REQUEST FOR QUOTE
PAGE __ of __
CUSTOMER INFORMATION
Company _______________________________________________
Contact Name
_______________________________________________
_______________________________________________
Telephone (s) _______________________________________________
Address
_______________________________________________
_______________________________________________
_______________________________________________
_______________________________________________
Item #
Option Number
Option Name
Quantity
Required
FAX TO: Ross Video Limited, P.O. Box 220, 8 John St., Iroquois, ON., Canada K0E 1K0
Fax. (613) 652-4425
Page 48 of 48
March 2005
Synergy 3.5 MD-X Ordering Guide, v3