Distributor Bid Request

This form is for use in competitive bid situations. Minimum quantity requirements apply per the list below.

Brand	Product Line	Minimum Quantity or Amount
Chief	Mounts	100 or $10,000
Chief	Electric Lifts	10
Da-Lite	Manual Screens (Tripod, Model B, IDEA Screens)	10
Da-Lite	Manual Screens (Model C, Advantage Manual)	5
Da-Lite	Electric Screens	3
Da-Lite	Fixed Frame and Fast-Fold Screens	$8,000
Da-Lite	Wireline	2
Vaddio	All Products - Discount is available for Design/Specifier Only	$10,000
Luxul	All Products - Discount is available for Design/Specifier Only	$10,000
MAP	All Products excluding ISOCenter, Viewpoint, GRK products, and Wiremold	$10,000
C2G	All Products	$1,000

Company Contact Information

Distributor Name*

Account Number*

Country* Select one... United States Canada Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua And Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia And Herzegowina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos Keeling Islands Colombia Comoros Congo Congo The DRC Cook Islands Costa Rica Cote DIvoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France France Metropolitan French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard And MC Donald Islands Holy See Vatican City State Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea DPRO Korea Rebuplic Of Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Federated States Of Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Burma Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Kitts And Nevis Saint Lucia Saint Vincent And The Grenadines Samoa San Marino Sao Tome And Principe Saudi Arabia Scotland Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia And South SS South Korea Spain Sri Lanka St Helena St Pierre And Miquelon Sudan Suriname Svalbard And Jan Mayen Islands Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania United Republic Of Thailand Togo Tokelau Tonga Trinidad And Tobago Tunisia Turkey Turkmenistan Turks And Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay US Minor Islands Uzbekistan Vanuatu Venezuela Vietnam Virgin Islands British Virgin Islands US Wales Wallis And Futuna Islands Western Sahara Yemen Yugoslavia Serbia And Montenegro Zambia Zimbabwe

Street Address*

City*

State/Province*

Zip/Postal Code*

Contact First Name*

Contact Last Name*

Email*

Phone*

Project Job Information

Reseller Name*

Reseller Contact Information Tip: Include name, email address, and/or phone number.

Project Name*

Project Country* Select one... United States Canada Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua And Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia And Herzegowina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos Keeling Islands Colombia Comoros Congo Congo The DRC Cook Islands Costa Rica Cote DIvoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France France Metropolitan French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard And MC Donald Islands Holy See Vatican City State Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea DPRO Korea Rebuplic Of Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Federated States Of Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Burma Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Kitts And Nevis Saint Lucia Saint Vincent And The Grenadines Samoa San Marino Sao Tome And Principe Saudi Arabia Scotland Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia And South SS South Korea Spain Sri Lanka St Helena St Pierre And Miquelon Sudan Suriname Svalbard And Jan Mayen Islands Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania United Republic Of Thailand Togo Tokelau Tonga Trinidad And Tobago Tunisia Turkey Turkmenistan Turks And Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay US Minor Islands Uzbekistan Vanuatu Venezuela Vietnam Virgin Islands British Virgin Islands US Wales Wallis And Futuna Islands Western Sahara Yemen Yugoslavia Serbia And Montenegro Zambia Zimbabwe

Project Street Address*

Project City*

State/Province*

Zip/Postal Code*

Expected Decision Date*

Anticipated Installation Date*

Architect

Consultant

Are Legrand AV products recommended on End User's Bid? YesNo

Is this your design? YesNo

If you designed it then please make your Legrand AV field sales rep aware and forward a copy of the specification and any supporting documentation to av.bids@legrand.com.

End User Information

End User Company Name*

End User Country Select one... United States Canada Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua And Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia And Herzegowina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos Keeling Islands Colombia Comoros Congo Congo The DRC Cook Islands Costa Rica Cote DIvoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France France Metropolitan French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard And MC Donald Islands Holy See Vatican City State Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea DPRO Korea Rebuplic Of Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Federated States Of Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Burma Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Kitts And Nevis Saint Lucia Saint Vincent And The Grenadines Samoa San Marino Sao Tome And Principe Saudi Arabia Scotland Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia And South SS South Korea Spain Sri Lanka St Helena St Pierre And Miquelon Sudan Suriname Svalbard And Jan Mayen Islands Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania United Republic Of Thailand Togo Tokelau Tonga Trinidad And Tobago Tunisia Turkey Turkmenistan Turks And Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay US Minor Islands Uzbekistan Vanuatu Venezuela Vietnam Virgin Islands British Virgin Islands US Wales Wallis And Futuna Islands Western Sahara Yemen Yugoslavia Serbia And Montenegro Zambia Zimbabwe

End User Street Address

End User City

End User State/Province

End User Zip/Postal Code

End User Contact Name

End User Contact Title

End User Phone Number

End User Email Address

Products to Quote

Competitive Product Information (if applicable)

Additional Comments