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Company Name *
Address*
City*
State*
Zip Code*
Contact Name*
Email*
Company Phone Number*
Secondary Phone Number
    
What model(s) are you interested in?
Xerox ColorQube 9201
Xerox ColorQube 9202
Xerox ColorQube 9203
Xerox 6204 Wide Format
Xerox 6279 Wide Format
Xerox Workcentre 7120
Xerox Workcentre 3550
Kip 3100
Kip 5200
Kip 7200
Kip 9000
Sharp MX2600/3100
Sharp DXC311/C401
Sharp MX4101/5001
Sharp MX6201/7001
Sharp MX850/950/1100
Sharp MXB401
Sharp MXM283/363/453/503
Sharp MXM550/620/700
Sharp MXM623N/MXM623U
Sharp MXM753
When do you anticipate needing your new equipment?
Black & White or Color Output?*
How many black and white prints/copies needed per month?

    

How many color prints/copies needed per month?
Required features:
Copy
Scan
Print
Fax
                      
Finishing requirements:
Stapling
Folding
Saddle Stitching
Hole Punch
Purchasing options*
Cash
Credit Card
Lease
                   
If lease: choose length
24 months
36 months
48 months
60 months
63 months
Please enter any other requirements you may have (scan to email, barcode printing, server or mainframe applications):
Do you want a sales representative to contact you with just a quote based on the information you provided, or would you them to contact you with other options to make sure you are getting exactly what you need?



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