Ensemble General Information Sheet

Company Name: _______________________

Main BTN: (____) ____-_______

1. Billing Address (Not applicable to Resale	ENSEMBLE Service Address (Installation site):

Street Address:

City:

State:

Zip Code:

LSO CLLI:
End User Business Contact (Decision Maker)

Name:

Title:

Phone Number: ( ) -

Pager Number: ( ) -

E-Mail Address:	End User Contact for Operations (LCON)

Name:

Title:

Phone Number: ( ) -

Pager Number: ( ) -

E-Mail Address:
Account Manager:

Phone Number: ( ) -

Pager Number: ( ) -

E-Mail Address:	Tech Planner:

Phone Number: ( ) -

Pager Number: ( ) -

E-Mail Address:
PRE-SALE Information

Check which apply: Tariff ICB RFD

Associated RFD/ICB numbers:

ENSEMBLE LATA: (Chic, Detr, Milw, Cleve)

Best guess probability of sale %

Expected close date of ENSEMBLE sale (best

Guess): / /	POST-SALE Information

Actual close date of ENSEMBLE sale

(contract): / /

ICB Contract number:

Number of ENSEMBLE PRI Contracted:

ENSEMBLE growth forecast (total PRIs):

6 mos.

12 mos.

24 mos:

36 mos:
What type of RAS/Access Concentrator/Modem Banks will the ISP customer be using?

Does the ISP have Custom or National ISDN PRI today at the above listed installation site?

(Y/N)

Does end user CPE support NFAS/back-up D channel? (Y/N)	Service Manager Assigned:

Phone Number: ( ) -

Fax Number: ( ) -

Pager Number: ( ) -

E-Mail Address:

Orders (numbers & due dates)

Facilities: Date: / /

Primes: Date: / /

DID/TGP #: Date: / /

SPS/trigger: Date: / /

Other: Date: / /

Other: Date: / /

Other: Date: / /

ENSEMBLE Datasheet Instructions

GENERAL INFORMATION SHEET

BOX NUMBER	DATA INORMATION
1	ISP address to receive the ENSEMBLE bill - Not applicable to Resale
2	ISP operations location (site where Modems are located). This is the installation site. Also include the CLLI (central office identification code) which can be obtained from the pre-order system.
3	The business contact for the ISP. This would likely be the individual whose signature is or will be on the ENSEMBLE contract.
4	The LCON (local contact) is the individual that will be involved in the actual installation for the ISP. This will be the person that Industry Markets Service Manager contacts for details on the installation.
5	Industry Markets Account Manager
6	Industry Markets Technical Planner working n the account with the Industry Markets account representative. In some cases there will not be any technical planner involved, when this is the case leave this box empty.
7	Indicate whether this sale is: TARIFFED / ICB / RFD

Indicate the LATA

Indicate to the best of your ability, what you believe the probability of sale will be.

Write in the estimated time the sale will be won (or lost, whichever the case may be.)
8	Enter the date when the ENSEMBLE actually closes. This field will not be filled out until the account representative has received a signed contract from the CLEC.

Enter the ICB (not tariff) contract number assigned by CIM (contract information management). If the sale is tariff, leave this field blank or indicate N/A (not applicable).

Enter the number of ENSEMBLE PRIs that the end user is looking to purchase. This field should be estimated/filled out prior to the sale. If necessary, update after the end user has returned a signed contract.

Enter the estimated growth forecast for the ENSEMBLE end user. This should be completed as soon as possible. If necessary you may need to update this after further negotiation with the end user.
9	What make and mode of Modem Bank/RAS (remove access server)/Access Server does the ISP currently use? (Ascend Max TNT, Cisco 5300, Livingston/Lucent PM3/4).

Does the end user currently have PRI? If so, do they have Custom or National (NI2)?

Does the end user’s equipment support NFAS and backup D-channel? NFAS is used when the end user wants to support multiple PRIs with a single D channel for signaling. Backup D channel is used when NFAS is being used, in case of D channel failure.
10	Indicate the Industry Markets Service Manager assigned to your account.

Orders should be documented here by the Service Manager after orders have been submitted to the provisioning team. This will serve to keep track of due dates and make appropriate updates/changes if necessary.

CW9155

2001-07-11

Ameritech