The URL can be used to link to this page

Home My WebLink About129614 PROFESSIONAL DOCUMENT SOLUTIONS - CONTRACT - CONTRACT - 3229SALIE / MAINTENANCE AGREEMENT THE DOCUMENT COMPANY XEROX Customer Legal Name (Bill to) Name Overflow (d needed) Street Address Box#/Routing City, State Zip Code Tax ID# City of Fort Collins Street Dept. 625 9th Street Fort Collins, CO 80525- Customer Name (Install) Name Overflow (if needed) Installed at Street Address 625 9th Streat Floor/RoonVRouting City, State Zip Code County Installed In Customer Requested Install Date Fort Collins, CO Worksheet Unit Check all that apply ❑X Tax Exempt (Ccrtiftcate Attached) ❑ Assoc /Coop Name ❑x Negohated Contract# 0250t7712 ❑ Attached Customer P O #s Supplies Sale Mamt ❑ State or Local Government Customer ❑ Replacemrmt/Modificahon of Prior Xerox Agreement Agreement covering Xerox Equipment Serial# (or 95#) is hereby ❑ modified ❑ replaced Effective Date Comments Installment Sales Information Total Int 80525- Install Sale Tenn _ mo hit Rate % Payable $ ❑ Prepaid Invoice months ❑ Refin of Prior Agri[ ❑ Xerox (95#) ❑ 3rd Party Fq Amt Refin $ Int Rate % Total lot Payable $ ❑ Maintenance Information Maintenance Term months ❑ Supplies included in Base/Print Charges Cash Sale/Installment Sale - Pavment Information Product with serial number if m lace equipment) Qty Prev Install Fin'] Interim Cast Install Wart # mo List Price (Total) Down Pavment Total Discount Inc Tmde-In) Net Price (Tota6 DCOL12 I $ wtCq-mo,t a Kt FT I AI sArocr $ E]269500 JG-12 I@r $ $ 9500 $ MONTBLY INSTALLMENT SALE PAYMENT (excl ofapphc taxes) Paimenl Frequern, 12 Monthly Other Payment Mode ❑ Advance ❑ Arrears Maintenance Agreement Price Information ❑ Adjustment Period (Maintenance Agreement Only) Period A - Mos Affected Period B - Mos Affected Monthly Base Charge S S Monthly Base Charge Monthly Base Charge Print Charge Meter I Print Charge Meter l..$,' jv.." Print Charge Meter I Prints 6,401 1 - t 1145 Prints 1 - $ Prints l - $ Prints - $ Prints - $ Prints - $ Prints - Prints - Prints - Pnnt Charge Meter 2 Print Charge Meter 2 Pnnt Charge Meter 2 Pnn[a{stJ 41 - s o39 Prints I - Prints 1 - $ Pnnts - Prints - Prints - Me Mm # of Prints (based on Meter 1 Print Charges) ❑ Put Lhascd Supplies ❑ Cash ❑ Fm d Mo Mm # of Prints (based on Meter I Print Charges) 9 Me Min # of Pines (based on Meter I Print Charges) Application Software Reorder # Qty Description nce Software Title Initial License Fee Annual Renewal Fee $ Total Price = $ Total Initial License Fees = ❑ Trade -In Allowance Fmol Principal Payment# ❑ K46 Billing Additional Options (check an that apply) Manufacturer Model/Sepal # llowance Suspension ❑ Run Length Plan ❑ Fixed Price Plan (check I as required) ❑ Per -Foot Pncmg ❑ Annual Charge Plan Months affected ❑ Extended Service Hours $ ❑ June only ❑ Description / $ mo Total Allowance = July only ❑ ❑ Comp Replacemen, Program $ Total Allowance Applied to ❑Trade -In Equip Balance $ August only ❑ $ /year ❑ SidAttached Med $ June - July ❑Attached Addenda dead []Price of Re Icm[ Equip P E9 P ❑ July -August formic S/$(r `iV 9 form# Agreement Presented Bs 970 Customer NamE 3,1/ RCII/V Phone ZOci-6927 Nacre jampq g Q'NpillOone 97n-7i1-677Q Xerox Corporation - Acceptance By Title ate /go Nacre Signature Date Sigmtu V t ` v [fi DocaBroker Panne 51858 (08/1999) 11/2/1999 Page I of AGREEMENT ADDENDUM THE DOCUMENT COMPANY XEROX CUSTOMER CREDIT ADDENDUM This ADDENDUM ("Addendum") amends the agreement between you and Xerox to wluch it is attached (the "Agreement") The parties agree to the following terms which shall be additive to those found elsewhere in the Agreement 1 As part of the Agreement, Xerox will provide