I am a Sales Rep
    Contact Name
    Company
    Title / Position
    Contact Phone
    Contact Email
    Job / Project Name
    Sold to: Name
    Quantity
    Type Lighting
    Part Number / Description
    Description of Problem
    File Upload
    Please upload any supplemental pictures or videos you may have regarding the defective equipment. Security is a huge priority for us at Visionaire, so we restrict file types to safe files only. These are: - Images like .png, .gif, .jpg - Documents such as .doc, .xls, .ppt, .pdf - Audio like .wav, .mp3, .mp4 - Video like .mpg, .mov, .wmv
    Please fill out the below for separate product part numbers
    Second Product Part Number
    Quantity
    Second Lighting Type
    Second Description of Problem
    Second File Upload
    Ship to: Name
    Site Contact Name
    Site Contact Phone Number
    Site Contact Email
    Ship to: Address for Replacement Parts
    City
    State
    Your Zipcode