Supply Order Form Perceptive Media Writer D200, D100, D35...
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SUPPLY KITS CD/DVD MEDIA e c i r P e c i r P t i n U n o i t p i r c s e D t c u d o r P r e b m u N t r a P y t i t n a u Q Subtotal Subtotal of all sections Sales Tax Total PER9146 PER9133 PER9134 PER9135 High yield CYAN (C) ink cartridge (1) for Discproducer, prints approximately 1000 discs High yield LIGHT MAGENTA (LM) ink cartridge (1) for Discproducer, prints approximately 1000 discs High yield MAGENTA (M) ink cartridge (1) for Discproducer, prints approximately 1000 discs High yield LT CYAN (LC) ink cartridge (1) for Discproducer, prints approximately 1000 discs PER9138 High yield BLACK (K) ink cartridge (1) for Discproducer, prints approximately 1000 discs PER9136 Media Writer D200 / D100 Replacement ink cartridge – Black Media Writer D200 / D100 Replacement ink cartridge – Cyan 1000 Perceptive water repellent CDs, Discproducer ink cartridges (6) Media Writer D200 / D100 Replacement ink cartridge – Lt Cyan Media Writer D200 / D100 Perceptive CD Supply Kit PER9145 1000 Perceptive Premier CDs, Discproducer ink cartridges (6) Media Writer D200 / D100 Perceptive Premier CD Supply Kit Media Writer D200 / D100 Replacement ink cartridge – Magenta Media Writer D200 / D100 Replacement ink cartridge – Lt Magenta PER9137 PER9127 PER9126 High yield YELLOW (Y) ink cartridge (1) for Discproducer, prints approximately 1000 discs Media Writer D200 / D100 Replacement ink cartridge – Yellow CD-R Media, 50 discs, 700MB, 52x, glossy white, water resistant surface CD-R Media, 50 discs, 700MB, 52x, non-glossy white, water repellent surface Perceptive CDs (50) Perceptive Premier CDs (50) Perceptive Premier DVDs (50) PER9132 Media Writer D200 / D100 Replacement color ink cartridges High yield color ink cartridges (6) for Discproducer, prints approximately 1000 discs Perceptive Media Writer D200 / Perceptive Media Writer D100 INK CARTRIDGES Supply Order Form Perceptive Media Writer D200, D100, D35 Perceptive MDR Video Billing Address is Same as Shipping Address Billing Address: Shipping Address: Facility: _____________________________________________ Address: _____________________________________________ Address 2: _____________________________________________ Address 3: _____________________________________________ City: __________________________ State: ____________ Zip Code: __________________ Country: _________________ Phone: _____________________________________________ Facility: _____________________________________________ Address: _____________________________________________ Address 2: _____________________________________________ Address 3: _____________________________________________ City: __________________________ State: ____________ Zip Code: __________________ Country: _________________ 4309 Hacienda Drive, Suite 500 Pleasanton, California 94588 USA Use Credit Card Info Payment Information (select one, required): PO Attached Perceptive Media Writer Supply Order Form Perceptive Software For questions, please contact Perceptive Software at [email protected] Fax completed form to +1 913 495 8825 Contact Name: ______________________________________________________ Contact Email: ______________________________________________________ Contact Phone: ______________________________________________________ Credit Card Type: ______________________________________________________ Credit Card #: ______________________________________________________ Expiration Date: ____________________ Security Code: ___________________ Name on Card: ______________________________________________________ Signature: ______________________________________________________ Ground shipping included with all orders PER9328 DVD-R Media, 50 discs, 4.7GB, 16x, glossy white, water resistant surface PER9332 Media Writer D200 / D100 Perceptive Premier DVD Supply Kit 1000 Perceptive Premier DVDs, Discproducer ink cartridges (6) Email (required): ___________________________________________
Transcript of Supply Order Form Perceptive Media Writer D200, D100, D35...
