Code Blue Corporation

Step 1 of 6 - Primary Billing & Payments Contact

Your Email

A confirmation copy of this submission will be sent to this email address.

Who will Code Blue invoice at contract renewal?(Required)

Reseller / Integrator

End User Customer

Managed Cloud services at Code Blue are a great recurring revenue opportunity for Resellers. However, if a Reseller is not interested in managing recurring services billing and agreements with their customers, Code Blue must be notified in this form so the customer can be billed directly (MSRP) at the contract's renewal.

End User Customer Information

End User Customer Information is mandatory to provide with Managed Cloud services. If billing communications with a reseller or distributor fail (due to employee turn-over, non-response or incorrect contact information), the customer reserves the right to be contacted to prevent a lapse in their service due to non-payment.

End User Customer's Company/Organization(Required)

Owner of property where products are being installed.

End User Customer Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

End User Customer Name(Required)

First Last

End User Customer Email(Required)

End User Customer Phone(Required)

Reseller Information

Reseller Company Name(Required)

Reseller's Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Reseller's Name(Required)

First Last

Reseller's Email(Required)

Reseller's Phone

Fallback Contact to Invoice at Renewal

Must be a completely different contact than previously given: This is a fallback contact if the Primary contact is not responding, no longer working at the company, or otherwise unreachable. In cases where the Reseller is managing the recurring services billing and provides a secondary Reseller contact here, both the primary and secondary Reseller contact would need to be unresponsive before Code Blue would contact the End User Customer with an MSRP invoice.

Company Name(Required)

Secondary Contact Billing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Secondary Contact Name(Required)

First Last

Secondary Contact Email(Required)

Secondary Contact Phone

Cloud Services Billing and Turn-Up

In preparation for the turn-up, or renewal, of your Cloud services, please provide current billing contact information for renewals.

Turn-Up Call

End User Customer Information

Reseller Information

Order Information

Fallback Contact to Invoice at Renewal

Consent and Submit