CUSTOMER PROFILE & ORDER REQUEST
GPStoGO
Business Name ______
Order Contact Name ______Installation Contact Name ______
Order Contact Phone ______Installation Contact Phone ______
Order Contact E-mail ______Installation Contact E-mail ______
Ship to Address Installation Address
Street ______Street ______
City ______City ______
State, Zip ______State, Zip ______
Profile/Order Request Submitted to GPStoGO (Date): ______
Installations require access to dashboard and steering column of vehicles.
Franchise presence required to assure access to facility and vehicles as needed.
Product/Services Requested
Item / Description / Quantity / Unit Price / Total Price
Go5 / Tracking only. / $199.00
Go5 Anti-Tamper Cable / Secures device and prevents removal or tampering. / $ 45.00
Go5 Monthly Service / Unlimited airtime service and support / $ 35.00
Go4 / Tracking only. / $259.99
Go4 Installation / Technician installation required. / $135.00
Go4 Cable / Required with Garmin use / $ 99.00
Go4 Monthly Service / Unlimited airtime service and support / $ 41.00
Garmin 5" # 1490T w/Sim Card / Purchase from GPStoGO? YES NO / Varies
Garmin 4.3" # 1390T w/Sim Card / Purchase from GPStoGO? YES NO / Varies
ITEM / FRANCHISE RESPONSE
1) / Will installation be performed in a sheltered area (garage) or outdoors
2) / Are there special instructions regarding access to the facility?
3) / Currently, are there GPS devices installed in any vehicles that require de-installation?
If yes, # of vehicles that require GPS de-installation.
4) / Currently, is there any equipment installed in the vehicle that may impede ability installation? (Access to dashboard, steering column).
If yes, please describe.
5) / Currently, is there any equipment or devices using the diagnostic plug-in port (ODBDII/CANBUS/JBUS)?
If yes, please describe.
6) / #1 Preference- Installation Date/Start Time: / DATE / START TIME
#2 Desired Installation Date/Start Time: / DATE / START TIME
#3 Desired Installation Date/Start Time: / DATE / START TIME
7) / Individuals to be setup with access to MyGeoTab.com (Web Tool for setting up routes, tracking devices, report, Garmin Text Messaging.)
Provide user name and e-mail address. / USER NAME E-MAIL ADDRESS
______
______
______
______
VEHICLE INFORMATION
Vehicle Year / Type(i.e., 2011 Ford) / Vehicle Model
(i.e., Focus) / Vehicle Identification # (VIN)
(Used in MyGeoTab Setup) / Vehicle Daily Use Description
(i.e., Team #, Vehicle #) / Device Serial Number
(Capture at install. Required for MyGeoTab Vehicle Assignment) / Vehicle Odometer Reading
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
3 | Page