Equipment Request
1. Who is requesting the equipment?
Name:
Position/title:
Contact email and phone:
2. Current problem or situation resulting in this request?
3. What equipment capabilities do you require to resolve the problem or situation?
a. Do you require Color? ( Yes or No )
b. Do you require tabloid size (11” x 17”)? ( Yes or No )
c. Do you require a finisher? (staple/hole punch/collate) ( Yes or No )
d. Do you know what kind of volume requirement you will have? (approximate pages/month) # _________
e. How many people will be utilizing this machine? (approximately) #__________
User Options Requested (Circle Y or N)
y n Scan to email
y n Scan to network share
y n Scan to USB / Print from USB
y n LDAP Lookup
y n Local Fax / email / Address book
y n Network Fax Address book
y n Standard Accounting Training
y n Standard Accounting setup
y n Standard Accounting driver setup
y n Network Accounting (CPAS system) Training
y n Network Accounting (CPAS system) setup
y n Fax
y n Fax forward to email
y n Custom scan to buttons / destinations
y n End user training required. by (mm/dd/yyyy)
If other, please describe:
4. If this request results in an added cost to the department, is it a justifiable cost increase?
5. When do you need this equipment to be in place? (day/month/year) _____/_____/__________
6. Are there currently other printers and multifunction devices in the work area?
a. #_______ black only printers
b. #_______ color printers
c. #_______ fax machines
d. #_______ multifunction devices
e. Current Xerox device serial numbers:
 ________________________
 ________________________
 ________________________
 ________________________
 ________________________
 ________________________
7. Estimated print volume if known on all devices:_____________________ / impressions per year
Upon receiving the request, we will analyze your current print volume on the Xerox to determine any cost increase and
the best model to meet your needs. If required, we may need to do an assessment of your current print environment.
Please provide 3 dates when we would be able to come over to review the area.
Date 1 - (day/month/year) _____/_____/__________
Date 2 - (day/month/year) _____/_____/__________
Date 3 - (day/month/year) _____/_____/__________
Please print this document, fill it out and email it to devin.morin@xerox.com or send it via campus mail to Devin Morin –
Printing Services in the General Purpose Building.
SOW Check List / RACI Chart
Authorized by (Print Name):
R = Responsible
(who is to make sure the work was completed)
Signature:
A=Accountable
(who is to do the work)
C=Consulted, I=Informed
Xerox Corporate
UofS Department
UofS IT
Xerox On Site
New
Xerox
Equipme
nt
Delivery
Steps
1
2
3
A
C
R
A
C
A
I
I
R
4
A
C
I
I
5
I
R
A
I
6
7
8
I
R
I
A
A
I
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
A
A
C
C
A
R
A
C
R
C
C
C
C
R
C
C
A
A
A
A
A
A
C
A
A
A
A
A
A
A
A
A
C
C
A
A
A
A
Completed Y/N
Procedure
Xerox calls to arrange tentative delivery date
Department relays delivery date to their IT people
Equipment arrives
Equipment is unboxed and assembled by delivery company
(Large MFP's)
Equipment is unboxed and assembled by UofS IT (small
printers and MFP's)
New equipment has host name assigned and network access
request submitted
Print Queue setup
MACD - Add submitted to Xerox
Equipment is configured with all the options requested by the
department
User Options Requested (Circle Y or N)
y
n
Scan to eMail
y
n
Scan to network share
y
n
Scan to USB / Print from USB
y
n
LDAP Lookup
y
n
Local Address book
y
n
Network Address book
y
n
Standard Accounting Training
y
n
Standard Accounting setup
y
n
Standard Accounting driver setup
y
n
Network Accounting (CPAS system) Training
y
n
Network Accounting (CPAS system) setup
y
n
Fax
y
n
Fax forward to eMail
y
n
Custom scan to buttons / destinations
y
n
End user training required? by (mm/dd/yyyy)
Black set as default at the driver
Home Screen options / button visibility
NTP Date / Time setup
SNMP v2 enabled
Person
Accountable to
Complete Step
Xerox
Name
Xerox
Xerox
Name
Name
Name
Xerox
Name
Name
Name
Name
Name
Name
Name
Name
Xerox
Name
Name
Name
Name
Name
Name
Name
Date
Name
Name
Name
Name
30
31
32
33
34
I
A
A
A
A
A
35
C
A
TCP/IP fully setup
SMTP fully setup
Support information page programmed
Device information page programmed
Equipment password is changed to secure password
End users are setup to be able to print to relevant new
equipment
R
I
R
C
WIRF submitted to FMD to remove old Xerox equipment as
per Device Removal List
Xerox
MACD - Update Asset Record submitted to Xerox for moved
equipment
Xerox
Non-Xerox equipment removal or re-disposition as per Device
Removal List
Name
Deliver Xerox training
Xerox
Create Device Information Label
Xerox
Create Device Information Signage as needed
Xerox
36
I
37
R
38
39
40
41
C
I
A
A
A
R
I
R
A
A
A
Name
Name
Name
Name
Name
Name