SPECIAL PRICING AUTHORIZATION FORM
Please submit this form to Product Team for special pricing approval. Product Team will process and generate an official quotation from the system. Thanks.
Customer Information:
Type of Customer:
New Customer Existing Customer
Company Name:*
Branch (if any):
Contact Person:*
Email Address:
Project Information:
Project Name:*
Job Site Location:
Project Start Date:
Month Day Year
Project End Date:
Month Day Year
Special Price Valid Until:
Month Day Year
*If not specify, special price is valid for 60 days from the date of price approval
Number of Releases:*
1 release 2 releases 3 releases 4 releases
Estimated delivery date:
Estimated delivery date:
Estimated delivery date:
Estimated delivery date:
SPA pricing given is based on all information on the form. If the form is not completed, the SPA cannot be done. Thank you.
Model Number Color Temp Min. QTY Current Sales Price Requested Price Discount
Submitted by:
Date
Month Day Year
Should be Empty:

Customer Information: