Security and Surveillance Quote Request

Business Name:

Contact Name:

Email Address:

Address:

City: State: Zip:

Phone#: Fax#:

1. How Would You Best Describe Your Current Video Surveillance Needs?
We are looking for a new system
We are looking to expand our current system
We are looking to replace our current system

2. What Type Of Location Are You Interested In?
Commercial Office Location
Retail Location
Restaurant/Bar/Night Club
Industrial/Manufacturing Facility
Institutional (i.e. Education, Government, etc.)
Medical (i.e. Hospital, Doctor's Office, etc.)

3. Approximately How Many Security Cameras Are You Interested In?
1-4
4-8
8-12
12-16

4. Where Will the Video Surveillance Cameras Be Located?
Indoors Only
Outdoors Only
Both Indoors and Outdoors
Not sure

5. Would You Require Professional Installation Services For This System?
Yes
No
Not sure

6. What is the approximate square footage of this location?
0 - 2,499 sq.ft.
2,500 - 4,999 sq.ft
5,000 - 9,999 sq.ft.
10,000 - 49,999 sq.ft.
50,000+ sq.ft.
Not sure

7. What is your estimated budget for this system?
Less than $2,000
$2,000 - $4,999
$5,000 - $9,999
$10,000 - $24,999
$25,000+
Not sure

8. What is your buying timeframe for this system?
ASAP
1 - 2 Weeks
2 - 4 Weeks
1 - 2 Months
2+ Months
Not sure

Please Describe Any Additional Requirements You Have