Commercial Site Survey Business Name* First Installation Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Point of Contact* First Last Title Phone Number*Email* New Construction?* Yes No Anticipated date of completion MM slash DD slash YYYY Within how many feet can the truck and trailer come to the delivery entrance?* On what floor level will the equipment be installed?* What entrance is recommended?* Elevator Access?* Yes No Elevator Ceiling Height: Elevator Door Width: Elevator Interior Dimensions: Total number of stairs into the installation location? (Interior & Exterior)* Width of Stairs: How many turns or corners are on the stairs? Width of turns/corners on the stairs? How many doorways must the equipment pass through to complete the installation?* What is the width of the narrowest door the equipment must pass through? Please account for trim, door handles, and the door itself.* What room will the equipment be installed in?* Ceiling height? Door height? Flooring type?* Please enter any additional information that will be helpful for delivery personnel. (Special walkways such as pavers or difficult landscaping, steep driveways, etc.)Electrical Requirements (If applicable)Number of available electrical outlets for equipment: TreadmillsMost commercial grade treadmills require a dedicated 120V/20A circuit with a non-looped (isolated) ground. *contact your sales rep to ensure electrical requirements are known. A dedicated circuit means that each outlet you plug into should not have anything else running on that same circuit. Each treadmill must have its own circuit breaker with dedicated neutral and ground terminated at the panel. Non-Treadmill Cardio Powered All non-treadmill cardio equipment uses a NEMA 5-15P plug. The equipment requires a 120V/15A circuit. Multiple units may be daisy-chained together, up to four units per 15A circuit. Note: This is a recommendation only. NEC (National Electric Code) guidelines or local region electric codes must be followed. WARNING: Failure to follow these specifications can cause damage to your product and can void the warranty.Are the appropriate power requirements available? Yes No If no, when will they be made available? Treadmill Electrical Requirements: Treadmills must be connected to a 20 amp individual branch circuit. An individual branch circuit provides a hot conductor and neutral conductor to a receptacle. These conductors must not be looped, "daisy-chained", or connected to any other conductors. The circuit must be grounded according to NEC guidelines or local region electric codes.Entertainment/VPSService Provider name: Type of Signal: Digital Analog STD IRC HRC Type of service/connection for the entertainment system: Cable Satellite Combination Internet Provider Wi-Fi Available? Yes No Digital installations: Is the system currently working? Yes No If no, date of installation: MM slash DD slash YYYY Installation Disclaimer Installation can take up to several hours to complete depending on the amount of equipment and the challenges of the location. Additional charges may apply depending on the number of Service Technicians required to complete the installation. Obstacles that increase the risk and difficulty of the installation, may also affect installation rates. Better Body Fitness of Montana, Inc. reserves the right to decline installation of product (s) due to dangerous or high risk factors regarding safety of Service Technicians not disclosed in this Site Survey.If the facility requests removal of fitness equipment at the time of delivery a removal and disposal fee will be assessed based upon the removal requirements.* “I understand there may be additional fees assessed if equipment removal is needed.” If the facility cannot accept delivery and installation on the date(s) of the scheduled install a service fee of no less than $299 per day will be assessed.* “I understand there may be additional fees assessed if we cannot accept delivery on scheduled date." By signing below you are agreeing to the terms set forth by and agree to any applicable fees as described above.* First Last Date* MM slash DD slash YYYY
