Cogent Communications Request for IPv4 AND IPv6 address space. See http://www.cogentco.com/Guide/IPQ_NA-Sample.txt for instructions and a sample. I. CUSTOMER INFORMATION Company Name: Order Number: Tech Contact 1: Tech Contact 2: II. TYPE OF SERVICE 1. Do you need to run BGP? [ ] No [ ] Yes please complete http://www.cogentco.com/Guide/BGPQ.txt 2. Do you need Cogent to run Authoritative or Secondary DNS for your company? This is not for DNS resolvers, those will be provided during installation. [ ] No [ ] Yes please complete http://www.cogentco.com/Guide/DNSQ.txt 3. Do you need Backup Mail Service? [ ] No [ ] Yes please complete http://www.cogentco.com/Guide/SMTPQ.txt III. ASSIGNMENT REQUEST 4. Cogent Interface IP Address Needs. Please check a box. A: [ ] I will connect the Cogent circuit to a single Layer 3 device. B: [ ] I will connect the Cogent circuit with two Layer 3 devices for redundancy and need a /29 on the connected interface. C: [ ] I will connect directly to the Cogent circuit with a Layer 2 device need more than a /29 on the interface. (Multi-tenant Office Buildings and Cogent owned data centers only) SKIP TO SECTION IV D: [ ] I will connect the Cogent circuit to a Layer 2 device and need only a /29. (Multi-tenant Office Buildings and Cogent owned data centers only) YOUR'RE DONE SUBMIT THIS REQUEST. 5. Cogent Routed IP Address Needs. A: [ ] I do not need any additional Cogent Assigned IP Addresses for my LAN. YOUR'RE DONE SUBMIT THIS REQUEST. B: [ ] I need a /29 routed to my Layer 3 device. C: [ ] I need a /24 to run BGP and do not have one from any other provider. If you need a /24 for BGP and didn't get one from any of your other ISPs, please provide the email address of the human contact with your other ISP that can verify your BGP and IP address requirements. A generic "support" address is insufficient. Email: D: [ ] I need a larger block than the IP blocks listed above. CONTINUE TO SECTION IV *************************************************************************************************** For 5 if you checked A, B, or C you're done. STOP here and submit your IP request for processing. *************************************************************************************************** IV. Current IP Address Space Utilization Provide detail usage for the IPv4 addresses you already have. Network Size Assigned By Assign Date % in use 6. IP Justification: Please check the box that best describes your needs: A: [ ] I am going to renumber and return IPs from another ISP. When will this be complete? B: [ ] I have reached 80% usage of my current IPs and need more. C: [ ] I currently have no IPs and I am not renumbering from an other ISP. This is a new network. V. IPv4 IP Address Space Request 7. IP Block Size Requested: [ ] /28 [14 useable IPs] [ ] /23 [510 useable IPs] [ ] /27 [30 useable IPs] [ ] /22 [1022 useable IPs] [ ] /26 [62 useable IPs] [ ] /21 [2046 useable IPs] [ ] /25 [126 useable IPs] [ ] /20 [4094 useable IPs] [ ] /24 [254 useable IPs] [ ] /19 [8190 useable IPs] 8. Describe your planned usage of the requested IP assignment. Please be concise. Network Subnet Size Now 3-mo 6-mo 12-mo Description 9. Please complete the following for web-hosting services you provide. A: Total number of servers: B: Name-based hosting: domains using: IP addresses. C: IP-based hosting: domains using: IP addresses. D: How many websites do you have with SSL: E: Technical justification(s) for IP-based hosting: F: List of URLs and current IPs: URL Current IPs: VI. Network Diagram - Please complete this section if you are requesting IPv4 addresses. 10. Please provide an ASCII map showing how the requested block will be subnetted or provide a Visio file. ********************************************************************** *IPv6 is available for customers in On-Net Carrier Neutral * *Datacenters and On-Net Cogent Datacenters. Customers have the * *option of Dual Stack or IPv6 only. An order must be placed with * *Cogent Sales in order to activate IPv6. * ********************************************************************** VII. IPv6 IP Address Space Request Order Number: 11. Prefix length requested: [ ] /64 [1 subnet] Maximum connected IPv6 block size. [ ] /56 [256 Subnets] [ ] /48 [65k subnets] [ ] We have our own IPv6 space 12. Does this site currently have IPv6 space? [ ] No [ ] Yes. Please indicate current and planned usage for existing assignments, as well as planned usage for the requested prefix example: Network Prefix Now 6-mo 1-yr Description VIII. Network Diagram - Please complete this section if you are requesting IPv6 addresses. 13. Please provide an ASCII map showing how the requested block will be subnetted or provide a Visio file. ADDITIONAL COMMENTS (add additional sheets as necessary) View Cogent forms at http://www.cogentco.com/Guide/ View Cogent's IP allocation policy at http://www.cogentco.com/Guide/IP_Allocation_Policy.txt View Instructions at http://www.cogentco.com/Guide/IPQ_NA-Sample.txt http://www.cogentco.com/Guide/IPQ_NA.txt IPQ NA-IPv4/IPv6-v1.3 02/05/10