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*required information


*Company Name  
*Contact  
*Phone  
*Email  
Company Size    
Industry Type    
Copier Specifications:
please check all boxes that apply
What type of documents will you need to produce?
 Black & White B&W w/ Spot Color  
B&W w/ Full Color  
What types of media will you be using?
 8-½" x 11"  8-½" x 14"  
 11" x 17"  Letterhead  
 Card Stock  Tab Paper  
Other   
What is your anticipated monthly output volume?
 
What percent of output will be in color?
Do you want to connect the machine to your network for:
 Printing  Scanning                      
 Faxing     
Do you require special finishing for the document output?
 Stapling  Hole Punch  
 Sheet Insertion  Saddle-Stitch  
Is this acquisition to replace an existing machine?
Make and Model 
Monthly Lease  Payment 
Is the current equipment under a service contract?
Monthly Volume   
Monthly Cost 
Anticipated budget for new machine:
Outright Purchase  Price 
Monthly Lease  Payment 
Additional Requirements/Comments:
                                    

415-656-2400 x200
200 valley drive | suite 12 | brisbane, ca 94005