Suncoast PC: Order Road Runner Internet Access St. Petersburg Tampa Bay Clearwater Florida FL Business High Speed Order Form

Road Runner Order Form - Business Class

For Tampa Bay Florida and Surrounding Areas Only! This service is available only in the Bright House Networks Cable service area located throughout the West Coast of Central Florida.

Please complete all questions. Fields in Bold are required.

Company Information

Business Name:
Contact Name:
Address1:
Address2:
City:
Zip Code:	5 digits: xxxxx
Phone:	Include area code: xxx-xxx-xxxx
Email:	Used to send your order confirmation only!

Billing Information

	Click if same as above Customer Information
Address1:
Address2:
City:
Zip Code:	5 digits: xxxxxx
Phone:	Include area code: xxx-xxx-xxxx
Email:	Used to send your order confirmation only!

Additional Information

Installation Type:		Notes
Self Install PC USB		No charge. Must have available USB Port.
Self Install PC NIC		No charge. Must have available Ethernet card.
Self Install MAC		No charge. Must have available Ethernet card.
Self Install Other		No charge (i.e. Router / Firewall).
PC Tech Install Desktop		Additional fee. If you do not have an Ethernet card / USB port, we can install one.
PC Tech Install Laptop		Additional fee.
PC Tech Install Other		Additional fee (i.e. Router / Firewall).
Package:
*Virtual Office*
Advanced		Residential Addresses Only!!!
Preferred		Residential Addresses Only!!!
Ultimate		Residential Addresses Only!!!
*Commercial*
Unknown		We will contact you to determine your requirements.
Economy
Standard
Advanced
Preferred
Premium
Ultimate

VPN (Work from home access)

If additional IP addresses are needed, please specify the quantity in the comments field below.

Schedule Installation Time

Note: Preferred Date must be at least 4 days from the current date.
Preferred Date:	mm/dd/yy - (Monday -> Friday only)
Time Frame:
Alternate Date:	mm/dd/yy - (Monday -> Friday only)
Time Frame:
Comments:

Please contact or e-mail us to discuss your needs.