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Site Survey

I hereby affirm that I have the authority to authorize, and I authorize MBG Office Systems to connect the above multifunctional print device and/or printers, scanning software and our automated meter collection tool to our network, based on the network information provided in this site survey. I agree that the installation can be done on our company server(s) and workstation(s) by your staff with my authorization. I agree to indemnify MBG for any post-installation issues that may arise regardless of their origin, and will resolve, or contract with a third party to resolve, any maintenance, repair or support issue that arise after the installation of the multifunctional device.

Contact Information

Company(Required)

Name(Required)

First Last

Address(Required)

Street Address City State Zip

Additional Information

Your IT Support Staff(Required)

Always Onsite

Offsite

Available By Appointment

3rd Party

No IT Support

Workstation Operating Systems(Required)

Macintosh

Windows 10

Windows 11

IT Support Person Name, and Email or Phone #

What type of Printer Driver installation is required?(Required)

Local PC

Print Server

Other

How many workstations would you like setup to printer?(Required)

None

1-5

Does this equipment replace a current machine?(Required)

Do you have a dedicated outlet for your new MFP(s)? It's a requirement for all MFPs(Required)

Does this installation require Account Codes (tracking) setup?(Required)

What physical connection will you be using for the equipment?(Required)

CAT5

CAT6

USB

Wireless

What is the Subnet of the equipment being installed?(Required)

What is the Gateway of the equipment being installed?(Required)

What is the IP address to the equipment being installed?(Required)

To add additional IP addresses, click the + sign at the right side of the row. You can add as many rows as needed.

Is there an Active Data Port within 6 feet of the equipment?(Required)

If Not 6ft, how far?

Scanning(Required)

Network Folder

Desktop

Email (select option below for Email server type)

None

Faxing(Required)

Analog Line

Digital Line

No Fax

Using VOiP to send and receive faxes would be inconsistent with fax requirements and may cause concern.

All Windows Server(Required)

Email Server Type(Required)

Email address to be used in machine(Required)

I would like my Printer Driver to default for?

Black and White (Print Driver will print Black and White, unless I choose Color)

Automatic (Print Driver will select depending on the file being printed, unless I choose Color or Black and White specifically)

Auto Meter Collection Tool Contact

Please provide the contact information of the person who we should contact to install our Meter Reading Software.

Name

Phone

Approval

Authorized Digital Signature(Required)

By typing in my name, I hereby confirm the above information to be accurate and agree to the above terms and conditions.

Phone

This field is for validation purposes and should be left unchanged.

Corporate Office
509 Hillcrest Industrial Blvd Macon, GA 31204
Phone (478) 742-2588
Toll-Free (800) 342-4309
Fax (478) 746-7842