FicheNet Imaging Solutions, LLC 110 West C Street Suite 2000 San Diego, CA 92101-3998 Ph: 619.326.0644 Fax 619.326.0647

Printable Questionnaire For a Electronic Imaging (paper scanning) Quote - BETA

On-Line Form

My Contact Information:
	Name	_____________________________________
	Company	_____________________________________
	Title	_____________________________________
	My companies web http://	_____________________________________
I Prefer to be Contacted By:
	Phone	ext ___________
	e-mail	____________________________________

Name of My Application or Job:

_________________________________

I am interested in this media(s)
File Format:
	Tif Images
	PDF Images
	Other:	_______________________________________________
Output Media:
	CD-ROM
	DVD-ROM
	Other:	_______________________________________________
Hybrid Solution: (microfilm and electronic images)
	ArkScan
If you are interested in Attorney Copy Services Please go to the Attorney Services Page and use the customized pdf order form designed specifically for you.

Number of Documents Approximately:
	Documents	___________________________________________
	File Boxes	___________________________________________
	File Drawers (standard)	___________________________________________
	File Drawers (Deep Cabinet)	___________________________________________
	Lateral File Drawers	___________________________________________
	Other Explain
		___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________ ___________________________________________

My Documents are this size:
	Mostly 8.5" x 11" or less
	Mostly 8.5" x 14"
	Mostly Greater than 8.5" x 14", but less than 11" x 17"
	Oversized - Greater than 11" x 17"
	Bound Books
	If Bound Books Please Explain:
	Type of Book	________________________________
	Can they be unbound?	YES - NO
	If the media allows for it would you like two pages per image?	YES - NO
	If you have a mix of the above can you give more details below:
	__________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________

My Documents are in the following Condition
	Excellent (no folded corners, no tears, no sticky notes)
	Good (a few folded corners, a few torn pages...)
	Fair (some folded corners, some torn pages...)
	Poor (many folds, tears and rips)
	Very Poor (looks like your dog had it for lunch)
	Comments:
	_________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________
	Oversized drawings (11" x 17"+) they are:
	Rolled Folded Flat or Hanging Other

Do Your Documents Have Staples?
	YES		NO
		1 every 2 or 3 pages
		1 every 5 to 10 pages
		1 every 10 to 20 pages
		1 every 20 to 50 pages
		1 every 50 to 100 pages
		Less than 1 per 100 pages

Do You Documents Have Any Colored Elements?
	YES	NO
	Please Explain:
	____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________

Will You Prepare or Consider Preparing the Material for Filming/Scanning ti Ensure it is Arranged in Proper Order and Indicate any Missing Pages or Item?
	YES	NO
	Please Explain:
	____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________

Media Duplication

FicheNet Imaging Solutions clients customarily choose to purchase at the minimum 2 generations of microfilm or electronic media. The first generation is the Master. This Master serves as the archival media and should be kept in an environmentally controlled storage facility. The second generation, or Duplicate, is the working copy of the Master. This is the media that should be used on a day to day basis for retrieving and viewing
Would You Like Duplicates of Your Media?
	YES	NO
	If so how many: ______________________
Electronic Media: (all with custom covers & printed labels)
	CD-ROM
	DVD-ROM

Indexing Levels:
	Approximately how many documents per file or how how many pages per reference point?
	_________________________________________________________________
	There are four Levels of Indexing for Document Scanning:
	Level I	Very basic and most affordable.
		This method creates a single-image file for each individual page that references the documents in sequential order per the order in which they were received. (i.e. first page in a box becomes = 00001, the second page = 00002 and so on...) These files are batched into folders with the folder name being the file name, box name or any other singular naming method predetermined by you.
	Level II	Very Intense and most expensive.
		This method creates a single-image file for each individual page just as in Level I. However we then can rename every image with a name that pertains to each individual page like a SSN or something common on every document.
	Level III	Moderate and average.
		This method creates a multi-image file that encompasses all the pages from a batch into a multi-image file. This multi-image file is then renamed using a singular naming method predetermined by you. File names are limited to 165 characters for Win '95, '98, '00, ME, NT and XP.
	Level IV	Intense and average.
		This method creates an cross referenced index in an electronic format and can be used with either single-image or multi-image files. This index can be imported into a retrieval system you already have or it will require the purchasing or FicheNet Imaging Solutions Barracuda Image Retrieval Software. Can be used with any of the batching methods listed above. The cross referenced index uses up to 5 fields (or more) of objective indexing. (user keyed) This index provides at table references the objective data, the file name, path and sub-path data and can be imported into almost any program. We can provide the index in .xls, .doc, .mdb, .foxpro etc.. look all of them up jackass
	Please list the specific data for a Level IV index and approx. character length of each field below
	(i.e. Data Field#1=SSN# and is 11 characters)
	_________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________
	Level IV Index Special Data Instructions:
	_________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________
	Interested in Barracuda Image Retrieval Software:
		YES NO
	Number of Workstations: __________________
	Operating System: _______________________

Delivery or Shipping:
	FicheNet Imaging Solutions Pick Up and Deliver
	Use my own Company Courier
	Ship with Fed Ex
	Ship with UPS
	Ship with USPS
	Overnight? Second Day? Special Hours? Other:
	_________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________

I Wish to Pay by: (all Invoices are Due Upon Receipt unless otherwise arranged)
	Purchase Order / Company Check
	PayPal
	Personal Check
	Cash
	Other:
	_________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________

Post Conversion Document Destruction or Return:
	After the conversion project is completed do you wish to have your documents Returned or Destroyed. Destruction takes place a min of 90 days after your project is completed and there is an authorization form that must be approved before we complete the destruction for more information about Destruction see our web site.
	Return Documents
	Hold for Destruction
	Notes:
	_________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________

Any Other Details Below:

_________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________