CPS SERVICE COMPANY

Quote Worksheet

Client:_________________________________________________Date:_____________

Physical address:  _________________________________________________________

________________________________________________________________________

Telephone no. ______________________________ Other:  _______________________

Type of business: _________________________________________________________

Reason for survey: ________________________________________________________

Additional: ______________________________________________________________

________________________________________________________________________

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Building sq. ft.: _______________________x $____ =  __________________

Warehouse sq. ft.: _____________________x $____ =  __________________

Telco lines: _up to 9_ lines @ $135.00 per line =   __________________

Additional telco:  _10 to 25_ lines @ $110.00 per line =  __________________

Additional telco instruments: _______instruments @ $145.00 ea. = __________________

Additional: ________________________________   __________________

Time & mileage @ $.65 per mile & $165.00 per hour
   
(Outside of area)
Per Diem expenses @ $350.00 per technician per 24 hour period    __________________

Air Travel         __________________

Additional 20% of sub total (if applicable)    __________________

Total         __________________

Minimum survey fee @ $1500.00 (if applicable)   __________________