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<br /> <br />MIA <br /> <br />------ -- <br />-. ~ <br />..... TOSHIBa COMItAIIty. <br />CAn:. <br /> <br />CUSTOMER AGREEMENT "Retained Title" <br />SotILES REP NO. SAL-ES TYPE. fUffiJRE OF BUSINESS <br /> <br />14039 <br /> <br />INSTAlL. CAll: . <br /> <br /> <br />:lVON <br /> <br />ACCOUNT NO. <br /> <br />c.J1 <br /> <br />., 1 .- <br /> <br />";.' ;-t1iu' <br /> <br />,It- _ . -.... <br /> <br />........ .".,,,!"':.,, <br /> <br />II <br /> <br />. .,:~ :.);JfJ;:bc. <br /> <br />. . ,",', ., <br /> <br />. '..... <br /> <br /> <br />~~i~~~~~; <br /> <br />7 <br /> <br />i <br /> <br />10 ' <br /> <br />REPlACf:MENT <br />NET ADO <br />'RCHASE <br />AMS <br /> <br />o .' CANCEL MIA <br />o '.OVES ONO <br /> <br />o c.tl Net Due On DelIvery <br />00.- .' <br /> <br />Amount $ <br /> <br />Date <br /> <br />',_1--:....1- <br /> <br />~/-'- <br />1--1 <br /> <br />"RlW No. 01 Months <br />S <br />AdvllnCe ~ of 11m and last <br />1blaI amount 01 adwnc:e S <br /> <br />s <br /> <br />s <br /> <br />S <br />NO. <br /> <br />MYOFF <br /> <br />O~ <br /> <br />" ?7:' <br />..' "'-" <br /> <br />s <br /> <br />Amount S <br /> <br />s <br /> <br />Good r. <br /> <br />Ortgrnaa" :""',.: ro. -OJ'' <br /> <br />o Cell In 0 Self GenereIIId <br />~ES'. ~'i-! t.' .~lli~::L.J :!''. ~ <br />'. O~"~'1"" .-.S\.~"'CooponIIeSupply <br />o DeII-..cI .. EquIpmenIl'nlm Ihnc:tl <br /> <br />NO. <br /> <br />lIVERY <br />;TRUCTlONS <br /> <br /> <br />DeIIvefy Date~ <br />Q AM Q PM <br />o Sales Rep, 0 Copyco Delivery <br /> <br />P.yabIe 10 <br /> <br />CEPTANCE: THIS AGREEMENT IS NOT VALID <br />LESS SIGNED BY AN ~ER OF COPYCO. <br /> <br />:. <br /> <br />.x <br />~ CUSTMR SlGNAJ\JlE <br /> <br />PRlNT(D N.m<<IIUZED CUSTOM(R IWoE <br /> <br />X <br />OfRCEA APPROVAL DEllVEllY ACCEPTANCE SlCNATtJIlE <br />In ".. ..."" the llOJD'Wll 's ""I Dad r." and 'her"""" POCked \4l :tier ... be . $06 por C<lIlY US8gII ctlaIQlt and ..~ ~ ~ <br />DELM:RY CHARGE: FAA Tlif\\J SEGMENT 3: $75.00 SEGMENTS.; $125.00 <br />~lE rEAm.JARTEflS SALfS. StOMaJvl 8RMOi CJ'R:E. BRNOHHl:E:. BRAIOllJ'Fn; ':!'" ',. '/~liUiNSSlII.1ITOSaw;c <br />S.w. :lmH~ 17tU PO'MJUE F{J 9..ITE H 0011'<lJmfUiT Pl<WY SLm 120 14394 au.e:n WAY , 3212 SlJ1H u.s., ".., :!8tiHHcrtJISRlW SIE. 700 <br />'(U) EEAOi. A. 33442 tmHlD EEAOi. A. 33442 WEST P6lM!EQ(}i. FI. 33407 tdAMlms. R.3:ll16 RFTPER:E. R.34982 \_q<~~RlJO.32!DI <br />42~ 1:ro (9541428-1:JlJ [56' I 684-2DJ (X61 B2S97tU (5611 46'~ (4IJ7} 852-1110 . SlIQ 27G 1869 <br />1541 429-OCW FAX [95414006713 FAX [56' I 616-4598 FAX 1X61112S335O FAX (561)4608340 ll\X (4Cl7I816-t5\ L:n ,.' <br />_~.~\~~~~'~I.-='1.'I:l:l"I~"'''''''''II:!IIII5.."..c:tl'I:'''.l'''''','''''''''................,...... - . . ~ <br />