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Technician Name
*
Date
MM
DD
YYYY
6ft High Speed HDMI Cable
*
Yes
No
6ft High Speed HDMI Cable Quantity
*
10ft High Speed HDMI Cable
*
Yes
No
10ft High Speed HDMI Cable Quantity
*
15ft High Speed HDMI Cable
*
Yes
No
15ft High Speed HDMI Cable Quantity
*
35ft Active HDMI High Speed Cable
*
Yes
No
35ft Active HDMI High Speed Cable Quantity
*
50ft Active HDMI High Speed Cable CL3
*
Yes
No
50ft Active HDMI High Speed Cable CL3 Quantity
*
HDMI Pass Through Single Gang Wall Plate AL
*
Yes
No
HDMI Pass Through Single Gang Wall Plate AL Quantity
*
3ft DisplayPort Cable - Digital A/V
*
Yes
No
3ft DisplayPort Cable - Digital A/V Quantity
*
6ft DisplayPort Cable - Digital A/V
*
Yes
No
6ft DisplayPort Cable - Digital A/V Quantity
*
10ft DisplayPort Cable - Digital A/V
*
Yes
No
10ft DisplayPort Cable - Digital A/V Quantity
*
15ft DisplayPort Cable - Digital A/V
*
Yes
No
15ft DisplayPort Cable - Digital A/V Quantity
*
6ft DisplayPort to HDMI Cable - Digital A/V
*
Yes
No
6ft DisplayPort to HDMI Cable - Digital A/V Quantity
*
DisplayPort to HDMI Adapter Converter
*
Yes
No
DisplayPort to HDMI Adapter Converter Quantity
*
1m USB Extension Cable - 2.0 M/F Black
*
Yes
No
1m USB Extension Cable - 2.0 M/F Black Quantity
*
2m USB Extension Cable - 2.0 M/F Black
*
Yes
No
2m USB Extension Cable - 2.0 M/F Black Quantity
*
3m USB Extension Cable - 2.0 M/F Black
*
Yes
No
3m USB Extension Cable - 2.0 M/F Black Quantity
*
4-Port USB-A Hub
*
Yes
No
4-Port USB-A Hub Quantity
*
6FT 18AWG HSPTL PWR CBL, 5-15P-C13 BK
*
Yes
No
6FT 18AWG HSPTL PWR CBL, 5-15P-C13 BK Quantity
*
8FT 18AWG HSPTL PWR CBL, 5-15P-C13 BK
*
Yes
No
8FT 18AWG HSPTL PWR CBL, 5-15P-C13 BK Quantity
*
10FT 18AWG HSPTL PWR CBL, 5-15P-C13 BK
*
Yes
No
10FT 18AWG HSPTL PWR CBL, 5-15P-C13 BK Quantity
*
12FT 16AWG HSPTL PWR CBL, 5-15P-C13 BK
*
Yes
No
12FT 16AWG HSPTL PWR CBL, 5-15P-C13 BK Quantity
*
15FT 16AWG HSPTL PWR CBL, 5-15P-C13 BK
*
Yes
No
15FT 16AWG HSPTL PWR CBL, 5-15P-C13 BK
*
6ft Micky Mouse Power Cable
*
Yes
No
6ft Micky Mouse Power Cable
*
10ft Micky Mouse Power Cable
*
Yes
No
10ft Micky Mouse Power Cable Quantity
*
6in Cable Tie Multipack (100 pack) Black
*
Yes
No
6in Cable Tie Multipack (100 pack) Black Quantity
*
4in Cable Tie Multipack (100 pack) Black
*
Yes
No
4in Cable Tie Multipack (100 pack) Black Quantity
*
1/4in Nylon Cable Clamp - 50pk
*
Yes
No
1/4in Nylon Cable Clamp - 50pk Quantity
*
1ft MONITOR POWER ADPTR CORD
*
Yes
No
1ft MONITOR POWER ADPTR CORD Quantity
*
10ft 18 AWG Outlet Saver Power Cord
*
Yes
No
10ft 18 AWG Outlet Saver Power Cord Quantity
*
8ft POWER EXTENSION CORD(5-15R to 5-15P)
*
Yes
No
8ft POWER EXTENSION CORD(5-15R to 5-15P) Quantity
*
12ft OUTLET SAVER POWER EXT CORD
*
Yes
No
12ft OUTLET SAVER POWER EXT CORD Quantity
*
TOGGLER SNAPTOGGLE BB 1/4"-20 Anchor
*
Yes
No
TOGGLER SNAPTOGGLE BB 1/4"-20 Anchor Quantity
*
1/4"-20 x 2" Phillips Flat Head Zinc Screw
*
Yes
No
1/4"-20 x 2" Phillips Flat Head Zinc Screw Quantity
*
1/4"-20 x 2-1/2" Phillips Flat Head Zinc Screw
*
Yes
No
1/4"-20 x 2-1/2" Phillips Flat Head Zinc Screw Quantity
*
1/4"-20 x 3" Phillips Flat Head Zinc Screw
*
Yes
No
1/4"-20 x 3" Phillips Flat Head Zinc Screw Quantity
*
Wiremold Cordmate Kit- 2900 White 15ft
*
Yes
No
Wiremold Cordmate Kit- 2900 White 15ft Quantity
*
Wiremold Cordmate Kit- 2700 White 15ft
*
Yes
No
Wiremold Cordmate Kit- 2700 White 15ft Quantity
*
Arlington CE1-10 Recessed Low Voltage Plate
*
Yes
No
Arlington CE1-10 Recessed Low Voltage Plate Quantity
*
Universal Tilt Wall Mount for 39" to 75" Displays
*
Yes
No
Universal Tilt Wall Mount for 39" to 75" Displays Quantity
*
Cable Corral Jr Wire Basket
*
Yes
No
Cable Corral Jr Wire Basket Quantity
*
1/2 “ VELCRO QWIK Tie Tape Black
*
Yes
No
1/2 “ VELCRO QWIK Tie Tape Black Quantity
*
Vertical Small CPU Holder (black)
*
Yes
No
Vertical Small CPU Holder (black) Quantity
*
Vesa Screw Kit
*
Yes
No
Black Electrical Tape
*
Yes
No
Packing Tape
*
Yes
No
Painters Tape
*
Yes
No
Micro Fiber Cloth
*
Yes
No
Drywall repair
*
Yes
No
Hide It
*
Yes
No
Hide It Quantity
*
TV Kit
*
Yes
No
Tripp lite
*
Yes
No
Tripp lite Quantity
*
HARD HAT
*
Yes
No
STEPDOWN
*
Yes
No
PILOT BITS
*
Yes
No
VEST
*
Yes
No
#14 WOOD SCREWS
*
Yes
No
Thank you!
