Order

NEW BIM OHIO NATIONAL WEBCHECK FINGERPRINT SYSTEM ORDER FORM

Please completely fill out and submit this form if you have discussed your quote with Sales and wish to purchase a fingerprint system from BIM.

If you have not yet received a quote and spoken with Sales, please contact sales@bioinfomgt.com or call (614) 456-1296 opt. 2 for a quote.

If you wish to purchase more than one fingerprint system, please submit one complete form for each system or location. Alternatively, please coordinate with Sales on sending in a custom location list along with a signed quote.

Agency Information
Agency Name*

Enter the name of your agency, company organization, entity, etc.
Agency Address*
Address Line 1 Address Line 2 City State ZIP Code

There is where we will ship your fingerprint system.
County*
BCI Agency Code*

Your 6-digit agency code provided by Ohio BCI. If you do not yet have an agency code from Ohio BCI, please input all zeros: 000000. You must apply for and provide your Ohio BCI agency code to BIM before we can deliver your fingerprint system.
Contact Information
Primary Contact Name*
First Last
The primary buyer or organizer for the fingerprint system within your agency.
Primary Contact Phone #*
Primary Contact Phone Ext (optional)
Primary Contact Email Address*
LSA/Technical Contact Name*
First Last
Live Scan Administrator or Technical contact; who we may contact for Support.
LSA/Technical Contact Phone #*
LSA/Technical Contact Phone Ext (optional)
LSA/Technical Contact Email Address*
Billing Contact Name*
First Last
Person responsible for handling A/R or A/P for fingerprint system.
Billing Contact Phone #*
Billing Contact Phone Ext (optional)
Billing Contact Email Address*
Billing Address (if different than agency address)
Address Line 1 Address Line 2 City State ZIP Code

It is only necessary to complete the billing address fields IF your billing address differs from your agency address.
Purchase Information
Are you tax exempt?*
If you answer YES for your agency, you must submit your Ohio Sales Tax Exemption Certificate to accounting@bioinfomgt.com.
Would you prefer to purchase a laptop or desktop computer with your BIM Fingerprint System?*
You must purchase a new computer from BIM for your new BIM fingerprint system. Please choose either a Laptop or Desktop computer that BIM will provide.
Would you like to purchase any of these optional add-ons?
- Additional 12 months of Support
Adding one or more of these optional additions will increase the price of your system purchase, which will be reflected on your invoice. Please refer to your quote for pricing.
Purchase Consent*
I have examined the sales quote, I have reviewed my entry for accuracy and completeness, and I commit to purchasing a BIM Ohio National Webcheck fingerprint system.
By clicking this checkbox, you agree that you are committing to purchase a BIM Ohio National Webcheck fingerprint system and that the information you are submitting is accurate and complete to the best of your knowledge. BIM is not obligated to provide a fingerprint system until payment is made or other arrangements are satisfied. After submitting this form, BIM will follow-up with next steps, including sending your invoice.

Order

NEW BIM OHIO NATIONAL WEBCHECK FINGERPRINT SYSTEM ORDER FORM

Agency Information

Contact Information

Purchase Information