Machine order

Sales Rep*

Sales Rep

Sales Rep Email*

Used for confirmation email

Company Name*

Exact company name

Install Address*

Street Address

Street Address Line 2

CityState

Zip Code

Is the Billing Address the same as the Install Address?*

Billing Address

Street Address

Street Address Line 2

CityState

Zip Code

Contract Contact Name*

First NameLast Name

Contract Contact Phone Number*

Contract Contact Email*

example@example.com

Is the Equipment Contact the same as the Contract Contact?*

Equipment Contact Name

First NameLast Name

Equipment Contact Phone Number

Equipment Contact Email

example@example.com

Type of agreement*

Vaulequix order numbers for tracking in DOS prompt

Machine Model being installed*

Any special info like apps defaults etc.*

Base install Hours

Do we need to do training?*

Is there a trade?*

If yes, what is the model and serial number?

If yes, where is the trade going?

Delivery type*

Stairs or Elevators*

How many Stairs

Loading Dock*

SME Yes/No*

If yes, what is the SME number for the machine

If yes, what is the SME number for the CPI

Is machine new or used*

If used, what is the SN#

If used, what is the black meter

If used, what is the color meter

Machine needs to be ordered through our vendorsMachine was ordered through valueQuixMachine is at the office no need to orderXPPS Only, customer already has machine

Does DCA/XDA need to be installed*

YesNo

How is it being billed*

Who is billing for the equipment*

Other Billing Information

Base charge for XPPS

Cost per page B&W

Cost per page color

Cost per page escalation after year 1

Notes

*** Please include exact pricing breakdown that matches leasing paperwork so sales can be properly funded *****Please include any additional notes that are important for office staff to know

Type option 1Type option 2Type option 3Type option 4

New Order

Billing Info