SIPA Service Request Form
Colorado Statewide Internet Portal Authority (SIPA)
Please complete the following form to request a single service from Colorado SIPA.
If at any time you need assistance completing this form, please email sipa@cosipa.gov or call (720) 409-5636.
Contact Information
Date of Request
Date Service Needed
Is there a mandated or legal requirement for this project?
Yes
No
Entity Name
Entity Type
Please select...
Municipality
County
Higher Education
Water District
State Agency
Fire District
Health District
Library District
Other Special District
Other
Entity Website URL
Requestor First Name
Requestor Last Name
Requestor Title
Requestor Phone
Requestor Email
Project Sponsor First Name
The Project Sponsor has signing authority for the project.
Project Sponsor Last Name
Project Sponsor Title
Project Sponsor Phone
Project Sponsor Email
Please briefly describe your project goals and requirements related to this service request
How did you hear about SIPA?
Type of Service Requested
I am interested in
No-Cost Colorado.gov Portal Services
Low-Cost Services and Licenses
Implementation or Consulting Services
No-Cost Colorado.gov Portal Services
Please select the service being requested. Each service requires a separate form to be completed.
Payment Processing - Accept credit/debit cards or electronic checks online and/or over the counter
Payment Integration (API) - Connect our payment engine to your custom application
Online forms - ability to take payments
Website - Colorado.gov Website
Event Registration - A solution for your event and meeting registrations. Collect payments and track registrations
MyEvents2Go - Mobile conference agenda solution for iOS, Android, and Windows phones
Low-Cost Services and Licenses
Please select the service being requested. Each service requires a separate form to be completed.
Call Center Solutions - Five9
Cirrus Insight - Integrate e-mail inbox with Salesforce
Digital Communications - Marketing Cloud or Granicus
Document Management - AODocs
DocuSign - Electronic Signature and Complete Digital Transaction Management
e-Health Records - CORHIO or QHN
Form Assembly - Online web forms that can work as a stand-alone or as a Salesforce Integration. Can include payment integration & signature.
Google Applications - e-mail, calendar, contacts, docs, sites, drive and video.
MUNIRevs or LODGINGRevs
Network Monitoring - Affiniti Network Assure
Online Video Streaming and Hosting - Granicus
Salesforce.com - Platform as a Service, CRM and Community Management Tool, Application Development
Virtru - Email Encryption
Implementation or Consulting Services Requested
Please select the service being requested. Each service requires a separate form to be completed.
Custom Application Development- Custom applications that do not fit within other services
Cyber Security Assessments, Penetration Testing
Google Cloud Platform Development
Salesforce Implementation Work
Other - Please contact us at 720-409-5636 or sipa@cosipa.gov
Custom Application
Please describe in as much detail as possible, the custom application's features and functions being requested?
Please describe your current method, if any, for performing this process.
Please describe how this process will be improved by the implementation of the application requested.
Who is the end user or customer for the application?
Approximately how many users will be using this application?
Event Registration
For what type of events and how many different events are you requesting the Event Registration Tool?
Will you be collecting payment as part of your Event Registration Process?
Yes
No
Payment Processing Information
Payment Processing Options - Please check all that apply
Accept Credit Cards Online
Accept Credit Cards Over-the-Counter
Accept Credit Cards on a Mobile Device
Accept Electronic Check Online
Accept Electronic Check Over-the-Counter
How are you currently collecting payments (manually, cashier, mail, etc.)?
What payment types do you plan to collect?
Will you require integration into the state accounting system (CORE)?
Yes
No
Not sure
What is the average transaction amount?
please put a $ amount here.
Please estimate the average number of transactions per year
Will you require integration with a 3rd party provider or application (e.g. court fines, utility payments, or other software, etc)?
Which 3rd Party Vendor will support your payment integration if needed?
What Bank/Financial Institution does your organization use?
In a given year, do you expect high or low transaction periods? Please explain.
How many Over-the-Counter Stations, if any, will you need?
For Over-the-Counter transactions, what Internet Browser will your staff be using. Please list all versions in use - i.e. Internet Explorer 11, Chrome 42, etc.
Salesforce.com
Please describe your Salesforce needs
New Salesforce Application
Additional Licenses
Additional App Exchange Products
Service or Support Agreement
Other
Please describe the solution needed - any requirements, number of licenses, timeline, alternatives, etc.
Google Applications
Which Google Applications are you interested in
Google Licenses (email, calendar, drive, sites, docs, video, etc.)
Google Message Encryption
Google Vault (Message Archiving)
Other Google Product (Maps, App Engine, etc)
What is your current email platform?
How many email accounts does your organization currently have?
Approximately how many licenses will you need?
Will you need help migrating from your current email platform to Google Apps?
Yes
No
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www.colorado.gov/sipa
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Contact Information