Order Form

Order Form
Internal Invoice number

Contact Information
Name*

First NameLast Name
Company Name*
Company Fleet
Email*
example@example.com
Additional Emails to Be CC'd on Shipment Details
example@example.com
Phone Number*
Please enter a valid phone number.
Are you a vendor putting in an order on behalf of a Customer?*

YesNo
Who is the company you are ordering for?
Please type out the full name on the client you are ordering for
Is the bill to email address the same as the contact email?*

YesNo
Bill to Email*
example@example.com
Is there a PO Number associated with this order?*

YesNo
Please Enter PO Number
IS there a subgroup associated with this order?*

YesNo
Please enter the subgroup number:*

Shipping Address
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Device Category
Device Category *
Enter the date this order is needed by*

MonthDayYear
Date
Do you need Priority Shipping for this order at an $100.00 fee?

Yes
Please verify that you are human*

Need help filling out the form? Click the link below for Full Kit and Part Descriptions and a Video Guide to help you fill out the form. Follow the link below

Product Description Link

How to Fill Out the Order Form(Video Steps)

Multiple Location Bulk orders please contact orders@utilimarc.com directly

Please Select GO9 Kit(AT&T) and Quantity you wish to order
Click Add Row to add multiple Geotab GO9 Kits(AT&T)
Geotab GO9 Kits (AT&T)

Please Select GO9 Kit(Verizon) and Quantity you wish to order
Click Add Row to add multiple Geotab GO9 Kits(Verizon)
Geotab GO9 Kits (Verizon)

Please Select GO9 Kit(Rogers) and Quantity you wish to order
Click Add Row to add multiple Geotab GO9 Kits(Rogers)
Geotab GO9 Kits (Rogers)

Please Select GO9 Kit(Telus) and Quantity you wish to order
Click Add Row to add multiple Geotab GO9 Kits(Telus)
Geotab GO9 KIts (Telus)

Please select GO Rugged Kit(AT&T) and Quantity you wish to order
Click Add Row to add multiple Geotab GO Rugged Kits(AT&T)
Geotab GO9 Rugged Kits (AT&T)

Please select GO Rugged Kit(Verizon) and Quantity you wish to order
Click Add Row to add multiple GO Rugged Kits(Verizon)
Geotab GO9 Rugged Kits (Verizon)

Please select GO Rugged Kit(Rogers) and Quantity you wish to order
Click Add Row to add multiple GO Rugged Kits(Rogers)
Geotab GO9 Rugged Kits (Rogers)*

Please select GO Rugged Kit(Telus) and Quantity you wish to order
Click Add Row to add multiple GO Rugged Kits(Telus)
Geotab GO9 Rugged Kits (Telus)*

Please Select GP9 Kit(AT&T) and Quantity you wish to order
Click Add Row to add multiple Geotab GP9 Kits(AT&T)
Geotab GP9 Kits (AT&T)

Please Select GP9 Kit(Verizon) and Quantity you wish to order
Click Add Row to add multiple Geotab GP9 Kits(Verizon)
Geotab GP9 Kits (Verizon)

Please Select Phillips device to order and Quantity you wish to order
Click Add Row to add multiple Phillips Parts
Phillips Devices

Please select the Fleethoster Device and Quantity you wish to order
Click Add Row to add multiple Fleethoster Parts
Fleethoster devices

If you have a PO Form Please upload Below
PO File Uploader

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