Department making request: Date (mm/dd/yy): Contact Person: Extension: Location: To be billed - when charges apply. CUFS ORG: CUFS FUND: Type of Service Requested: Installation of new telephone(s) Move of existing telephone(s) Jack installation for modem/FAX Type of Telephone Set Requested: 2500/IP 4606 $30.75/month Standard single line. 7406/8410/IP 4612 $44.50/month Multi-line display, 10 call buttons, speakerphone. 8434/IP 4624 $48.00/month Multi-line, display, 24 call buttons, speakerphone. RJ11 $27.00 Fax,Modem