Request for Copy/Print Device Questionnaire

Request for Copy/Print Device Questionnaire

Purdue Campus*

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Requestor phone number*

Are you the end user for the printer? *

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End User Contact Name*

End User Phone Number*

Contract Billing Contact

Contract Billing Contact Email

Contract Billing Contact Phone

Current Equipment Information

Is your request to replace an existing machine?*

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Current Device Make*

Current Device Model*

Current Device Serial Number*

Current Device ID Number*

Photo of Current Device You are wanting to Replace if Applicable

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New Equipment Information

Color Device?*

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Print Tracking (Copy Codes)*

Do you utilize "Copy Codes" to track printing within departments/users utilizing this device?

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Fax*

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Envelope Printing*

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11x17*

Adds $1,000+ to machine cost.

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Graphics quality color requirement*

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What is the most common size you are printing?*

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What are you scanning?*

8.5 x 11 Documents

ID Cards

Books

11x17 Documents

What do you print on your wide format?*

Graphics (high coverage)

Technical Documents (low coverage)

Label Requirements*

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Timeline of Purchase*

Immediate (need device for new install or current device is non-functioning)

Soon (current device is having service issue or need device for new install)

Budgetary (requesting quote for budgetary purposes for next Fiscal Year)

Other

List any other features you are needing on your new device

Most of our jobs are:*

Example: Short run = 10 page document

Long run = 200, 15 page exams

Short Run

Long Run

Specialty Media

Do you need to print on any type of specialty media (ex: Cardstock, Glossy Paper, etc)? If so, please list what type of media you are currently using:

Estimated Monthly Page Usage

Other devices located in general area of request:

Copier/Multi-Function Devices:

Printers:

Scanners:

Faxes:

What power outlet do you have?*

Help me pick

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Send me a copy of my responses

Contact Information

Current Equipment Information

New Equipment Information