Options Worksheet – Russia & CIS Countries

VoIP Telephones ONLY

Please note that all NON Display Hospitality VoIP telephones by Cetis are Power over Ethernet (PoE) only

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

All Cetis Distributors, Dealers, and Installers (including partners that purchase through a Cetis Master Distributor) are required to complete the Cetis SIP Certification Course prior to shipment of products. Please provide the following contact information so that we may coordinate and/or confirm that this certification has been obtained. Information on the course and certification procedures can be found at: http://telematrix.thesipschool.com

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 (Include Country Code):

Fax Number:	On Site Date:

Country of Ultimate Destination:

Section 2

NOTE: If you are a reseller that has purchased Scitec, Teledex, or TeleMatrix 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):

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):

Contact Name:	Email Address:

Section 4

Model Number (1):	Part Number:	Cordless Frequency:

Custom Printed Paper Faceplates:

Telephone Color:	Describe Other:

Model Number (2):	Part Number:	Cordless Frequency:

Custom Printed Paper Faceplates:

Telephone Color:	Describe Other:

Model Number (3):	Part Number:	Cordless Frequency:

Custom Printed Paper Faceplates:

Telephone Color:	Describe Other:

Model Number (4):	Part Number:	Cordless Frequency:

Custom Printed Paper Faceplates:

Telephone Color:	Describe Other:

Model Number (5):	Part Number:	Cordless Frequency:

Custom Printed Paper Faceplates:

Telephone Color:	Describe Other:

NOTE: For orders containing Trimline IP phones, a 15 foot Ethernet cable is supplied which can be used for desk mounting applications. If you require a stub Ethernet cable for a wall mount applications, please check here

(Please use separate sheets IF ordering different models with different specifications)

Section 5

IP-PBX Manufacturer:	Other:

Section 6

Tropicalization of the Circuit Boards Required:

1.	Additional charges apply for orders requiring Tropicalization (refer to the Russia & CIS Countries Ordering Guide for prices).

2.	Additional Lead Times apply for orders requiring Tropicalization 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 50 units or more: 10 week lead time after receipt of completed Options Worksheet and pre-payment (if applicable).

Section 7

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 their 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 Russia & CIS Countries Customer Service (aroth@cetisgroup.com) or fax to Amanda Roth at +719.638.8757 and include a cover page.

Certificate of Origin Required for Shipment:

I hereby confirm that the product ordered meets the cordless frequency requirements of the geographical location where the items will be installed for use.

Section 8

Signature:	Date:

Print Name:

Company Name:

Email completed worksheet to Russia & CIS Countries Customer Service (aroth@cetisgroup.com) or fax to Amanda Roth 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 purchase our products.

Section 9

All Cetis Distributors, Dealers and Installers (including partners that purchase through a Cetis Master Distributor) are required to complete the Cetis SIP Certification Course prior to shipment of products. Please provide the following contact information so that we may coordinate and/or confirm that this certification has been obtained. Information on the course and certification procedures can be found at: http://telematrix.thesipschool.com

Installer Company Name:

Contact:

Telephone Number:

Email Address: