First Name    Last Name 

City   State    Zip Code

Phone Number Extension

Conformation Email:

Super Easy Questions Copier Printer Request Quote Form :

   Print on 11 x 17 pages?17 pages?17 pages?17 pages? Not Sure Yes No

   Print on 12 x 18 pages? Not Sure Yes No

   Scan documents to your computer? Not Sure Yes No

   Send and receive faxes? Not Sure Yes No

   Network printing option? Not Sure Yes No

   Use more than two paper types? Not Sure Yes No

      If, yes how total paper drawers do you need? Not Sure 3 4 5

   Produce color pages? Not Sure Yes No

How many people are going to use the copier? Not Sure 1-2 3-5 6-10 11-15 16-20 21-30 Over 31

How fast - copies per minute? Not Sure 20-25 26-30 31-40 41-50 51 plus

Do you need a stapler option? Not Sure Yes No

Do you need a multi-bin sorter finisher? Not Sure Yes No

Tax advantages - Do you want leasing information? Not Sure Yes No

Additional comments, information needed or request:

Please make sure all the contact information is correct. We will contact you as soon as we receive this information.

Payment: If you are a current client with terms then you will be billed for the supplies based on your terms with our company. If you are a new client or a current client on COD basis please have payment ready when the supplies arrive.

Safe Site: Please note the information provided is only used to support your request. The information is kept confidential. Our company policy does not allow us to provide this information to other companies without your express consent. We do not release your contact information to any other company.