Lingo Ethernet Pre-Order Form

Ethernet Pre-Order Questionnaire Version 2022.05.01 Please provide the requested information to assist in the provisioning of your order and return to your dedicated Order Manager. Service Address: Street Address: Enter street address Building: Enter building; if only one, enter “Main” Floor: Enter floor; if only one, enter “First” Room/Suite: Enter room/suite/unit of network equipment City, State, Zip: Enter city, state, zip Shipping Address: Attention: Enter contact receiving equipment Shipping Address: Enter Street Address/City/State/Zip Local On-Site Contact: • Contact must be local to site and be able to grant access to telco MPOE (where the main electrical/telco comes into building) and customer’s network area: Name: Name Phone Number: Phone Number Email: Email Building Information: Is this building controlled by a separate riser/management entity? ☐Yes ☐No • If yes, provide contact information: Riser Contact Name, Number, Email Is there available backboard space at the MPOE? ☐Yes ☐No Is there available power and ground bar at the MPOE? ☐Yes ☐No Technical Details: The carrier will install the circuit at the MPOE of the building, handing off on a Fiber interface. A managed router will connect to the customers suite via the Fiber handoff from the carrier. The customer/building management is responsible for and charges associated with completing the inside wiring to extend the service between the MPOE and their suite, whether hiring Bullseye or using a 3rd party. If a fiber extension is required from MPOE to the customer’s suite, how would you like this installed? ☐ Customer/Building Management will run (Fiber details provided after carrier circuit install) ☐ Bullseye will run (This will need to be quoted out separately and a Site Survey may be required) Who is the customer’s technical contact for this order if additional information is needed for BullsEye? Name: Name Phone Number: Phone Number Email: Email Carrier Handoff (Non-Standard Configuration) If the default Single Mode Fiber handoff with an LC connector is not able to be used, please write in what is to be ordered from the carrier, ______________________________________________________________________.