DESIGN REQUEST FORM - Bogen Communications: …

1 Company:Contact: address :City/State/ZipTe l: E- mail :To Send completed DESIGN form , click on SUBMIT reset the form to original state, click on RESET : Bogen Communications, MacArthur Blvd., Suite 304 Mahwah, NJ 07430 Attn: Bogen Paging DesignEmail: mail or E- mail theCompleted DESIGN form ,or to submit hard copy/.dwg files of site plans:E. Is Supervision Required? YES NO If Yes: Amplifier Speaker Line DESIGN REQUEST FORMINTERNAL REFERENCE INFORMATION (Required)Company:Contact: address :City/S tate/ZipTel: E- mail :1.

2 System Needs: Concerns the requirements of the entire Paging Method: Voice Switch. If so, what type? Analog IP / Digital If IP / Digital, what type?FXO FXS MIC OtherB. All-Call or Zone Paging If Zone Paging, how many?Indicate how Zones should be laid out in section 3. Zone Is MIC Zone Paging Required? YES NO D. If MIC Zone Paging, how many MICs are needed?: A. Environment:Office/Professional/Retail Store Factory/IndustrialInstitutional/Remote Public Area WarehouseAisles created by High Storage HallwaysCafeteria/Break Room AuditoriumLoading Dock/Shipping Area OutdoorsHearing Protection Required Other:B.

3 Ceiling Speaker Type Required :Standard Round w/Grille Pendant Drop-In Tile No PreferenceC. Are Volume Controls required on each Speaker?: YES NOIf Yes, what type? Recessed Knob Detachable Knob (24V only) D. Where will Speakers/Horns be placed? Indoors OutdoorsE. How can the Speakers/Horns be mounted? Wall* GroundSuspended/Drop Ceiling**Beams, Columns, Other Structures*Make note of any changes in wall angles, surfaces, and heights.** Make note of any changes in surfaces or positions for actual speaker Ambient Noise Levels (estimate from chart shown here):G.

4 Will there be changes in Ambient Noise Levels?:YES NO If Yes, note the range: dB to dBH. Do you want an Ambient Noise Sensor in the DESIGN ?YES NOI. Are Wall-mounted Attenuators needed for area s Volume Control? YES NOJ. Is Feedback Elimination Equipment needed? YES NOK. Is Background Music needed? YES NO If Yes, BGM source is:CD Player Tuner Satellite OtherL. Do any areas contain products that could explode? YES NOIf Yes, Aerosol Cans Airborne Flammable Gases OtherNOTE: Installations that contain areas with different style environments or sound levelsmay require this section to be filled out separately for each area (zone).

5 Be sure to makeenough photocopies of this section with this in mind. 2. Specific Area Needs: Concerns specific areas (zones) within the installation. 3. Zone Layout: If you checked the Zone Paging box in Section 1 Fabove, indicate the specific areas (zones) into which the customer would like todivide the facility. Add a separate sheet for additional zones (up to 99 zones).F. Is Sound Masking Required? YES NO G. Override (Emergency) Paging? YES NO If Yes, check all that apply:Telephone Microphone Pre-recorded Messages Fire AlarmH.

6 Number of Time Tones Needed to signal Shift Changes:I. Is Talk Back required? YES NOFACILITY INFORMATION (Required)NOTE: FLOOR PLANP lease send a scaled hard copy (to below address ), or E- mail a .dwg file to: PREFERENCES:Select One: Bogen AVAYA Select One:70V Centralized Amplifier 24V Self-AmplifiedSOUND PRESSURE LEVELS:LOW: 55 - 65 dB= Speech is easy to : 66 - 75 dB= Must raise voice to be : 76 - 85 dB= Speech is difficult to HIGH: 86+ dB= Speech almost impossible to #ALL-CALL123456789 AREATALK BACKNIGHT BELLBACKGROUND MUSICHEARING PROTECTIONCEILING TYPECEILING HEIGHT57-1000-02I