Ross Synergy 2 SD - Customer Information

Page 40 of 40 September 2005 Synergy 2 SD Ordering Guide, v16A
REQUEST FOR QUOTE
PAGE __ of __
CUSTOMER INFORMATION
Company ______________________________________________
Contact Name ______________________________________________
E-mail ______________________________________________
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