Exhibit 10.4
XO Telco Collocation Request Form
Exhibit A
To Collocation Schedule No. __
Submission Date: | 2/1/2005 | Please note Requested Delivery Date is not guaranteed | |
Requested Delivery Date |
| Rep. Name: | Tim McGrath |
Customer Name: | Wenzel Data |
|
|
Address of Install: | 250 Marquette Ave. S, 1st Floor Minneapolis, MN 55402 |
|
|
Customer Contact: | Brad Wenzel | Technical Contact: | Ted Letofsky |
Address: | 1950 Northwestern Avenue Stillwater, MN 55082 | Address: | 1950 Northwestern Avenue Stillwater, NM 55082 |
Phone: | 651-351-7386 Ext 11 | Phone: | 651-351-7386 ext 16 |
Fax: | 651-351-7460 | Fax: | 651-351-7460 |
brad@wenzeldata.com | ted@wenzeldata.com | ||
24 hour Contact | Brad Wenzel | Billing Contact | Kris Caulfield |
Address | 1950 Northwestern Avenue Stillwater, MN 55082 | Address | 1950 Northwestern Avenue Stillwater, MN 55082 |
Phone | 651-351-7386 ext 11 | Phone | 651-351-7386 ext 14 |
Fax | 651-351-7460 | Fax | 651-351-7460 |
brad@wenzeldata.com | kjc@wenzeldata.com | ||
Period of Agreement | 3 years | Order type Agent Order | New Order No |
SPACE REQUIREMENTS | |||
Caged Space | Cabinets | ||
Square feet required: |
| Quantity of Cabinets: | 1 XO Cabinet |
| Width of Equipment |
| |
XO to provide cage layout & proposed rack layout for customer approval | Depth of Equipment |
| |
Minimum cage size is 100 square feet | XO does not provide shelves for any cabinets | ||
Racks cannot exceed a height of 84” | If installing customer cabinet, please include cabinet dimensions Customer cabinet cannot exceed depth of 36” and Height of 84” | ||
Please list all equipment to be installed by rack # | Please list all equipment to be installed by cabinet # | ||
|
|
|
|
Equipment | Dimensions (HXWXD) | Equipment | Dimensions (HXWXD) |
Rack 1 |
| Cabinet 1 See attached list |
|
|
|
|
|
Required Key Cards | |||
Note: 3 supplied at no charge. Additional key cards can be supplied at $50 charge per additional key card | |||
| Name | Phone | |
Card 1 | Brad Wenzel | 651-351-7386x11 | brad@storageelements.com |
Card 2 | Ted Letofsky | 651-351-7386x16 | ted@storageelements.com |
|
|
|
|
POWER REQUIREMENTS
DC Requirements:
Rack/Cabinet # | 3 of Feeds | Single or Dual Feed | Amps/Breakered/Fuse Size | Total |
|
|
|
| 0 |
Total | 0 |
|
|
|
Custom is responsible for subsequent distribution of power within customer cage or cabinet
AC Requirements:
Rack/Cabinet # | UPS Yes or Not | # of Circuits | Amps Breakered/Fuse Size | Receptacle Type/NEMA | # Receptacles Single/Duplex/Quad | Total |
1 | Yes | 3 | 20 |
| Quad | 60 |
|
|
|
|
|
|
|
Total |
| 3 |
|
|
| 60 |
NEMA: National Electrical Manufacturers Association
Notes: Standard AD power is 120 volt single phase. Other voltages available on an ICB based on market.
AC receptacles are provided above cabinets. Customer must provide own power stripes if required.
UPS is available on an ICB per site. Rack-mount UPS units are the responsibility of each customer.
The minimum power provisioned is 20 Amps. Additional power is sold in 10 Amp Increments.
XO provides Bell Core Standard Grounding.
XO provided Convenience AC Outlets fused @ 20 Amps (unprotected and not to power equipment)
BANDWIDTH/CROSS CONNECT REQUIREMENTS
Type and Number of Signal Terminations to be Cabled
Terminations to be cabled are those that are being requested to support the equipment listed on this application. An application requesting an augment must be submitted for additional terminations to be cabled. The following cables refer to the physical equipment interfaces (ex: if a DS3 is ordered, but is handed off as 28 DS1s, not 28 in the DS1 column, not 1 in the DS3 column).
Example:
DS1=28, DS3=6, VG1 pr=4 or 25 pr, Optical=12 fibers
Incremental Forecast: (mandatory for initial and 1 year)
| Initial | 60 days | 6 months | Year | Yeas-end Total | Cabinet# | Intra-building |
1 PR |
|
|
|
|
|
|
|
DS1 |
|
|
|
|
|
|
|
DS3 |
|
|
|
|
|
|
|
OC3 |
|
|
|
|
|
|
|
OC12 |
|
|
|
|
|
|
|
OC48 |
|
|
|
|
|
|
|
10Base T |
|
|
|
|
|
| N/A |
100 Base T |
|
|
| 1 | 2 | 1 | N/A |
Dark Fiber |
|
|
|
|
|
| N/A |
**Year-end Total represents the sum of the circuits installed initially plus the incremental circuits installed at 60 days, 6 months, and year end.
Type of voice jack (Standard: RJ-11 surface):
Intra-building Cross Connect Information:
*Please check with Local Market to confirm available carriers
Requested Carrier:
Carrier on XO's list? Yes No
If NO, please provide Collocation Provider:
Floor:
Suite Number:
SPECIAL REQUIREMENTS
Stratum Timing Yes No X
Special Requirements:
Customer's Vendor Selection:
Installation Vendor:
Address:
Phone: Fax:
Customer Equipment Deliveries MUST be scheduled with XO one (1) week in advance.
XO WILL NOT ACCEPT ANY DELIVERIES.
A Collocation License Agreement must be executed by the parties prior to or concurrently with a Collocation Schedule including all its Exhibits in order for this Request Form to be effective. This Request Form must be filled out with the customer and accepted by XO before it and the associated Collocation Schedule can be signed. Once both a Collocation Schedule and the Request Form have been signed, this form shall become Exhibit A to such Collocation Schedule. This Request Form shall not be deemed to be fining or a contract of any kind unless and until attached to the application Collocation Schedule associated with a fully executed Collocation License Agreement.
**Both this Request Form and an applicable Collocation Schedule must be executed for each location.
FAILURE TO PROVIDE ALL REQUESTED INFORMATION AND ASSOCIATED DOCUMENTATION MAY RESULT IN DELAYS IN THE PROCESSING OF THIS REQUEST.
CUSTOMER SIGNATURE:
By/s/ Brad D. Wenzel Printed: Brad Wenzel
Title: President Date: 2/25/05