Full Name *
Email Address *
Phone / WhatsApp *
Company / Organization
Do you already have an ORTENTIQ reference? * Select Yes No Not sure Quote, invoice, blueprint, procurement, handover, or request number.
Reference / Quote / Invoice / Blueprint Number
Delivery Engagement Type * Select Full delivery after assessment and blueprint Procurement-to-delivery coordination Supplier / installer / partner coordination Execution management for approved scope Verification and defect visibility Handover documentation and sign-off Delivery feasibility review first Not sure - qualify my request Choose the closest delivery control need.
Delivery Area * Select Smart Living & Automation Security & Surveillance Energy-Ready Environments Furnishing & Modern Spaces Building Finishing Support Office & Technology Setup Mixed / Multi-system project Other
Project / Site Type * Select Home / residence Apartment / estate Office / workspace Hotel / hospitality facility School / institution Hospital / clinic Commercial facility Construction site Warehouse / storage location Industrial facility Other
Project / Delivery Location *
Exact Site / Delivery Address * Weak address details create delivery and handover risk.
Google Maps Location Link Strongly recommended.
Nearest Landmark *
Current Project Stage * Select Need assessment first Scope is defined but not approved Blueprint / specifications are ready Procurement is ready Items / materials are already procured Installation / execution is underway Verification / defects review needed Handover is pending Not sure
How clear is the delivery scope? * Select Clearly defined and documented Partially defined Defined verbally only Changing / uncertain Need ORTENTIQ to define or validate it
Describe the Delivery Scope / Expected Outcome * This is the main qualification field. Be specific.
Procurement Status * Select Not started Need ORTENTIQ procurement intelligence Supplier identified but not approved Quote received but not verified Procurement approved Items purchased / in transit Items already on site Not applicable Delivery risk is lower when procurement terms, warranties, and product documentation are clear.
Supplier / Installer / Partner Readiness * Select No supplier or partner selected Supplier / installer needs review Approved supplier available Approved installer/subcontractor available Multiple partners need coordination ORTENTIQ should recommend/control partners Not applicable
Budget Readiness * Select Budget approved Budget estimate available Budget not approved yet Need ORTENTIQ to validate budget Budget is uncertain Prefer not to say
Estimated Budget Range Select Need assessment first Below $5,000 $5,000 - $20,000 $20,000 - $100,000 $100,000 - $500,000 $500,000+ Prefer not to say For qualification only, not a quotation.
Timeline / Delivery Expectation * Select Immediate / urgent Within 1-4 weeks Within 1-3 months Within 3-6 months Scheduled project milestone Planning ahead Not sure
Payment / Release Structure * Select Payment terms already agreed Deposit ready after approval Part payment made Awaiting invoice / quote Milestone release required Payment structure not clear Not applicable
Site Access Readiness * Select Ready and accessible Accessible with notice Partially restricted Access depends on third party approval Not ready yet Not sure
Site Constraints, Risks, or Dependencies *
Known Defects, Quality Concerns, or Past Delivery Issues
Who will approve access, receive updates, and sign off handover? *
Approval / Handover Contact Phone *
Supplier / Partner / Contractor Notes
Supporting Documents / Photos / Drawings Link Useful for faster qualification.
Additional Delivery Instructions
Consent & Acknowledgement *