Access 3™ and Pyramid System Information Document

System: AP AS / AHS	CLIQ	Pyramid
NOTE: System Information Document required for all new systems; see reverse for additional document requirements.
Facility Name:	Facility Name:
Mailing Address:	Shipping Address:
City: State:	City:	State:
Zip Code:	Zip Code:
Phone: ( )	Time Zone:
Fax: ( )	Daylight Savings:
E-Mail: By:
(Print Name, Primary Systems Administrator)	(Title)	(Authorized Signatures)
I understand that if any of the authorized representatives of this Facility (as set out below) are removed from their duties for any reason whatsoever, it is my responsibility to notify Corbin Russwin Key Systems Administration, in writing, of their release and the names of their replacements.
Date:
Authorized Facility Representatives (Printed Name)	(Title)	(Authorized Signatures)
Please attach any additional.		(Signature or Initial by System Administrator Only)

o "OPT-OUT" Option (System Type AS & AHS Only): By selecting this option I elect not to use the randomized

security codes and agree to substitute them with a Letter of Authorization.

Access 3™ AP and Pyramid Required Administrative Documents:

• Mandatory; all new systems will require a completed System Information Document (orders can not be entered without this document). The fully executed original document will be kept on file at Corbin Russwin.
• Subsequent order requirement. A letter of authorization will be required if the product is shipped to an address other than what's recorded on the System Information Document, and/or if the address on the purchase order is different than what is listed on the System Information Document.
• Letter of Authorization must be signed by one of the facility's authorized representatives
• Letter of Authorization must contain the same shipping address that appears on the customer's Purchase Order.
• Letters of Authorization will not be kept on file at factory.

Access 3 AS & AHS Required Administrative Documents:

• Mandatory; all new systems will require a completed System Information Document (orders can not be entered without this document). The fully executed original document will be kept on file at Corbin Russwin.
• Subsequent order requirement: A specific randomized security code will be required for each order unless "Opt-Out" has been authorized by the systems administrator.
• If the "Opt Out" option is NOT selected
  • o A correct system specific (randomized) security code must be included with each subsequent order.
• Security codes are specific to each order.
  • o If the shipping address is other than the one listed on the System Information Document, a Letter of Authorization signed by one of the recorded authorized representatives of the facility is required.
  • o Letter of Authorization must contain the same shipping address that appears on the customer's Purchase Order.
  • o Letters of Authorization will not be kept on file at factory.
  • o Without the proper security code, Letter of Authorization, or if the shipping address is other then what's listed on the System Information Document, the order cannot be processed.
• If the System Administrator elects not to use security codes as part of the authorization process, the "Opt Out" option can be authorized by the system administrator.
  • o If the "Opt Out" option IS selected
• A system-specific security code is not required.
• Letter of Authorization must be signed by one of the facility's authorized representatives.
• If the shipping address is other then the one listed on the System Information Document, a Letter of Authorization will be required.
• Letter of Authorization must contain the same shipping address that appears on the customer's Purchase Order.
• Letters of Authorization will not be kept on file at factory.

Access 3 CLIQ Required information:

- Mandatory: In addition to the above information Access 3 CLIQ systems require Time Zone and Daylight Savings information.