B I L L I N G |
S H I P P I N G |
| Company: | Company: |
| Address: | Address: |
| Address: | Address: |
| City: | City: |
| State: | State: |
| zip/postal code: | zip/postal code: |
| Country: | Country: |
| Attention: | Attention: |
| Phone: | Phone |
| Fax: | Fax |
| Email: | Email: |
QTY |
Product |
Available Platforms |
COM
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EDU/GOV
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Total Cost |
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| RPM Remote Print Manager Elite | Windows 2000/NT/XP/2003 | $598.00 | $498.00 | ||||
| RPM Remote Print Manager Select | Windows 2000/NT/XP/2003/Vista | $324.00 | $194.40 | ||||
| ExcelliPrint Premium | Number of devices | Windows 2000/XP/2003/Vista | $795.00 (per device) |
$690 (per device) |
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| ExcelliPrint Standard | Number of devices | Windows 2000/XP/2003/Vista | $495.00 (per device) |
$495.00 (per device) |
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| INTELLIscribe | Windows 2000/XP/2003/Vista | $295.00 | $177.00 | ||||
Shipping and Handling Charges (please check one) |
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| NO CHARGE for electronic delivery (software has been or will be downloaded) | |||||||
| $5.00 per CD-ROM + Shipping costs (you will be charged for shipping) (note that CD contains 21 day trials (RPM, INTELLIscribe & ExcelliPrint) and online support materials) |
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(select only one) Educational____ Government____ Commercial____ Non-profit____ TOTAL: |
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Payment Information / Details |
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| Purchase Order number: (You must FAX signed PO along with this form) | |
| Check Number: | Amount: |
| Credit Card: (please select) Mastercard _____ Visa____ American Express____ | |
| Account number: | Expiration Date: |
| Name on card: | Signature: |
| NOTES:
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