extConnect OGies TECHNOL Installer and Customer Approval Date 4lit2021 Installation Start Date: 4/23/2021 JobNumber: [~NXJ214374 ‘Scheduled Complete: 4/23/2021 Installation Dates are non-negotiable unless otherwise directed ‘by NextConnect Program Menagement Site Location Sunrise Uraent Care / Grace Family Care 31500 Dequindre Road Time. mA RA Warren MI 152560 Time out: _|0' BQ Site ID:7932341 Total hours:__2 Site Contact: Marina M Techs on Site:_Z SitePhone: (586) 495-6293 Project Name: Inte ach Scope of Wor fie eee 41) Called NextConnect and Insight Help Desk to check in on site yee 8) Took dgtlpetures (each outel ard each owet test Suga 3 Emailed piotures fo PPToles@insight, bee e DL 5) Called Insight Help Desk for site release code at pire eet NOTE HELP DESK RELEASE CODE HERE: 6) Call NextConnect to close installation Poca Wasa ast 9 as [er anaaenay ajeeecee | certify that the installation/service has been completed in a professional manner. | also certify that | have called the NextConnect Program Manager and verified site completion. | have also noted time/hours in_ S ric above. Lead Technician Signatur Vu Date: ‘23-1 Customer Approval formed to my satisfaction: Yes No (use back of this form if necessary). —- Date:_4 [ Ad) 4 Lorie (att NextConnect Technologies The Scove of Work has beer If No, please describe defi Customer Signature: Print Name: I