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Name:
Telephone:
Email (if available):
Organization:
Service Street Address:
Service City, State, Zip:
Current Technology Provider:
Annual Technology Budget:
Number of users:
Number of desktop computers:
Number of servers or network appliances:
Operating Systems (Windows, Mac, UNIX; list all):
Internet Access Type:
Hardware Devices or Appliances to be supported (please list all):
Software Applications to be supported (please list all):
Other special requirements (certifications, experience, etc.):
Contract Period Requested:
Support Hours Requested:
Response Time Requested:
Other Comments:

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