First Name *

CONTACT INFORMATION

Last Name *

Phone Number

Email Address *

State

ZIP Code

Country

Company Name

Role

Type of Residence

RESIDENCE INFORMATION

Number of Units

How many locations would you like for wired internet?

DATA DISTRIBUTION

Will you be using Cat 5e, Cat 6, or Cat 6A cabling?

Would you prefer a metal or plastic (WiFi compatible) enclosure?

Will you be mounting 3rd party equipment in the Leviton SMC? (modem, router, etc)

LIST ALL NON-LEVITON EQUIPMENT TO BE INSTALLED IN ENCLOSURE, INCLUDING SPECIFIC MODEL INFORMATION IF AVAILABLE (MODEM, ROUTER, UPS, ETC):

How many power outlets will be needed to power this equipment?

How many locations would you like telephone service? (Note: standard phone service will allow up to 12 locations to ring at a time)

TELEPHONE DISTRIBUTION

Will your security system be tied to your telephone line?

Will you have Cable TV/Over the Air (OTA) or Satellite TV service?

CABLE TV DISTRIBUTION

How many coaxial cable TV locations do you want connected simulaneously? (For example, you might run 20 coaxial cable, but will only use 8 at a time?)

POWER

Please Note All Leviton Structured Media Enclosures will be configured with surge protected power supplies to provide protection for the active equipment inside the enclosure.

ANY OTHER DETAILS YOU CAN PROVIDE TO ALLOW US TO BETTER UNDERSTAND YOUR APPLICATION (I.E. EXISTING PRODUCTS/SYSTEMS, EXISTING WIRING, SPECIAL CONSIDERATIONS REGARDING BUILDING STRUCTURE, ETC.)?

ADDITIONAL INFORMATION

For quoting purposes only, would you like Leviton to forward this project bill of material list to a Leviton distributor and have them contact you?

BILL OF MATERIALS

Comments

I agree to provide my personal information to Leviton for use in accordance with its Privacy Policy. *

For California residents only. In accordance with the CCPA, I understand that I may be providing the following Categories of Personal Information (as defined in the CCPA) to Leviton by completing this form: Identifiers, Commercial Information, and Internet or other similar network activity, for the purpose of fullfilling my request.

By submitting this form, I certify that the information I have provided is true.

I have read and understand the Warranty Terms and Conditions. *

I have read and understand Leviton's Privacy Policy. *

For additional configurations, applications, or options not listed above, please email appeng@leviton.com for assistance.