Requisition Supplies/Materials Form

Optima Purchase Order Form
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Dealer Company Name
Requesters Name

First NameLast Name
Terms of Payment
How many Optima Rewards points would you like to use towards your purchase?
*To check your points balance, log into the Dealer Portal. Your points total will be displayed at the top, next to your name. If you have any questions, please don't hesitate to contact us.
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Products List
POS Systems

APOS Series

Rows	Quantity Requested
1. APOS-01: 6” Portable Touch Screen System
2. APOS-02: 8” Touch Screen System
3. APOS-03: 8” Touch Screen System
4. APOS-04: 10” Touch Screen System
5. APOS-05L: 12” Touch Screen System
6. APOS-05: 15.6” Touch Screen System

WPOS-Series

Rows	Quantity Requested
1. WPOS-05: 15.6" Windows Based POS Terminal

Scales

Rows	Quantity Requested
1. OPT-OSGX-30: POS Interface Scale

Receipt and Kitchen Printers

Rows	Quantity Requested
1. OPT-P100: Thermal Receipt Printer 3 1/8” (80mm)
2. P200 Thermal Printer (2 1/4” paper size)
3. OPT-P250: Thermal Receipt Printer 2 ¼” (58mm)
4. OPT-150KP: Thermal Kitchen Printer 3 1/8” (80mm)
5. OPT-P300-BR: Dot Matrix Kitchen Printer 80mm (3 1/8")

Kitchen Display

Rows	Quantity Requested
1. OPT-KP: Kitchen Display

Pole Display

Rows	Quantity Requested
1. APOS-E2PD: External 2-Line USB Pole Display
2. OPT-EPD7: APOS 7” remote pole display
3. OPT-EPD10: APOS 10” remote pole display

Cash Drawers

Rows	Quantity Requested
1. OPT-4141: 4 or 5 Adjustable Bill Holder ,410(W) x 420(D) x 100(H)mm

Barcode Scanners

Rows	Quantity Requested
1. OPT-5000: 2D & 1D Omni Ddesktop Barcode Scanner
2. OPT-3500-CD: 1D/2D Wireless Hand held Barcode Scanner & USB Data (Crade Dock) with Bluetooth
3. OPT-3500-AT: 1D/2D Wireless Hand held Barcode Scanner & Stand with Bluetooth

Stands

Rows	Quantity Requested
1. OPT-04S: Utility Stand for APOS-04

Optima Purchase Order Form