Cable Run Request Form

CABLE RUN REQUEST AND SERVICE AGREEMENT

Client Name:   Department:

Service Provider:   Contact:

Request Date:   Request ID:

WHEREAS

WHEREAS, Client Name: requires the installation, routing and termination of structured cabling to support data and/or voice services at facilities identified in this document; and

WHEREAS, Service Provider: represents that it is qualified to perform cabling services in accordance with applicable industry standards and this Agreement; and

WHEREAS the parties desire to set forth the scope, pricing, scheduling, and terms under which the cable run work will be performed.

SCOPE OF WORK

TECHNICAL SPECIFICATIONS

Cable Type (check all that apply):
Cat5e Cat6 Cat6a Coax Fiber   Other:

Number of Drops:   Estimated Total Cable Length (feet):

Source Location:

Destination Location:

Termination Requirements: Keystone jacks Patch panel Faceplate Conduit required

Patch Panel Port(s) / Panel ID:

Testing Required: Yes   Test Standard:

ACCESS, SCHEDULING, AND SITE CONDITIONS

Preferred Start Date:   Preferred Completion Date:

Normal Work Hours / Access Window:   After-hours Work Authorized: Yes

COSTS AND PAYMENT TERMS

Estimated Cost: $   Charge Account / Project Code:

Late Payment Fee:    Invoicing Frequency:

Payment Terms Clause: Provider shall invoice Client in accordance with the Payment Schedule. Unless otherwise agreed in writing, Client shall pay undisputed invoices within the number of days specified in the Payment Schedule. Late payments shall accrue the Late Payment Fee on the unpaid balance until paid. Disputed invoices must be submitted in writing within 14 days of receipt.

TERM AND TERMINATION

Agreement Start Date:   Expected Completion or End Date:

Termination Notice Period (days):

Termination Clause: Either party may terminate this Agreement for cause upon material breach by the other party if such breach remains uncured for the notice period specified above. Upon termination, Client shall pay Provider for all work performed and reasonable demobilization costs incurred through the effective date of termination.

CONFIDENTIALITY

Confidentiality Clause: Each party shall maintain in confidence all non-public information received from the other party in connection with this Agreement and shall not disclose such information except to employees, contractors, or agents who need access for performance and who are bound by confidentiality obligations no less protective than those herein. Confidential information shall not include information that is or becomes publicly available through no breach of this Agreement or was rightfully known by the receiving party prior to disclosure.

GOVERNING LAW

This Agreement shall be governed by and construed in accordance with the laws of the jurisdiction specified below, without regard to conflict of law principles.

Governing Law (State or Jurisdiction):

ENTIRE AGREEMENT

Entire Agreement Clause: This document, including the Scope of Work and any attachments incorporated by reference, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior proposals, representations, and agreements, whether written or oral. Any modification or waiver must be in writing and signed by authorized representatives of both parties.

APPROVALS AND AUTHORIZATIONS

Client Approver Name:   Title:

Provider Approver Name:   Title:

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