RBPINC Request for Supplies

1

Company Name* This field is required.

2

Contact Name* This field is required.Full Name of person that we will be in contact with

3

Type of Machine* This field is required.

COPIER

PRINTER

MULTI FUNCTION (Print/Scan,Copy and Fax)

4

COLORS* This field is required.

COLOR

BLACK AND WHITE

5

PAPER SIZES* This field is required.

8 1/2 x 11

8 1/2 x 14

11 x 17

6

Notes:

7

VOLUME EXPECTED: (Approximately how many reams of paper of use per week)* This field is required.

Reams

8

Network Capability?* This field is required.

Yes

No

Not Sure

9

Data Security Overwrite?* This field is required.

Yes

No

Not Sure