Shannon Prince

Submit an Order
Salesperson Name
Customer Name
OR
Select a Preset Customer
SFMC Location
St. Anthony Location
Little Company of Mary Location
St. James Location
St. Joseph Location
OSF Holy Family Location
St. Elizabeth Location
OSF Heart of Mary Location
OSF Sacred Heart Location
OSF Location
OSFMG Location
Is there a project number associated with this order?*

YesNo
Design Number*
Project Name*
View, Edit, or Submit Install Quote*

Yes - Go to Install Quote

Install Quote
Quote Number*
Quoted Cost*
Quoted Install Hours*
Suggested Sell 33%
Install Sell
Quoted Notes
NOTE: If revised quote is needed, please remove Install Cost then go back to the previous page and resubmit
Install Quote Upload

Upload a File

Cancelof
Completed By
PM Suggested:

Yes

Customer
Is there a design number associated with this order?*

YesNo
Design Number*
Billing Address - Do not include Business Name*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Billing Address (Preset)
Contact 1*
Purpose of Contact 1*
Contact Phone*
Contact Email
Contact 2
Purpose of Contact 2
Contact Phone

Area Code Phone Number
Contact Email
Add Additional Contact

Yes
Contact 3
Purpose of Contact 3
Contact Phone

Area Code Phone Number
Contact Email
Credit Card?

YesNo

Credit Card
Cardholder's Name*

First Name Last Name

Direct Ship
Check box if shipping address is the same as the billing address
Shipping Address - Do not include Business Name*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Shipping Address (Preset)*
Tag

Deliver and Install (Contract Installer)
Install Company*
OR
Preset Contract Installer
Shipping Address - Do not include Business Name*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Warehouse Shipping Address (Preset)*
Contract Install Contact*

First Name Last Name
Contract Install Contact Phone

Area Code Phone Number
Contract Install Contact Email
Check box if installation address is the same as the billing address
Installation Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Installation Address (Preset)*
Tag
Install Quote
Quote Reference
i.e. Quote number, MRI rate sheet...
Quoted Cost*
Install Sell*

Salesperson to Deliver
Ship-To Location*

PeoriaRockfordBloomington
Delivery Charge?

YesNo
Amount:

Rate Sheet
Installation Sell*
Upload Rate Sheet*

Hourly
Hourly Rate*
Notes for Hourly Rate

Vendors
Vendor
Other Vendor
HMI Contract
Contract
HON Contract
Humanscale Contract
Humanscale Spiff
Spiff
Freight*
Bill Freight at
Bill Freight at
Vendor 2
Other Vendor 2
HMI Contract 2
Contract 2
HON Contract 2
Humanscale Contract 2
Humanscale Spiff 2
Spiff 2
Freight 2
Bill Freight 2 at
Bill Freight 2 at

Notes
Order Notes
i.e. invoicing instructions, special freight instructions, etc.
Scheduling Notes
i.e. instructions for scheduling installation, target dates, etc.
Installation Notes
i.e. specific installation instructions for lead installer, etc.
Upload other Supporting Documents

Proposal, Customer PO, Account Application, Vendor Quotes, GSA Paperwork, etc.
Upload File

Upload a File
You can upload any type of file. Max: 300 MB Cancelof
Should be Empty: