North America Options Worksheet (OWS)

Analog Telephones ONLY

Every Section of this form must be completely filled out prior to acceptance by Cetis.

Section 1

NOTE: Section 1 should ONLY be completed by the company purchasing directly from Cetis, Inc. If you are completing this form on behalf of the end user, Section 3 is also required.

Distributor / Dealer Company Name:

Contact Name:	Email Address:

Purchase Order Number:	Telephone Number :

Fax Number:	On Site Date:

Country of Ultimate Destination (required field for ALL orders):

Section 2

NOTE: If you are a reseller that has purchased Cetis products from a Master Distributor (not directly from Cetis) please complete Section 2 and email this document back to the Master Distributor from whom you have purchased our products. Please do not complete the information in Section 1.

Reseller Company Name:	Contact Name:

Email Address:

Telephone Number (Include Country Code, if applicable):

Section 3: End User Information (Required)

NOTE: If you are a hotel or end user, complete Section 3. Please do not populate either Section 1 or Section 2 above. Once complete, please email this document back to the Cetis Partner from whom you purchased your products. Do not send this form directly back to Cetis.

Hotel or End User Name:

City:	State:	Country:

Telephone Number (Include Country Code, if applicable):

Contact Name:	Email Address:

Section 4

Model Number (1):	Part Number:

Custom Printed Paper Faceplates:	Pre-Programming of Memory Keys*:

Telephone Color:	Describe Other:

Model Number (2):	Part Number:

Custom Printed Paper Faceplates:	Pre-Programming of Memory Keys*:

Telephone Color:	Describe Other:

Model Number (3):	Part Number:

Custom Printed Paper Faceplates:	Pre-Programming of Memory Keys*:

Telephone Color:	Describe Other:

Model Number (4):	Part Number:

Custom Printed Paper Faceplates:	Pre-Programming of Memory Keys*:

Telephone Color:	Describe Other:

Model Number (5):	Part Number:

Custom Printed Paper Faceplates:	Pre-Programming of Memory Keys*:

Telephone Color:	Describe Other:

NOTE: For Trimline telephone orders, please check the appropriate box.

6 Inch Line Cord

15 Foot Line Cord

(*) NOTE: All Scitec, Teledex & TeleMatrix telephones with memory keys come with pre-programmed factory defaults such as *24101 through *24111 in the case of a 10 memory key model (i.e. Diamond +10). These codes can be translated in the PABX System for Mitel, Avaya, NEC, Nortel and Alcatel.

Section 5

PABX Manufacturer:	Other:

PABX Message Waiting:	Other:

1.	Additional charges apply for orders requiring Siemens & FSK Message Waiting Modifications.

2.	Additional Lead Times apply for orders requiring Siemens & FSK Message Waiting Modifications as follows:

A.	Orders Containing 50 units or less: 4 week lead time after receipt of completed Options Worksheet and pre-payment (if applicable).

B.	Orders containing 51 units or more: 10 week lead time after receipt of completed Options Worksheet and pre-payment (if applicable).

Section 6 (Canadian Orders Only)

Cetis supplied Commercial Invoice:

NOTE: Cetis Supplied Commercial Invoice will include the Dealer or Distributor’s actual cost.

Dealer or Distributor supplied Commercial Invoice:

NOTE: Dealer or Distributor must supply a company generated Commercial Invoice no later than 3 (three) business days prior to shipment of products. Dealer or Distributor Supplied Commercial Invoices must have a unit value of at least the amount that Cetis is charging. Commercial Invoices with a value of less than the amount Cetis is charging will not be accepted.

Email signed commercial invoice to Customer Service (customerservice@cetisgroup.com) with “Commercial Invoice” in the Subject Line or fax to Customer Service at +719.638.8757 and include a cover page.

Certificate of Origin Required for Shipment:

Section 7

Signature:	Date:

Print Name:

Company Name:

Email completed worksheet to Customer Service (customerservice@cetisgroup.com) or fax to Customer Service at +719.638.8757 and include a cover page.

NOTE: If you are an end user or a reseller NOT purchasing directly from Cetis, please send this form back to the company from whom you purchased our products.