Reseller Orders Head Office 895 Waverley St., Suite 110Winnipeg, ManitobaCanada, R3T 5P4 Partner Information Company Name: Your Name: Your Email Address: Your Phone Number: Customer Information Please tell us about your customer. Company Name Industry Select an Industry Aerospace Defense Energy Heavy Equipment Manufacturing TIC Other Street City State/Province Zip Country Website Primary Customer Contact First Name Last Name Email Phone Onsight Order Information Please tell us about the customer opportunity. Customer Opportunity Description (Describe the company business unit or division that will utilize Onsight and how they will be using the solution. What components of the Onsight platform will be most utilized? (Connect, Flow, Workspace, other): Region wherein Customer will be using Onsight (This is the region where Onsight will be primarily used by the customer. If users of Onsight are dispatched to various regions, select the region where the dispatching operations unit is located.): Select a Region USA Middle East – Africa Australia – New Zealand Europe Asia Pacific Latin America Canada Other Additional Notes (Please provide any other information that is important to convey regarding this customer opportunity): Type of Onsight License: Select a License Type Connect Connect + Workspace Connect + Workspace + Flow (full platform) Number of Onsight Licenses: Platform Tier: Select a Platform Tier Essentials Professional Enterprise Other License Term (Months): Select a License Term 12 24 36 48 60 Other License Term Start Date (YYYY/MM/DD): Please list any additional products/quantities to be sold or describe any unique requirements for this order.: Onsight Provisioning Information Onsight Domain (This is the exact domain name that will be provisioned for the customer within Onsight. All Onsight user names will be @ this domain – Ex: customercompanyname.com): Customer Onsight & Flow Administrator Contact (This is the individual within the customer company who will administer users and settings in the customer’s Onsight domain.) OPM & Flow Admin Name: OPM & Flow Admin Email: OPM & Flow Admin Phone: