Sales Request

**Please check the warranty before you send in the sales request if applicable

Company Name*
Contact Name*
First
Contact Email*
DPC Team Member Sending in Request:*
Original Ticket# if Applicable:
Location/Address*
Hidden
Location/Address
Location in Office (E.g. Breakroom)
When does the client need this?
Objective:*
(Write an objective that covers any/every detail necessary to convey to the client the scope of work and everything we are responsible for as well as what they are responsible for. We want to avoid being vague leading us to doing extra work, but overly verbose objectives can also become problematic)
Parts & Labor:*
(example)
1 Standard Server Bundle + Install
2 Clerical Machines + Install
4 Clinical Machines + Install
Where should the products be ordered to?: (Select one)*
If these items are for a specific end users, list their Name, Email, Phone Number and Address & their Manager’s name:
Notes for installation technician: