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IT Procurement Services Request Form

To access this form go to: IT Procurement Services Request Form

General Form Information

Information we need for each type of request is listed below


Requestor Info

Requestor: Give name and contact information for the person for whom the service is being requested. If that person is not also the primary on-site contact, give the additional contact(s), as well.

Title: Position title of the requestor.

Location: Location of the requestor. If the location where the service is needed is somewhere else, please explain in the Description Section.

Phone: Phone number(s) at which the requestor and any alternate contacts can be reached if there are questions about the request.

Dept: Departmental affiliation of the requestor.

Contact(s): Anyone else besides the requestor who may need to be involved in order to complete the request (e.g., an on-site contact person who can provide access to a room where service is requested).


Budget Authorization Info

Budget Code: Provide the account code to which expenses should be charged.

Budget Authorization Signature and printed name: Usually the requestor's supervisor or campus/College Staff administrator who has authority to commit departmental funds.

Initial Cost Estimate: If there is no known basis for an initial cost estimate, provide the approximate amount available to fund the requested service.


Transaction Type

New Service: Check here if there currently is no service of the type needed at the location in question.

Update to Existing Service: Check this if some features are to be added or modified, or other changes need to be made to a service that already exists.

Removal of Service: Check this if an existing service needs to be terminated or entirely eliminated.

Location(s) of service: Physical location where the service is to be added/dropped/changed.

Requested completion date: All requests will be completed as soon as possible, but please indicate if there is a project deadline of other timeline that affects this request.


Specific Services Requested

Cabling for PC or IP Phone: Physical wiring and an active port are needed to connect these devices.

Cabling for analog phone/device: A slightly different connection is used if the device is analog (e.g., a fax machine, TTD, credit card machine) as opposed to digital (e.g., an IP phone). If unsure of the device type, give whatever details are available in the description section.

Wireless access point: Wireless connectivity requires proximity to one of these types of devices.

UPS service: Uninterruptible power supplies maintain operations in a power outage by using batteries.

Generator service: Generators keep power going longer than UPS batteries.

Personal computer: A standard desktop machine.

Laptop/Tablet PC/Pocket PC: Various types of compact/portable PCs.

IP phone handset: Current standard models are the Cisco 7910 (a single line "public area" phone) and the Cisco 7960 (office desk model).

Portable Phone: May be either an analog portable or a Cisco wireless device; please specify.

Cell Phone: Current contract service is provided by Cingular Wireless; phones are various Motorola or Nokia models (subject to change)

Pager: Current contract offerings from Metrocall include either numeric-only or alphanumeric service, with local or statewide service.

Other: Please specify.


Description and Justification

Please complete this section for justification for access to State-wide systems requested above.


IT Help Desk Use Only

Final Cost Estimate: The IT HD will provide feedback before processing your request if the final cost estimate exceeds the initial budget authorization.

E-mail approval received to proceed with new cost estimate? E-mail follow-ups will be considered acceptable authorizations to proceed.

Actual Cost: Actual costs, not estimated amounts, will be charged to departmental accounts.

Date of budge/expense transfer: The date ITSS initiates the financial transaction. (There may be a time lag before the actual posting appears in the accounting records for the given budget code.)

Additional AC or power outlets required? Some requests may require additional electrical work to be performed first.

Additional switches required? Some requests may require additional equipment to be installed first.

Referred to (if applicable) and date: If requests cannot be completed without involvement of additional staff, the IT HD will track the staff member to whom the request is currently assigned.

Assigned incident number: The IT HD assigns each request a number for identification and tracking purposes.

Date completed and completed by: Final close-out by the IT HD will note the last staff member who worked on the request.

Comments: Any additional, special IT HD notes regarding this request.