Purchase Order

Contact Name:
Company Name:
Address:
Suite:
City:
State:
Zip Code:
Phone Number:
Fax Number:
E-mail Address:
Total staff at your location:
How did you hear about BalaBoss?		If other please specify:
Which Time & Billing software do you use?		If other please specify:
Which Tax software do you use?		If other please specify:
Workstation Operating System
Network		if other please specify
BalaBoss Client Navigator
Qty	Description		Unit	Total
	Single User License		$499
	Five User License		$799
	Ten User License		$1,499
	Twenty-five User License		$3,699
	Additional User Licenses (to any of the above)		$199
	Sub Total
	Shipping and Handling		$29
	Sub Total
	Applicable taxes
	Data Conversion Deposit	Optional deposit of $500 to reserve data conversion service @ 25 cents/client subject to minimum of $500
	Total
Payment method
Payment must precede delivery
Check Visa		Cardholder Name
		Card Number
		Card Expiry MMYY
	Signature
	Date

User licenses include free updates and technical support for one year from date of purchase. System requirements: Personal computer with a 486 or higher processor (Pentium processor recommended) ; Microsoft Windows 95 or Windows 98 operating systems (will not run on earlier versions of Windows) ; 32 MB of RAM (64MB recommended) ; 50 MB of available hard disk space ; VGA or higher resolution video adapter ; On installation: Access to a local or network CD drive
INSTRUCTIONS Complete the form above then Print and Fax to (905) 771-1924 OR Click SUBMIT