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Home :: Managed Services :: Services a la Carte :: Hardware

Request for Quote

Submitted by admin on Tue, 06/30/2009 - 15:08.

Please complete the form below to submit a request to BERACHA for new hardware for your organization.

What is your name?: *

What organization are you with?: *

What is your Title?:

What is your eMail Address?: *

Please provide the best telephone number to reach you.: *

What type of hardware is this request for?: *

Laptop

Desktop

Monitor

Printer

Scanner

Other

If you chose Other, please list::

Please describe the intended purpose of this hardware.: *

Where will this hardware be installed?: *

Who is the primary user of this hardware?: *

Please provide any additional notes, including specific hardware or software options needed. : *

What is the "Do Not Exceed" amount?: *

In your organization, who is responsible for making purchasing requests?: *

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