SUPPLY KITS
CD/DVD MEDIAecirPecirP tinUnoitpircseDtcudorPrebmuN traPytitnauQ
Subtotal
Subtotal ofall sections
Sales Tax
Total
PER9146
PER9133
PER9134
PER9135
High yield CYAN (C) ink cartridge (1) for Discproducer, prints approximately 1000 discs
High yield LIGHT MAGENTA (LM) ink cartridge (1) for Discproducer, prints approximately 1000 discs
High yield MAGENTA (M) ink cartridge (1) for Discproducer, prints approximately 1000 discs
High yield LT CYAN (LC) ink cartridge (1) for Discproducer, prints approximately 1000 discs
PER9138 High yield BLACK (K) ink cartridge (1) for Discproducer, prints approximately 1000 discs
PER9136
Media Writer D200 / D100 Replacement ink cartridge – Black
Media Writer D200 / D100 Replacement ink cartridge – Cyan
1000 Perceptive water repellent CDs, Discproducer ink cartridges (6)
Media Writer D200 / D100 Replacement ink cartridge – Lt Cyan
Media Writer D200 / D100 Perceptive CD Supply Kit
PER9145 1000 Perceptive Premier CDs, Discproducer ink cartridges (6)
Media Writer D200 / D100 Perceptive Premier CD Supply Kit
Media Writer D200 / D100 Replacement ink cartridge – Magenta
Media Writer D200 / D100 Replacement ink cartridge – Lt Magenta
PER9137
PER9127
PER9126
High yield YELLOW (Y) ink cartridge (1) for Discproducer, prints approximately 1000 discs
Media Writer D200 / D100 Replacement ink cartridge – Yellow
CD-R Media, 50 discs, 700MB, 52x, glossy white, water resistant surface
CD-R Media, 50 discs, 700MB, 52x, non-glossy white, water repellent surface Perceptive CDs (50)
Perceptive Premier CDs (50)
Perceptive Premier DVDs (50)
PER9132 Media Writer D200 / D100 Replacement color ink cartridges
High yield color ink cartridges (6) for Discproducer, prints approximately 1000 discs
Perceptive Media Writer D200 / Perceptive Media Writer D100
INK CARTRIDGES
Supply Order FormPerceptive Media Writer D200, D100, D35
Perceptive MDR Video
Billing Address is Same as Shipping Address
Billing Address:Shipping Address:
Facility: _____________________________________________
Address: _____________________________________________
Address 2: _____________________________________________
Address 3: _____________________________________________
City: __________________________ State: ____________
Zip Code: __________________ Country: _________________
Phone: _____________________________________________
Facility: _____________________________________________
Address: _____________________________________________
Address 2: _____________________________________________
Address 3: _____________________________________________
City: __________________________ State: ____________
Zip Code: __________________ Country: _________________
4309 Hacienda Drive, Suite 500Pleasanton, California 94588 USA
Use Credit Card Info
Payment Information (select one, required):
PO Attached
Perceptive Media Writer Supply Order FormPerceptive Software
For questions, please contact Perceptive Software at [email protected] completed form to +1 913 495 8825
Contact Name: ______________________________________________________
Contact Email: ______________________________________________________
Contact Phone: ______________________________________________________
Credit Card Type: ______________________________________________________
Credit Card #: ______________________________________________________
Expiration Date: ____________________ Security Code: ___________________
Name on Card: ______________________________________________________
Signature: ______________________________________________________
Ground shipping included with all orders
PER9328 DVD-R Media, 50 discs, 4.7GB, 16x, glossy white, water resistant surface
PER9332 Media Writer D200 / D100 Perceptive Premier DVD Supply Kit
1000 Perceptive Premier DVDs, Discproducer ink cartridges (6)
Email (required): ___________________________________________
INK CARTRIDGES
Perceptive Media Writer D35
CD/DVD MEDIAecirPecirP tinUnoitpircseDtcudorPrebmuN traPytitnauQ
Subtotal
PER9126
PER9143
CD-R Media, 50 discs, 700MB, 52x, glossy white, water resistant surface
300 Perceptive water repellent CDs, one Bravo SE ink cartridge
PER9127 CD-R Media, 50 discs, 700MB, 52x, non-glossy white, water repellent surface
Perceptive CDs (50)
Perceptive Premier CDs (50)
Perceptive Premier DVDs (50)
Media Writer D35 CD Perceptive Supply Kit
PER9142 300 Perceptive Premier CDs, Media Writer D35 CD Perceptive Premier CD Supply Kit
Media Writer D35 Replacement color ink cartridge
High yield color ink cartridge for Bravo SE, prints approximately 300 discs
Perceptive MDR Video
SUPPLY KITS
CD/DVD MEDIAecirPecirP tinUnoitpircseDtcudorPrebmuN traPytitnauQ
Subtotal
PER9126
PER9140
CD-R Media, 50 discs, 700MB, 52x, glossy white, water resistant surface
300 Perceptive water repellent CDs,one DUET 46 ink cartridge
PER9127 CD-R Media, 50 discs, 700MB, 52x, non-glossy white, water repellent surface
Perceptive CDs (50)
Perceptive Premier CDs (50)
Perceptive Premier DVDs (50)
MDR Video / Media Writer D30 Perceptive CD Supply Kit
PER9139 300 Perceptive Premier CDs, one DUET 46 ink cartridgeMDR Video / Media Writer D30 Perceptive Premier CD Supply Kit
PER9130 MDR Video / Media Writer D30 Replacement color ink cartridge
DUET 46 color ink cartridge for DUET 400/MDR VideoPrints approximately 300 discs
See previous page for shipping and billing information.For questions, please contact Perceptive Software at [email protected]
Fax completed form to +1 913 495 8825
W Perceptive Media riter Supply Order FormPerceptive Software
SUPPLY KITS
INK CARTRIDGES
PER9131
Supply Order FormPerceptive Media Writer D200, D100, D35
Perceptive MDR Video
PER9328 DVD-R Media, 50 discs, 4.7GB, 16x, glossy white, water resistant surface
PER9333 Media Writer D35 DVD 300 Perceptive Premier DVDs, one Bravo SE ink cartridge
PER9328 DVD-R Media, 50 discs, 4.7GB, 16x, glossy white, water resistant surface
PER9334 MDR Video / Media Writer D30 Perceptive Premier DVD Supply Kit
300 Perceptive Premier DVDs, one DUET 46 ink cartridge
Perceptive Premier DVD Supply Kit
one Bravo SE ink cartridge
