please visit our global gsa website · please visit our global gsa website does this order utilize...
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Federal Government Order FormPlease visit our Global GSA Website
DOES THIS ORDER UTILIZE GSA CONTRACT # GS-03F-076GA? YES NO
IF YES: Is the GSA Contract # clearly identified on this order? YES
IF NO: Is open market clearly identified on this order? YES
ORDER TYPE:
DID YOU ATTACH THE APPROPRIATE DOCUMENTATION, AS APPLICABLE? YES
THIRD PARTY BILL? YES
IS THIS A CREDIT CARD ORDER? YES
NO
NO (if YES, the credit card form must be faxed securely or “Call for Card Info”)
WERE THE APPROPRIATE HANDLING CHARGES ADDED TO THIS ORDER? YES N/A
SPECIFICATION PROJECT #: SIF FILE ATTACHED? YES NO
WEB QUOTE #:
EVOLVE PRICE LIST: EVOLVE DISCOUNT APPLIED:
GLOBAL PRICE LIST: GLOBAL DISCOUNT APPLIED:
REQUEST ARRIVAL DATE:
SPECIAL NOTES:
GSA ELIGIBLE ENTITY INFORMATION:
END USER:
PROJECT NAME:
PO#: TOTAL PO $:
PHONE #: FAX #:
KEY CONTACT:
CUSTOMER EMAIL:
SERVICE ITEMS ON PURCHASE ORDER:
INSTALLATION $:
IS INSTALLATION 27% OR LESS
OF THE NET PRODUCT PRICE? YES NO
If NO,did Global receive GSA’s Approval?* YES
SHIP COMPLETE? YES NO
DEALER INFORMATION:
DEALER OF RECORD:
DEALER SALES REP:
PO#: KEY CODE:
PHONE #: FAX #:
KEY CONTACT:
DEALER EMAIL:
SHIP TO INFORMATION:
COMPANY NAME:
ADDRESS:
CITY:
STATE: ZIP:
CONTACT NAME:
PHONE #:
US DRIVER REQUIRED? YES NO
DELIVERY PAPERWORK ATTACHED? YES NO
IS THERE A DOCK?** YES NO
*Installation rates that exceed 27% of the net product price may be accepted underextenuating circumstances (ex: Union labor, stair carry, after hours, etc.). Globalrequires our Contracting Officers approval on this amount prior to acceptance ofthe order.**If a lift-gate truck is required, additional charges may apply.
CCR
SQ #
Date of Processing:
DEALER
3RD
DEALER DISCOUNT:
INTERNAL GLOBAL USE ONLY
For current lead times, see Dealer Website
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