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Sales & Cost Estimate Information
Form |
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| Customer Information: |
Date: |
Home & Property Description: |
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| Name: |
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Number of Stories of Home? |
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| Address: |
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Are There Trees In The Southern |
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| City: |
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Sky including
Southwest & |
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| State: |
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Southeast? |
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| Zip Code: |
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If Yes, How Close Are They? |
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| Spouses Name: |
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How Many TVs To Be Hooked Up? |
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| Home Phone #: |
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Is There A Central Location Where |
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| Times Can Be Reached: |
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All The Cables From All The |
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| Work #: |
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TVs Run To? |
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| Times Can Be Reached: |
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Is There A Phone Outlet At The |
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| Email Address: |
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Location Where The Satellite |
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| Billing Address: |
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Receiver Will Be Located? |
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| SSN # |
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Circle Program Chosen: |
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| Charge Card # |
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FREE DHP |
DHP |
| Expiration Date: |
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FOR ALL REGULAR |
PVR |
| Receivers: |
Perferred Installation Request: |
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| DHP301______ PVR508______ |
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Total Quoted To Customer: |
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| PVR721______ HD6000______ |
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Programming: "Check Box" Top 60 |
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Write-In Others Top 120 |
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| New Dish Account Number: |
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Top 180 |
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| Customer understands Dish Network's "NEW"
Customer Policy? |
Yes No HBO |
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Cinemax |
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| Does the customer understand what basic installation
is? |
Yes No Starz |
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Showtime/Movie Channel |
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| Dish Network Program - Additional Installation
Costs - Additional Accessories |
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| Non-Basic Installation Costs and Additional
Option Charges |
Panamax DBS + Surge Protectors |
Quoted: |
| Main UHF Receiver - Feed & Control in Every Room
$65 |
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DBS8+5 - 5yr DBS Warranty $149.95 |
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| Professional Head-End SMATV Installation.
$65 |
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DBS8+3 - 3yr DBS Warranty $99.95 |
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| Adding Cable to Additional Rooms From Head-End.
$30 |
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DBS8 "no"
DBS Warranty $44.95 |
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| Charges for "Fishing" Cable in Walls.
$30 |
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Dish Network |
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| Charges for Phone "Surface" Outlet
Installation $30 |
Dish Network UHF Extender Kit $79.95 |
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| Mounting Dish on Single Story Roof.
$10 |
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PVR 508 Rec.\DHP$50, FD$200,Reg$349
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| Mounting Dish on Two Story Roof.
$25 |
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PVR 721 Receiver
$599 |
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| Ground Pole Installation, Including Pole
$65 |
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6000 HDTV Receiver
$699 |
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| Electrical Ground Rod Installation w/ 6'
Rod $18 |
SMATV Distribution Amplifiers. |
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| Replacing Off-Air Antenna on Two Story Roof.
$50 |
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25db Gain SMATV U/V Amplifier. $49.95 |
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| Installing New Off-Air Ant. & Mt. on Single Story
Roof. $50 |
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15db Gain SMATV U/V Amplifier. $39.95 |
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| Installing New Off-Air Ant. & Mt. on Two Story
Roof. $70 |
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10db Gain SMATV U/V Amplifier. $29.95 |
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| Installing or Replacing Ant.Cable on Single Story
Roof. $60 |
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SMATV Channel Insertion Modulators. |
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| Installing or Replacing Ant. Cable on Two Story Roof.
$80 |
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Single Channel Adjustable Digital $79.95 |
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| Hourly Rate is from $65 to $55 per
hour |
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Three Channel Adjustable Digital $199.95 |
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| Trenching cable in ground is $0.75
per foot. |
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Channel 3 or 4 Combiner $30 |
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