Pricing Request Form

End User Details

End user Company Name:

End User Address:

Head Office Location (STATE)

Value is required

Industry

Value is required

Web address:

Primary Contact First Name:

Primary Contact Last Name:

Value is required

Primary Contact Email:

Date product required:

Reseller Details

Company Name:

Address:

Primary Contact Name:

Primary Contact Email:

Primary Contact phone number:

Competitors Information

What are the competitive risks?

Value is required

Who are the competitors?

Value is required

Competition Model(s)?

Value is required

Competitive price offered.

Value is required

Distributor Details

Distributor Company Name:

Distributor Contact Name:

Product Code	Quantity	Target Price*	Order Type	Rollout Period

What is the End User buying criteria?

Value is required

How are we (Targus and Partner) placed to satisfy the End User requirements?

Is engagement strategic or tactical with this End User?

Value is required

Bid Details

Requested BID validity period:

Value is required

Single drop or roll-out?

Value is required

Opportunity Notes

Pricing Request Form

TARGUS PRICING REQUEST FORM

End User Details

Reseller Details

Competitors Information

Distributor Details

Bid Details