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Contact Name: * Email: * Phone: * Preferred Method of Contact: * EmailPhoneEither Company Name: City: * State / Region: * —Please choose an option—AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingDistrict of ColumbiaPuerto RicoGuamAmerican SamoaU.S. Virgin IslandsNorthern Mariana IslandsAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon
What Make/Model Machine are you looking to upgrade? * Do you currently own or lease it? * OwnLeaseN/A If leased, what is the approximate date of your lease expiration? 0 – 6 months6 – 12 months12 – 24 months24 – 36 months36 – 48 months48 – 60 monthsI don’t know What type of equipment are you interested in? * Multifunction Machine (Copy/Print/Scan/Fax/Email/Apps)Black and White Laser PrinterColor Laser PrinterBlack and White CopierColor Copier“Specialized” Equipment”Other Are you in need of more than 1 machine? * What Speed of machine are you looking for? * —Please choose an option—15 to 20 prints/copies per minute21 to 30 prints/copies per minute31 to 45 prints/copies per minute46 to 70 prints/copies per minute71 + prints/copies per minute What is your projected monthly volume? * —Please choose an option—Less than 5,000 prints/copies per month05,000 – 15,000 prints/copies per month15,000 – 25,000 prints/copies per month25,000 – 40,000 prints/copies per month40,000 – 60,000 prints/copies per month60,000 – 99,000 prints/copies per monthOver 100,000 prints/copies per monthReally Not Sure – I need an assessment! What paper sizes do you require? * —Please choose an option—Letter (8.5×11) & Legal (8.5×14)Letter, legal & TABLOID (11×17) or Larger Do you use heavy weight or specialty paper? * YesNo What function do you consider most important? * —Please choose an option—Multifunction AbilityColorPrintingScanningEmailingAppsFaxingDocument Storage & RetrievalWe will just be making copiesNot sure – need an assessment! Would you like information on a Maintenance Agreement? * YesNo When would you require delivery? * —Please choose an option—ASAPIn Two WeeksIn One Month1 to 3 Months3 to 6 MonthsOther What purchase option do you require? * —Please choose an option—24 month lease36 month lease48 month lease60 month leaseCredit CardOutright PurchaseOn Account Comments: