HomeMy WebLinkAboutPitney Bowes-Rental Agreement-03.26.2007 J L 6 3——.PC.—u 7 Rental Account#
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STATE AND LOCAL GOVERNMENT TERM RENTAL AGREEMENT
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Your Business Information CAN # \ u i ( ORDER #
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FULL LEGAL NAME OF RENTER „r t c� ` t P 'N
DBA NAME
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BILLING ADDRESS
CITY d [ �--- I
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ZIP+4 0 a( ' .;1l 1 (. {''} ) '�f 1 ` l '' ( r
PHONE# -i 1 ,t CONTACT NAME 1;Lvlf`*k- .. -17 SEND INVOICE TO ATTN OF
EQUIPMENT LOCATION(IF NOT SAME AS ABOVE) CITY STATE ZIP+4
CREDIT CARD# EXP DATE NAME ON CARD TYPE
TAX EXEMPT# { SALES TAX(IF APPLICABLE)
FISCAL PERIOD FROM �6^S,A } TO - 6^Q— , RENTER PO#
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Your Business Needs
Qty Model Equipment&Services Description Equrrment p (New,nacr e,Demo,Newly Rtur� CH ITEMS TO BE INCLUDED IN YOUR PERIOD PAYMENT
It Equipment Maintenance Agreement On Rental
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Payment Schedule /Billing ,,
Rental Terms and Conditions
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By your signature as"Renter"below,you request that we rent to you the equipment described above or on any schedule
Your Payment Plan
attached hereto(the"Equipment")for essential governmental purposes in consideration of your payment to us of the amounts
set forth in the Payment Schedule,subject to the terms and conditions provided in this Agreement. For purposes of this
Initial Rental Term: Agreement,all payments set forth in the Payment Schedule shall be referred to as the"Total Payments." The payments
Frequency Cl Monthly XQuarterly ❑Other(specify ) referred to in the Payment Schedule other than the"Final Payment"shall be referred to singularly as a"Period Payment"
_ and collectively as the"Period Payments." Your offer will be binding on us when we accept it by having an authorized
(1 months $ per month employee sign it. All payments hereunder shall be payable only to us at our executive offices unless we direct you
otherwise in writing.
Next months $ per month 1. NON-APPROPRIATION. You warrant that you have funds available to pay the Total Payments until the end of your
Next current fiscal period,and shall use your best efforts to obtain funds to pay the Total Payments in each subsequent fiscal
months $ per month period through the end of your Initial Term. If your appropriation request to your legislative body,or funding authority
("Governing Body")for funds to pay the Total Payments is denied,you may terminate this Agreement on the last day of the
Anal Payment $ 100.00
fiscal period for which funds have been appropriated,upon(i)submission of documentation reasonably satisfactory to us
__ evidencing the Governing Body's denial of an appropriation sufficient to continue this Agreement for the next succeeding
Initial Check Amount — $ / _ fiscal period,and(ii)satisfaction of all charges and obligations under this Agreement incurred through the end of the fiscal
period for which funds have been appropriated,including the return of the Equipment at your expense.
SIGNATURE k...._____
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TITLE 16( tiro ty ,
PRINT NAME (1 .. ..., c ? �;. 1 i',� - DATE - 6- - n 7
PB ACCOUNT REP NAME 1morc,,,,. Cj tAil EMPLOYEE# 1 64(.5.5 DISTRICT NAME&#OrYvkYv,,
PB ACCEPTED BY TITLE DATE
EXECUTIVE OFFICE: 27 WATERVIEW DR•SHELTON,CT 06484-4361 •EQUIPMENT VENDOR:PITNEY BOWES,INC.•FOR SALES AND SERVICE CALL 1-800-322-8000
WHITE COPY PBCC•PINK COPY PITNEY BOWES INC.•YELLOW COPY CUSTOMER
PB SLR2(8/01) PAGE 1
1 SEE PAGE 2 FOR ADDITIONAL TERMS AND CONDITIONS
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