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* Current Equipment Supplier:
If other,
Approximate current lease term expiration
B&W Copy Volume
B&W Print Volume
Color Copy Volume
Color Print Volume
Where do you currently purchase your supplies (paper, toner, and staples)?
How often do you purchase supplies?
Do you know who your sales representative is?
Sales Representative's Name
Company Information
* Company Name:
* Your Name:
* Title:
* Telephone:
* Email:
Questions/ Comments:
Verification Image:
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  (only 6 lower-case letters)

 

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