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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



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