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Copier Order Form

Department:
Street Address/Room #:
Contact Person:
Phone:
Email:
Budget #(s):	/ %
	/ %
Budgetary Head Approval:
Are you replacing a copier?	Yes No
Must stairs be used?	Yes No
Model To Be Replaced:
Serial Number:

Requested Configuration: (Copier Services Catalog)
Bizhub 223 - 22 ppm. Features: Enlarges, reduces, automatic document feeder, automatic duplexing, two 500 sheet paper drawers.
Bizhub 283 - 28 ppm. Features: Enlarges, reduces, automatic document feeder, automatic duplexing, two 500 sheet paper drawers.
Bizhub 423 - 42 ppm. Features: Enlarges, reduces, automatic document feeder, automatic duplexing, finisher with stapling and sorting 3,250 sheet paper capacity, including 150 sheet intelligent bypass.
Bizhub 654 - 65 ppm. Features: Enlarges, reduces, automatic document feeder, automatic duplexing, stapling, sorting finisher 3,600 sheet paper capacity.
Bizhub 754 - 75 ppm. Features: Enlarges, reduces, automatic document feeder, automatic duplexing, stapling, sorting finisher 3,600 sheet paper capacity.
Bizhub 1052 - 105 ppm. Electronic Document Handler, duplexing, 3,000 sheet universal paper supply.
Bizhub C35 - 31 ppm. Features: Enlarges, reduces, 25-400% zoom range,250 sheet paper drawer, 10 sheet bypass.
Bizhub C224 - 22 ppm. Full Color Printer/Copier/Scanner with Emperon embedded print controller. for scanning, and printing, automatic document feeder, automatic duplexing, two paper drawers, 100 - 150 sheet bypass.
Bizhub C284 - 28 ppm. Full Color Printer/Copier/Scanner with Emperon embedded print controller for scanning, and printing, automatic document feeder, automatic duplexing, two paper drawers, 100 - 150 sheet bypass.
Bizhub C364 - 36 ppm. Full Color Printer/Copier/Scanner with Emperon embedded print controller for scanning and printing, automatic document feeder, automatic duplexing two paper drawers, 150 sheet bypass.
Bizhub C454 - 45 ppm. Full Color Printer/Copier/Scanner with Emperon embedded print controller for scanning and printing, automatic document feeder, automatic duplexing four paper drawers, 150 sheet bypass.

Do you require any accessories which are not included in the base price of your model?

Yes No

Describe:

Please complete all sections. Telephone Ces Grant, x14801 or Kip Portz, 303-463-1049, with questions. After you submit the form online, you will be contacted to confirm your order. Allow 10 business days for delivery.