| REQN No.: |
*
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Existing WSU Contract No.: |
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| Org Unit No.: |
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Department Name: |
*
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Physical location of equipment.
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| Unit Name: |
*
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Building and Room #: |
*
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| City: |
*
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State: |
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| Zip Code: |
*
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| Technical Contact Name: |
*
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Technical Contact email: |
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| Phone Number: |
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Fax Number: |
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Contract Information.
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| Contract Type: |
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| Contract Action: |
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| Contract Length: |
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| Contract Monthly Rate: |
*
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Per copy rate-black & white: |
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| Per copy rate-color: |
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Equipment Information.
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| Equipment Vendor Name: |
*
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Equipment Brand: |
*
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| Equipment Model: |
*
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Serial No.of existing: |
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| Comments: |
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