Type of system required  Copier Fax Printer Scanner

         Options Desired: Network Scanning  Network Printing  Faxing  Stapling  11 x 17 Capable

                        Full Color Capable  More Than 2 Paper Trays  Automatic Two sided

                        Automatic Original Doc Feeder  12 x 18 Capable  Color Scanning                         

        Monthly Print Volume:  Under 1,000 1,000 to 3,000 3,000 to 6,000 6,000 to 10,000 10,000 to 20,000 Over 20,000

        Price Range: 

        Estimated date for install:  Under 30 days 30 to 60 days 60 to 90 days Over 90 days  

        Payment Options:  Lease COD Rent

        Service Contract: Yes No

         Company Name:

         Address: 

         City, State, Zip: 

         Telephone:    Fax: 

         Email Address: 

         Preferred Method of Contact:  Phone Fax Email