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<br />- - --...- -- - <br />--- --- ......--- -- --- ~ <br />-. -~ ---- - ~---- <br />~~--- ~ ~~ <br />. .. ~ -a TUSH'" COMPUlV- <br />MIA ~LE2 '.:lEf NAN~ . t- if \ DATE I <br />--. '. '- ; t o' A\ 'r~ . ~ "-1/ k I <br />:.JV:JN ~'C.' L;;:.x L.~(" r.- ().~/'-'. <br /> <br />ACCOUNT :J NEW u.-6ISTlNG INSTALL DATE <br /> <br />12726 <br /> <br />SALES REP NO. <br /> <br />NATURE OF BUSINESS <br /> <br /> <br />(, 1:.- <br /> <br />L <br /> <br /> <br />: LEASING SOURCE <br />COMPANY <br /> <br />ACCOUNT NO. <br /> <br />...., ....A <br /> <br />- -... <br /> <br />CONTACT <br /> <br />, <br />K , ::~ .,: <br /> <br />/ <br /> <br />ACCOUNT NO. <br /> <br />/ <br />,. <br /> <br /><::.- ,-., L L! .... :' <br /> <br />l:....u~ <br />'" COUNTY <br />L~'-'- <br />STATE <br />FL. <br /> <br />/"~ <br />,:'-----'--.- <br /> <br /> <br />.-- <br />....- <br />" <br /> <br />STATE <br /> <br />Z1P+4 <br /> <br /> 2 <br /> 3 N\J (\(k F <br /> 4 <br /> 5 <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> 10 <br />REPlACEMENT 0 CANCEL MIA <br />NET ADD 0 o YES ONO <br /> <br />SUPPORT PLUS 0 1 <br />SUPPORT PLUS 0 2 <br /> <br />ADDlTlONAl SUPPORT <br /> <br /> <br />CUSTOMER P.O. NO. <br /> <br />MAINTENANCE AGREEMENT COPIER PLAN TYPES <br /> <br />PI <br /> <br />Covers parts, labor, drums. PM kits and toner <br />(excludes paper,stapleS,cOlor toners and optional color units) <br /> <br />Comments <br /> <br />E <br /> <br />Refer to separate contract for connectivity and software services <br /> <br /> <br />B <br /> <br />Covers parts, labor. PM kits. drums only (excludes paper, toner & staples) <br /> <br />c <br />o <br /> <br />Covers parts and labor only (excludes drums, paper, toner PM kits &. staples) <br /> <br />Covers parts and labor for non-copier equipment (excludes supplies) <br /> <br />F <br /> <br />Excluded, not covered under any se!Vice program <br /> <br />PERFORMANCE GUARANTEES <br /> <br />Equipment Guarent" . The equipment specified above is conditionally warranted by Copyco for as long as the above described Company shall own the mach Ine. provided <br />that it is covered by a Copyco maintenance and support program. The warranty shall cover the plan indicated and is subject to the terms and conditions on the reverse side. <br /> <br />Emergency Response TIme Guarant" - We guarantee to respond to an emergency call within 2 to 4 hours (depending on the type of equipment, see back for spectfIcs). This <br />guarantee is applicable during nonnal business hours. <br /> <br />Replacement Guarant" - If the equipment specified above is covered by Copyco maintenance agreement and becomes unrepairable within 36 months from the date of the <br />agreement, we will replace it with a piece of similar or like equipment at no additional charge. <br /> <br />Loaner Protection Plan - If we are unable to repair your equipment covered under this maintenance agreement within 8 hours of our lUrivaJ, we will provide a loaner for your use <br />at no additional cost. <br /> <br />Billing Terms <br /> <br />Equipment line No. I have reviewed Copyco's Maintenance Agreement Programs and DO NOT want to participate at this time. <br />is covered by plan: CUSTOMER SIGNATURE <br />at a Base Rate of: S S S ACCEPTANCE: THIS AGREEMENT IS NOT VALID X <br />to billed Ontel'lal): UNLESS SIGNED BY AN OFFICER OF COPYCO. AUTHORIZED CUSTOMER SIGNATURE <br />and includes allowable copies of: <br />Excess copies wdl be bIlled PRINTED AUTHORIZED CUSTOMER NAME <br />at a oel coo. arlce of: OFFICER APPROVAL <br />