Toshiba Special Bid Requests

*Fields noted with an asterisk are required.

Reseller Information

Account Number:*
Account Name:*
Address:*
Assigned Sales Rep:*
Contact Name:*
Contact Phone Number:*

End User Information

Business Name:*
Contact Name:*
Address:*
Phone:*
Email:*

Cart(s)

Machine Type/Model* Quantity* List Price Cart Name

Additional Information

Type of Pricing Request:*
What is the specific name of the Toshiba Value-Add being applied on this bid?:*
By what name does the end user refer to this project/opportunity?:*
TARGET END USER PRICE or discount (price from Business Partner to End User)?:*
What PRICE or discount for ScanSource is requested?:*
Rollout Start Date:*
Volume Per Month:*
Type Of Bid:*
Provide details (as much as possible) of your special bid request:*

Competitive Offering

What is the 'apples to apples' competitive offering with pricing to the best of your knowledge

Product Price to the End User Description


Special Bid Renewals

For each special bid renewal request, please provide the following information:

Quote #* Reason for Renewal*


Attachments

If using POS Technology Integration as VAE, please attach letter from end user (must be on their letterhead)