LibertyNET Office 4 Order and Upgrade Request

What would you like to do:

* Customer must be under a current maintenance contract. If you are unsure if your customer is still covered by a maintenance contract, contact us at 613 599-5571 x3202 or x3233

If upgrading, what
is your current version:

If other, please specify:

DEALER INFORMATION:

(for Dealer NFR, fill out customer section below instead)

Purchase Order # (optional):

Company Name:

Contact Name:

Address:

City

State/Province:

ZIP/Postal Code:

Phone:

E-mail:

CUSTOMER INFORMATION:

(and Dealers requesting NFR Licenses)

First Name:

Last Name:

Company:

Email:

Address:

City:

State:

ZIP/Postal Code:

Country:

Phone:

Industry:

DETAILS
MAC Address: (find your MAC Address)

Base system type:	Includes: Barcode and Routing Automation Module PDF and Native Viewers

LNOADD: Additional Client Licenses (Check the User Configuration Guide for reference)
Optional Software
LNOCR: OCR module (per fixed seat only)
LNOMP: Media Publisher
LNOSA: OSA Connector (per device). Requires Sharp OSA Support
LNOECOPY: eCopy Connector (per device)
Optional Services
LNOTS: Additional Technical Support, 8-hour blocks
Delivery Options

Desired FTP Password: Must contain both letters and numbers, and cannot include your company name

This Sales Order is submitted under the terms and conditions of the Liberty IMS - LibertyNET Office Reseller Agreement (LNORA). The terms of LNORA shall supersede any terms claimed or implied by any attached or referenced Purchase Order and/or other document. Liberty IMS' acceptance of this Sales Order shall be under the same conditions, unless otherwise specifically agreed.

I have read and agree with the terms and conditions above.