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<br />TO,SHIBA <br />BUSINESS SOLUTIONS <br />Florida <br /> <br /> <br />SAl,.ESR~~AM~ <br />.c ''r~ ~ ,~;~;_~'.~, e r,' '. <br /> <br /> <br />37633 <br /> <br />SALES REP NO. <br /> <br />ORDER STAGE NO. <br /> <br />-' <br />" :. ,'7' <br /> <br />ACCOUNT <br /> <br />o NEW <br /> <br />Q.EXISTING <br /> <br />NATURE OF BUSINESS <br /> <br /> <br />ACCOUNT NO. <br /> <br />ACCOUI)IT 0, <br /> <br />;' ( l~ <br />L r \ <br /> <br />,~~: f <br /> <br />. I <br />..r, <br /> <br />//, . <br />.#.lC__ f r_. <br /> <br />,~ .' <br /> <br />7/ <br /> <br />" <br />, " <br />"r ' <br /> <br />COUNTY <br /> <br />FAX <br /> <br />STATE <br /> <br />ZIP+4 <br /> <br />, <br />I <br /> <br />; /,/, <br /> <br />--?,. <br /> <br />2 <br /> <br />'c' ,.p. <br /> <br />3 <br /> <br />(~ <br /> <br />/' ...{_-I <:" ," ,~\C /",,,) <br /> <br />4 <br /> <br />5 <br /> <br />6 <br /> <br />I <br /> <br />7 <br /> <br /> <br />J <br />!, , , <br /> <br />, 'J <br />f".~. <br />" <br /> <br /> <br />I,. <br />~ ,f ...- .' /(-1':1 ..~'.("../.. 'j' <br /> <br />8 <br /> <br />10 <br /> <br /> <br />,r <br />,- <br /> <br />-f:~_:1. '7 -1 <br /> <br /> <br />9 <br /> <br />.** <br /> <br />..(./~d../ <br /> <br />,;\ r <br /> <br />/ <br /> <br />/ <br />'<'"/' <br /> <br />11 <br /> <br />DIGITAL INSTALL <br /> <br />SUPPORT PLUS 0-1 UP TO TWO (2) HOURS <br />SUPPORT PLUS 0 2 UP TO FOUR (4) HOURS <br /> <br />SEGMENT 1-5 Black & White & Fax $250.00 <br />COLOR $480.00 <br /> <br />CUSTOMER P.O. NO. <br /> <br />MAINTENANCE AGREEMENT COPIER & FAX PLAN TYPES <br /> <br /> <br />E <br /> <br />Extemal Fiery/controller parts and labor only <br /> <br />Equipment Line No. <br />is covered by plan: <br />at a Base Rate of: <br />to billed (interval): <br />and includes allowable copies of: <br />Excess copies will be billed <br />at a per copy price of: <br /> <br /> <br />Covers parts, labor, drums, PM kits and toner <br />(excludes paper, staples, color toners, optional color units & shipping) <br /> <br />B <br /> <br />Covers parts, labor, PM kits, drums only (excludes paper, toner, staples & shipping) <br /> <br />C <br /> <br />Covers parts and labor only (exludes drums, paper, toner, PM kits, staples & shipping) <br /> <br />o <br /> <br />Covers parts, labor. drums, PM kits and color toner (excludes paper, staples & shipping) <br /> <br />F Excluded, not covered under any service program <br /> <br />G Covers parts and labor for non copier equipment (excludes supplies and shipping) <br /> <br />PERFORMANCE GUARANTEES <br />Equipment Guarantee - The equipment specified above is conditionally warranted by Toshiba Business Solutions for as long as the above described Company shall own the machine, <br />provided that is covered by a Toshiba Business Solutions maintenance and support program. The warranty shall cover the plan indicated and is subject to the terms and conditions on <br />the reverse side. <br /> <br />Replacement Guarantee - If the equipment specified above is covered by Toshiba Business Solutions maintenance agreement and becomes unrepairable within 36 months from the <br />date of the agreement, we will replace it with a piece of similar or like equipment at no additional charge. <br /> <br /> <br />I have reviewed Toshiba Business Solutions Maintenance Agreement <br />Programs and DO NOT want to participate at this time, <br /> <br />x 1)0..\1 i D SC\.W\SO-rJ <br />PRINTED CUSTOMER SIGNATURE' , <br /> <br />~ <br /> <br />X <br />CUSTOMER SIGNATURE <br />ACCEPTANCE: THIS AGREEMENT IS NOT VALID UNLESS SIGNED <br />BY AN OFFICER OF TOSHIBA BUSINESS SOLUTIONS. <br /> <br />X <br />OFFICER APPROVAL <br /> <br />All transactions from the 25th to the 31 st of the month shall be prorated to the 15th of the following month. <br />