Attachment 3 - Site Survey.pdf

UNICOR/OFG SITE SURVEY FORM

Design/QBD #: _ Date: _

1. What is the name of the agency/building where the install will take place?

Street: City: State: Zip: County:

2. Point of Contact Name: Phone: Email:

Alt. Point of Contact Name: Phone: Email:

3. Would you like an Onsite Pre-Installation Meeting scheduled? Yes No (Site Pre-Installation Meetings are highly recommended for 40+ workstation, additional Charges $1,675.00 will apply).

4. Security Processing on base that exceeds 1 hour will result in additional charges-please advise if you anticipate there being long processing times: Yes No

5. Is there existing furniture you want removed and disposed? Yes No (Any omissions will be the customer’s responsibility to excess themselves or provide add’l funds to OFG/UNICOR.

*OFG will not remove non-furniture items. Not limited to safes, refrigerators or any electronic items.

**Enter room number where indicated “Room” and Quantities of items below for each room.

INVENTORY ROOM ROOM ROOM ROOM ROOM ROOM ROOM

DESK - METAL or WOOD

FREESTANDING STATION (L / U SHAPE)

PANEL/ SYSTEMS WORKSTATION

INDIVIDUAL PANELS

BOOKCASE/FILE/STOR CAB./LOCKER

CREDENZA BASE

CREDENZA HUTCH

CHAIRS

SOFA/ LOVESEAT/ LOUNGE CHAIR

SMALL SIDE TABLES- COFFEE, LAMP

TRAINING/ CONFERENCE TABLES < 7'

TRAINING/ CONFERENCE TABLES > 7'

(UNICOR can’t reconfigure non UNICOR systems furniture).

6. Does your building require the use of Union Labor? Yes No

7. Does your building require city or county permits? Yes No

8. Does the building have a loading dock? Yes 8b. If yes, what size truck will fit in the loading dock?

8c. Does the loading dock have size restrictions? Max Height Max Length

9. If no loading dock-Is there a space in a parking lot or on the street to park a semi-truck?

9b. Is there size restrictions or access hours we need to be aware of?

No

10. Push distance from offload to the install site in feet:

11. What floor of the building will the furniture install take place?

12. Do deliveries have to be done at a designated time (Weekend and nights will require aditional charges)?

13. Does the building have a freight ☐or passenger☐ elevator that will be available during the delivery of product? If so, what size is it W D H

13b. Are there time restrictions for usage of the elevator Yes No

14. Is stair-carry required? (Additional Charges) Yes No Please list number of steps between floors:

15. What are the work hours for installation of the furniture?

16. When the furniture is installed, which of the following conditions will exist: (All personal items must be removed prior to install. Customer is responsible for removal of existing unless otherwise noted on this form.)

Occupied but will be vacated prior to new furniture Brand new building, unoccupied Renovated building, unoccupied Install in Phases # (Additional installation fees will be applied when phasing is required)

17. If this project is using base infeed for electrical, do those feeds need to be delivered in advance of the furniture? Yes No

The customer will be responsible for the following: Electrical connections between building source and the furniture infeed and pulling and terminating phone/data lines. If removal is needed, customer will also be responsible for electrical disconnection of furniture infeed, and pulling and disconnecting phone/data lines. Initials:

18. What (if any) information do you require for security purposes?

19. Additional Notes:

I understand and have answered all the questions to the best of my ability. I am aware that if any of the information changes prior to installation that there will be additional costs that our agency will be responsible for.

Customer Signature: Date:

All the above questions are directly related to the quotation of the installation costs and/or the coordinating of delivery of the furniture.

Revision 2/6/23