |
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| Number of bullet cameras needed: |
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| Number of dome cameras needed: |
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| Number of bullet infrared cameras needed: |
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| Number of dome infrared cameras needed: |
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| Number of indoor
board or spy cameras needed: |
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| Number of pan tilt zoom cameras needed: |
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| Camera feature requirements: |
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Color |
Black and white |
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Mid res (420-470 TVL) |
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| Mounts: |
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Indoor |
Outdoor |
| Number of wall mounts needed: |
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| Number of ceiling mounts needed: |
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| Number of pole mounts needed: |
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| Number of corner mounts needed: |
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| Number of angle mounts needed: |
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Approximate distance between the camera and area you want to cover:
(Ex: cam1: 40ft, cam2: 50ft, cams 3, 4, 5, 6: 15ft) |
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| Example diagram: |
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Approximate size of the area or object that you want to monitor:
(Ex: cam1: 25 x 25 ft, cam2: 10 x 60 ft, cams 3, 4, 5, 6: 5 x 5 ft) |
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| Example diagram: |
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Approximate distance from each camera to the central location where the recording device will be located:
(Ex: cam1: 150 ft, cam2: 200 ft, cams 100 ft) |
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| Example diagram: |
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| Are all the cameras in the same building?: |
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| If no, please describe the layout: |
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| Where will the system be installed?: |
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| Recording device: |
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| Recording device requirements: |
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Remote Monitoring |
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| Additional comments: |
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| Please enter the code above (Required): |
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