Special Quote Request
 
 
 
 
 
 
 
 
 
 
Date Response Required*
 
 
 
 
 
Contact Information: 
 
 
 
Submitted By*
 
 
 
Email*
 
 
 
Business Phone*
 
 
 
Company Name*
 
 
 
Country [Please Select]*
 
 
 
 
 
Customer Information (if none, write "none") : 
 
 
 
Reseller Company Name*
 
 
 
End User Company Name*
 
 
 
End User First Name
 
 
 
End User Last Name
 
 
 
End User Email
 
 
 
End User Country [Please Select]
 
 
 
 
 
 
Distributor : 
 
 
 
 
Sourcing Distributor of Choice*
 
 
 
 
 
 
Special Quote Request : 
 
 
 
 
Product Category *
 
 
 
Product (PNY reference or product name)*
 
 
 
Quantity*
 
 
 
Unit Per System*
 
 
 
Current Distribution Cost*
 
 
 
Requested Distribution Cost*
 
 
 
Competitor(s) if N/A, write 'none'*
 
 
 
Competitive Cost*
 
 
 
 
 
 
Add an additional Special Quote Request
 
 
 
 
 
 
Product Category
 
 
 
Product (PNY reference or product name)
 
 
 
Quantity
 
 
 
 
Unit Per System
 
 
 
Current Distribution Cost
 
 
 
Requested Distribution Cost
 
 
 
Competitor(s) if N/A write 'none'
 
 
 
Competitive Cost
 
 
 
 
 
 
Project Information : 
 
 
 
 
Project Start Date*
 
 
 
 
Project End Date*
 
 
 
 
Intended Use Case / Application*
 
 
 
Justification to Consider Special Pricing*