you with a credit in the amount of $ 2114 0, 00 2 This credit shall be non -transferable and may only be used to offset the cost of goods and/or services ordered from Xerox within the United States on or after the date the Equipment is installed Your credit under this Addendum shall be valid until six months after the next anniversary date of the overriding Negotiated Arrangement between you and Xerox under which the Agreement was written 3 Except as set forth above, the Agreement shall remain as stated In the event of a conflict between the terms found elsewhere in the Agreement and this Addendum, this Addendum shall control Xc. F.4 )1864-4 (1011998) **DOD"IRD ARRAS** I o be completed by the Sales CBR All other areas to be completed by sales rep Price 1 nl #/Plan Description ras Exempt rax Codes ❑ e Tax Exempt State: I County. city ORDER AGREEMENT INTERNAL DOCUMENT Rep Lac Order Em,#—,IrrsWl Emp# Renal Prue List # THE DOCUMENT COMPANY XEROX Tax Osemdes C. Cede ❑PT&D ❑P&A ❑Rent ❑Sale ❑Other State County I City NUMBER OF EMPLOYEES CUSTOMF R INVOICING RFQU DUMB, N IS METER READS at the Customer's Location ____ i R Suite nitd IuW ❑ o ndmad ❑ d ❑ labounRIC (in place equipment) 1 1 ❑ 1-9 5 El I Wd99 Contract -" kw1i ❑ Mivir(alllemn ❑ I ax ❑ samm.ny 2 ❑ 10-19 6 ❑ 500-999 Con view (V1, Ovir1Ji 2 3 020-49 7.D 1000-t499 ElGnernment Form Contr¢Option (cluckalliwy) 1Mt Smg6lnnrI ❑ 3 4 11$499 8 1:1I$00-2499 ❑CuremmentFmlyear Option wcingmg 1 Lxwm soul 4 9 1:12.500+ Caternment I" lure Beers umg Link $ ❑ Summsy lnwums ❑ I lu0fiVaucfur6s IrarAllr ❑ Han i summary ❑ MS Stamm Inwrmg Supplies Automatic Replenishment Pont Volume Adl Supplies Aunar, ae Replemshmcal Ship -To Address ' Required for Supplies Included Madunes • Required for Supplies Included Machi ❑ Examined mint Print V.I. (EMCV) ❑ Slup-To Address Below ❑ Same a lmell Abbess ❑ Monthly Pan, Volumes (fill all Aim Nam` in months) Contact Nmao Jan Feb Mar Apr Pam May Jun Jul Aug special Delivery Instructions Sep Oct Nov Dec Delivery / Installation RegmrcnnO is Delivery Contact Phone Ext Alternate Delivery Phone Ext Survey Contact Phone Ext Delivery Location(Dept Floor # Room # Flooring ❑ Carpet ❑ Tile ❑ Marble ❑ Other Dehvcry Entrance ❑ Front ❑ Rack ❑ Side Delnery Hours to Doorway Width RIC/FAX# ❑ Loading Dock ❑ Elevator ❑ Passenger ❑ Freight ❑ Upend Required I ❑ Rails Needed' - NOTES - ❑ Stancrawler ❑ Tech Rep ❑ Steps # Landings # ❑ Space Ready' ❑ Site Cleari ❑ Supplies Ordered ❑ Stand /Table Required' ❑ In place equipment / furniture needs to be moved prior to delivery' ❑ Telephone Line Ready ❑ Fleetncity/ Receptacle Ready Power Cord Type Volts Amps ❑ 20 Amp Receptacle to Customer Customs 20 Amp Receptacle innalledv ❑ Yes 19 No ❑ Customrackrtowledges request to be billed for Xerox Service Installation charges on customerrmiallabli,egmpitei ❑Softwan. ❑ DTR Site Verification required^ ❑ Obstructmn / obsmcies in the delivery path' If checked cxplam in space to the right ❑ Installation Preparation Docum,nt mviewedo ❑ Customer Satisfaction Checklist Completed? ❑ SolunonQwX was used to validate this configuration ❑ Pick up trade unit at time of delivery? Date ERC Code ❑ Repack Knp Make Model Senal Number Competitive Equipment Replacement Tag# * * EXCEPTION APPROVALS SHOULD BE OBTAINED BY SALES REP PRIOR TO SUBMTF1 ING ORDER 10 CBR* Check all that apply Signatures below indicate approval for the items checked on the left ❑ Compemive Trade -In Range Extension Promotion ❑ XTI ICTI / CRP Headquarters Exception Approval ❑ Warver of Rental ETCs ❑ Other ❑ Olher ❑ Other Manager, Sales Operations ate CBU Controller ate Populated From Pricing DocuBrokcr Form# 51869H (10/1997) 11/2/1999 Internal Use Only