Affinity™ Site Survey

1

Submitted By Name: Territory Number:

Phone: Email:

Date Submitted:

Distributor: ACP #:

Address:

City: State: Zip:

Contact Name: Title:

Phone: Fax:

Job Name: Contact:

Address:

City: State: Zip:

Project is:� New Construction� Retrofit� Add on to an Existing Customer

Requested Installation Date:

Quantity of Encoders: _________

Quantity of PCs: _________

Quantity of Monitors: _________

Internal Use Only:

Vingcard Quote Number: ________________________

ASSA ABLOY DSS Quote Number: _______________

The Affinity™ Site Survey document MUST be completed for each job and submitted with quote request. Instructions:1. Fill out this cover sheet.2. Make additional copies of pages 2-5 for each door type or condition, such as resident rooms, storage closets, exterior doors, etc.3. Fill out an entire survey for each door type. Label each door type "Survey XX of XX" on each page.4. If there are unique situations for installation, digital pictures may also be submitted for review.5. All information must be completed to received quote. 6. Submitt form via e-mail only to both Wesley Colquitt and Paul Johnson.

For questions concerning pricing and quotes:Wesley Colquitt, Pricing ManagerASSA ABLOY Door Security Solutionswcolquitt@assaablydss-cs.com704-226-6103800-438-1951 x 6103

For questions concerning doors, frames and hardwarepreparations:Paul Johnson, Affinity™ Project ManagerASSA ABLOY Hospitality, Inc. - Vingcardpjohnson@vcegroup.com972-692-3126800-225-8464 x 3126

ASSA AABLOY Door Security Solutions Agency Information

Affinity™ Site Survey

2

Door Type:� Resident Rooms� Storage Room� Exterior Entrance� Other:

Survey: of

Lock Type:� Affinity™ Mortise Lock� Remote Reader

Handle Style:� VAU - Handle with Return� VAR - Wing Handle� VGH - Gothic Handle� VMO - Straight Handle

Function:� VCAF52 – Without Cylinder Override� VCAF53 – With Cylinder Override

Finish on Outside:� Bright Brass (605)� Satin Brass (606)� Bright Chrome (625)� Satin Chrome (626)

Finish on Inside:� Bright Brass (605)� Satin Brass (606)� Bright Chrome (625)� Satin Chrome (626)

Optional Metal Battery Cover on Inside:� Yes� No

Door Handing & Quantity

RH LH RHR LHR

(Locked side of door)Qty:

(Locked side of door)Qty:

(Locked side of door)Qty:

(Locked side of door)Qty:

Total Locks:

Spare Locks:

Total Quantity:

Edge of Door Characteristics (Circle One)

� Flush � Two Seams � Center Seam � Edge Seam

Edge of Door Material:� Wood� Wood Center� Steel� Aluminum� Plastic Veneer� Fiberglass� Solid Plastic

Notes:

Affinity™ Site Survey

Doors

3

Door Type:� Resident Rooms� Storage Room� Exterior Entrance� Other:

Survey: of

Door Characteristics (Check One)

� Double Flush � Double Fire Lite � Double Full Glass � Double Half Lite

� Single Flush � Single Fire Lite � Single Full Glass � Single Half Lite

� Double Six Panel � Single Six Panel � Other (Explain)

Affinity™ Site Survey

Doors

4

Door Characteristics Continued

Doors are:� Existing Doors� New Doors

Location:� Interior Corridor� Exterior Corridor� Exterior Breezeway

Interior of Door:� Solid Core� Hollow Core� Asbestos� Fiberglass� Solid Wood� Gypsum

Doors have:� Recessed Panels� Raised Moulding� Raised Glass Bead� Flush Glass Bead� Recessed Glass Bead

Distance from edge ofdoor to Moulding, Re-cessed Panel, RaisedPanel orGlass Stop (if any):

Height of Moulding(if any):

Material on Face of Door:� Solid Wood� Wood Veneer� Aluminum� Wood Grain Plastic Veneer� Wood Grain Vinyl Veneer� Stamped Sheetmetal� Sheetmetal

Finish on the Door:� Painted� Stained� Factory Veneer� Anodized� Unfinished

Doors are:� Prepped for

Affinity™ � Mortise Pocket

Only� Blank� Have Existing

Locks

DoorThickness:

Door Width: Door Height: Is there any otherhardware on thedoor:� None� Chain Guard� Bar Guard� Kickplate

Notes for this set of doors:

Affinity™ Site Survey

Frames

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Frame Material:� Wood� Steel� Aluminum

Frame is:� New� Existing

Frame Finish:� Painted� Stained� Wood grain vinyl� Anodized� Baked Enamel

Will the frameaccommodate a oneinch deadbolt extension?� Yes� No

Is the frame concretefilled?� Yes� No

Height of LocksetStrike (Critical)

Height of DeadboltStrike (Critical)

Distance betweenStrikes (Critical)

Notes:

Frame Characteristics (Check One)� Check here if Frame is new and prepped for Affinity™

� Double Rabbet1

� Double Rabbet2

� Double Rabbet3

� Double Rabbet4

� Double Rabbet5

� Double Rabbet6

� Double Rabbet7

� Double Rabbet8

� Double Rabbet9

� Single Rabbet 1

� Single Rabbet 2

� Single Rabbet 3

� Single Rabbet 4

� Single Rabbet 5

� Single Rabbet 6

� Single Rabbet 7

� Single Rabbet 8

� Single Rabbet 9

� Blade Stop 1

� Blade Stop 2

� Blade Stop 3

� Blade Stop 4

� Blade Stop 5

� Blade Stop 6

� Blade Stop 7

� Blade Stop 8

� Blade Stop 9

� Narrow Stop 1

� Narrow Stop 2

� Narrow Stop 3

� Narrow Stop 4

� Narrow Stop 5

� Narrow Stop 6

� Narrow Stop 7

� Narrow Stop 8

� Narrow Stop 9

Affinity™ Site Survey

Hardware

6

Lockset Backset:(edge of door to centerline)

Deadbolt Backset:(edge of door to centerline)

Lockset Bolt Height:(on edge of door)

Deadbolt Bolt Height:(on edge of door)

Lockset Manufacturer: Deadbolt Manufacturer:

Existing Lockset Characteristics � Check here if doors are Prepped for Affinity™

� Key in Knob/Lever withDeadbolt

� InterconnectedCtr. to Ctr. Dim. = _____

� Key in Knob/Lever � Mortise Lockset

� Tesa � Sargent � Saflok � Ilco

� Touch Mortise � Bar Mortise � Paddle Mortise � Exit Mortise

� Push Bar with Night Latch

� Adams Rite Star Rim � Touch Rim � Bar Rim

� Exit Rim � Bar Concealed Vertical Rod

� Touch Concealed Vert. Rod

� Exit Concealed Vertical Rod

� Bar Surface Vertical Rod � Bar Surface Vertical Rod � Bar Surface Vertical Rod � Other (Explain)

42658-5/09N