Laserfiche WebLink
<br />EXlDBIT 9-D <br />EQUIPMENT CHANGE REQUEST FORM <br /> <br /> <br />'" <br /> <br />Communications and Information Technology Services <br />4030 Esplanade Way. Suite II 5 <br />Tallahassee, Rorida 32.399-0950 <br />Tel: 850.487-9971 <br />Fax: 850.9225162 <br />www.dms.MyFlorida.com <br /> <br />Department of Management. <br /> <br />erVICeS <br /> <br />Governor Charlie Crist <br /> <br />Secretary Linda H. South <br /> <br /> <br />Complete and submit this "Wireless Data Services - Equipment Change Request Form" PRIOR TO adding new wIreless data services equIpment to the Wireless Data <br />contract. This change request form will only apply to BlackBerrys, Smartphones, PDAs and Alrcards equipment units. AJ.l. equipment changes must be approved by the <br />DMs-eITS Product Management & Contract Manager before being added to the Wireless Data Services contract. Submit to: Raghlb Qureshi <br />(raghlb.qureshll!!ldms.myflorlda.com) and cc: Jon Yeaton (Jon.yeaton@dms.myflorlda.com). Please attach any required additional documentation (I.e. spec sheets) <br />when submitting this form. <br /> <br /> <br /> <br />Equipment Change Request (ECR) Form <br /> <br />Com pa ny: <br /> <br />Contract No.: <br /> <br />Contract Expiration <br />Date: <br /> <br />Address: <br /> <br />City: <br /> <br />Request Date: <br /> <br />Zip Code: <br /> <br />Phone <br />No.: <br /> <br />State: <br /> <br />Contact: <br /> <br />Email: <br /> <br />Contract Manager Signature of Approval: <br /> <br />Signature <br /> <br />Date <br /> <br /> <br />Wireless Data Services Contract # MA4974 Amendment 9 <br />State of Florida, Department of Management Services and Verizon Wireless <br /> <br />Page 21 <br />