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 |
COMM |
EDU/GOV |
Total Cost |
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| RPM Remote Print Manager™ Elite | Windows 2000-2008/XP/Vista/Windows 7 | $648.00 | $388.80 | |||
| RPM Remote Print Manager™ Select | Windows 2000-2008/XP/Vista/Windows 7 | $324.00 | $194.40 | |||
| ExcelliPrint Premium® (includes 1 printer) | Windows 2000-2008/XP/Vista/Windows 7 | $795.00 | $477.00 | |||
| ExcelliPrint Premium® (additional printers) |
$375.00 | $225.00 | ||||
| ExcelliPrint Standard® (includes 1 printer) | Windows 2000-2008/XP/Vista/Windows 7 | $495.00 | $297.00 | |||
| ExcelliPrint Standard® (additional printers) |
$325.00 | $195.00 | ||||
| INTELLIscribe® | Windows 2000-2008/XP/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 the CD contains 21 day trial versions of RPM, INTELLIscribe, & ExcelliPrint and online support materials) |
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(please select one) Educational Government Commercial Non-profit TOTAL: |
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Payment Information / Details |
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| Purchase Order number: | (You must FAX a signed PO with this form) |
| Check number: | Amount: |
| Credit Card: (please select one) MasterCard Visa American Express | |
| Account number: | Expiration Date: |
| Name on card: | Signature: |
| NOTES:
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