Panduit IOT Software Fulfillment Form /

This form will be used to provide contact details for your Panduit IOT software order delivery & CAMA. Please provide the contact information below for the party(s) who shall receive the software license key, download instructions and End User License Agreement. Return form to

SOFTWARE*: NEW ☐ ADD ON: ☐ DEMO: ☐ REQUESTOR*: Enter Name Sensors*: QTY DATE*: Enter Date
CAMA CONTRACTS*: NEW:☐ RENEWAL:☐ - For Renewals, NO PROJECT Information Required
Panduit Annual Maintenance Agreement Number of year(s)*: Enter Number of years START DATE*: Enter Date
Panduit Existing CAMA Contract # (Renewals Only): Enter CAMA Contract # Current No. of Sensors*: QTY
Partner Information (PO Initiator)
Company Name[1]: / Click here to enter company.
Contact Name*: / Click here to enter contact name.
Street Address*: / Click here to enter text.
City: / enter city. / Zip Code: / enter zip. / State: / enter state.
Country: / enter country / Phone: / Click here to enter phone number.
Email*: / Click here to enter email. / Partner Order No.*: / Click here to enter text.
End User Information (Entity/Location of Software Installation)
Company Name*: / Click here to enter company.
Contact Name*: / Click here to enter contact name.
Street Address*: / Click here to enter text.
City*: / enter city. / Zip Code*: / enter zip. / State*: / enter state.
Country*: / enter country / Phone: / Click here to enter phone number.
Email*: / Click here to enter email.
Project Information
Project Name: / Click here to enter project name.
Project Location: / Click here to enter project location.
Start Date: / Click here to enter implementation date. / End Date: Click here to enter Date
Number of Sensor* / Click here to number of sensors.
Professional Services Involved*: / Panduit: ☐ Partner:☐ None: ☐
CRM OPP #*: Enter # / Special Instructions Click here to enter special instructions.
ENTER THE QTY FOR EACH SOFTWARE PART NUMBER ORDERED ON PAGE 2
Quantity / IOT Part Number / Description
QTY / IOT-9SW10DEMO / 900 MHz Enterprise DEMO License 90 Days (10 Sensor)
QTY / IOT-9SW50S / 900 MHz Enterprise Annual Subscription License and Support & Maintenance (50 Sensor)
QTY / IOT-9SW250 / 900 MHz Enterprise Perpetual License (250 Sensor)
QTY / IOT-9SW2K / 900 MHz Enterprise Perpetual License (2000 Sensor)
QTY / IOT-9SW250M / 900 MHz Enterprise Annual Support & Maintenance (250 Sensor)
QTY / IOT-9SW2KM / 900 MHz Enterprise Annual Support & Maintenance (2000 Sensor)
QTY / IOT-9CSW6 / 900 MHz Cloud Annual Subscription License and Support & Maintenance (6 Sensor)
QTY / IOT-9CSW25 / 900 MHz Cloud Annual Subscription License and Support & Maintenance (25 Sensor)
QTY / IOT-9CSW50 / 900 MHz Cloud Annual Subscription License and Support & Maintenance (50 Sensor)
QTY / IOT-9CSW100 / 900 MHz Cloud Annual Subscription License and Support & Maintenance (100 Sensor)
QTY / IOT-9CSW500 / 900 MHz Cloud Annual Subscription License and Support & Maintenance (500 Sensor)
QTY / IOT-9CSW999 / 900 MHz Cloud Annual Subscription License and Support & Maintenance (999 Sensor)
QTY / IOT-2SW250 / 2.4 GHz Perpetual Software License (250 sensor)
QTY / IOT-2SW2K / 2.4 GHz Perpetual Software License (2000 sensor)
QTY / IOT-2SW250M / 2.4 GHz Annual Support and Maintenance (250 sensor)
QTY / IOT-2SW2KM / 2.4 GHz Annual Support and Maintenance (2000 sensor)
IOT-FRM-0000-01
©2017 Panduit Corp. All rights reserved / Page 1 of 2 / 10/25/2017

[1] Required Field