Ricoh Printing Solutions Division

Ricoh Printing Solutions Division Authorized Service Provider Application

Date: Ricoh Partner ID (if applicable): Company: DBA (if applicable): Number of locations: (If more than one (1), please fill out the Additional Location Section) Address: City: State: ZIP Code: Country: Phone: Fax: Website: E-mail: Years in Business: Federal Tax ID#:

Billing Address: Same as main company address (if not, please fill out below) Address: City: State: ZIP Code: Country: Phone: Fax:

Primary Contact: Name: Position / Title: Same as main company address (if not, please fill out below) Address: City: State: ZIP Code: Country: Phone: Fax:

What are your company’s approximate total annual sales? Less than $100,000 Between $3 million and $5 million Between $100,000 and $500,000 Between $5 million and $10 million Between $500,000 and $1 million More than $10 million Between $1 million and $3 million

Authorized Service Provider Application 1 Submit via email to [email protected] Confidential Submit via fax to (678) 597-3506 Ricoh Printing Solutions Division Authorized Service Provider Application Questions: 1) Are you (check one): Regional Reseller National Reseller Self Service Provider Name of Company: Designated Service Org. Name of Account:

2) Please indicate the number of technical people that are directly employed b your company. Service Management Service Technicians Microsoft/Novell Certified Technicians Other Certified Technicians Certification(s):

3) How many of your service technicians do you plan to train on Ricoh printers / scanners?

4) What laser printers or scanners do you currently service? Service Authorized by Manufacturer Product Line(s) Manufacturer? Yes No

5) What other products do you currently service? Service Authorized by Manufacturer Product Line(s) Manufacturer? Yes No

Authorized Service Provider Application 2 Submit via email to [email protected] Confidential Submit via fax to (678) 597-3506 Ricoh Printing Solutions Division Authorized Service Provider Application 6) What is your response time target for the products listed in questions 4 and 5? Hours

7) Have you had experience servicing color laser printers? YES NO

8) Describe your service escalation process.

9) Do you have a Customer Satisfaction Measurement System? YES NO If YES, please attach a description of your system or a copy of your survey form.

10) Describe the geographic area you will be servicing. Please be as specific as possible and attaché a list of ZIP codes serviced by your company if available.

11) Identify the Ricoh product(s) you wish to be authorized on.

THANK YOU FOR YOUR INTEREST IN RICOH PRODUCTS AND SERVICES!

Authorized Service Provider Application 3 Submit via email to [email protected] Confidential Submit via fax to (678) 597-3506 Ricoh Printing Solutions Division Authorized Service Provider Application Provide address for all service locations If you need more space for additional locations, please forward a list that includes the requested information to your Ricoh Channel Account Manager Address: City: State: ZIP Code: Country: Phone: Fax:

Address: City: State: ZIP Code: Country: Phone: Fax:

Authorized Service Provider Application 4 Submit via email to [email protected] Confidential Submit via fax to (678) 597-3506