Date Merchant Information Name Address Phone Email Shipping Address Same as Merchant Info Name Address Phone Email Store Name Store Address Agent Name Bundle Yes No Quantiy - 1 2 3 4 5 6 7 8 9 10 Type of Database Blank Smoke Shop Blank Liquor Store Blank Convenience Store Contact Us Scanner 2D Wired Scanner 2D Wireless Scanner Quantiy - 1 2 3 4 5 6 7 8 9 10 Cash Drawer Yes No Quantiy - 1 2 3 4 5 6 7 8 9 10 Dual Pricing Yes No Percentage(%) Add-ons (not inculded in the bundle) Credit Card Terminal Pax S300 Pax A35 Pax A920 Dejavoo P1 Dejavoo QD4 Quantiy - 1 2 3 4 5 6 7 8 9 10 Credit Card Terminal Stand Yes No Label Printer Yes No Quantiy - 1 2 3 4 5 6 7 8 9 10 Label Roll Yes No Quantiy - 1 2 3 4 5 6 7 8 9 10 Battery Backup Yes No Quantiy - 1 2 3 4 5 6 7 8 9 10 5 Port Switch Yes No Quantiy - 1 2 3 4 5 6 7 8 9 10 Notes Send
