Email Address (required)

Contact Name (required)

Contact Number (required)

Date

Type of Request (required)
MAPSourcewell
RFP Issued? (If yes, please include a copy and any other documentation)
YesNo
Due Date to Dealer

Requesting Dealer (required)

Account Name (required)

Account Location (required)

Current Vendor (required)

Award Type
Single Order (Single order: Dealer will receive pricing for ONE time only)
Estimated Order Timeframe
Ongoing Orders (Multiple orders: Specify potential timeframe)
Estimated Order Timeframe
Revenue Potential (Sharp Equipment)
Account Information
Lease Term N/A36 Months48 Months60 MonthsOther If other, please specify
Current or Estimated Volumes (For Sharp equipment requested)
Black/White per month Color per month
Pricing Request (required)
Requested Pricing / Pricing Justification (This may include competitive pricing data, lease buyouts, maintenance, etc.)
(REQUIRED) Equipment & Options (Please attach appropriate equipment configuration template.)