Department Information:
Department:  
Requestor:  
Email:  
Phone:  
Address:  
Date:  
Type of Funds:  
Est Amt $:  

Copy Program Request:
Service Type:   Purchase
    Cost per Copy
    Lease
    36 mo. 48 mo. 60 mo.
Expected Copy Volume/Year:  
Peak Copy Volume/Month:  

Trade-in Information:
Trade-in?:   Yes No
Manufacturer:  
Copy Volume to Date:  
Model:  

New Model Specifications:
Desired Features:   3 Hole Punch
Digital
Reduction/Enlargement
Automatic Document Feeder
Bypass Feeder
Finisher
Stacker
Additional Paper Cassettes
Stapler
Color Copying
Book Copying
Auto-Duplexing
Auditron
Networking
Scanner
Fax Board
Copies per Minute:  
Brands Desired:  
   
   
   
   

Additional Comments: