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DocuSign Envelope ID: EC7C145A-71D1-41B2-9A48-AC19A21A0053 <br />Trade in, Upgrade, Return, Buyout Schedule ("Schedule") (SLS-900) Page 1 of 1 <br />%.�CAJJM <br />Canon Solutions America, Inc. ("CSA") <br />One Canon Park, Melville, NY 11747 <br />(800)-613-2228 <br />Return Schedule, Rider B of Agreement <br />Customer: KITTITAS COUNTY, WASHINGTOI <br />Agreement #: MA25015 <br />Salesperson: Brian Kaner <br />Transaction #: S21059297 <br />Order date: 2/7/2024 <br />Customer ("You") <br />Customer Account: 1846373 <br />Service Requested: <br />Company: KITTITAS COUNTY, WASHINGTON <br />Upgrade <br />Lease Information (if applicable) <br />Address: 205 W 5TH AVE CLERK RM 210 <br />Leasing company name <br />Lease Number <br />City: ELLENSBURG County: KITTITAS <br />CFS <br />001-0638482-013 <br />State: WA Zip: 98926-2890 Phone: 509-962-7531 <br />Contact name: Karen Bowen <br />Email: karen.bowen@co-kittitas.wa.us <br />Alternate Contact: <br />Alternate Phone: <br />If "Buyout Reimbursement' is selected above, the following MUST be completed: <br />$ To be paid upon delivery / acceptance pursuant to Rider B, Section 1. <br />Payable to: Reason for check issuance: <br />If transaction includes a Lease Upgrade or Buyout the following MUST be completed: <br />Select ❑ Not Applicable: No Equipment pick up required <br />one: ❑✓ CSA will pick up the Equipment <br />❑✓ Return Equipment to CFS <br />❑ Return Equipment to CSA Original Order Date <br />❑ You will return Equipment to leasing company according to the terms and conditions of your lease agreement <br />❑ You will retain the equipment. <br />Will retained equipment remain under a CSA Maintenance Agreement? <br />❑ No <br />❑ Yes: SELECT ONE: under an Existing Contract ❑ Or New Contract U <br />Trade in Equipment Condition: <br />Equipment for Trade -In, Upgrade, or Return <br />If transaction includes a Lease return the following MUST be completed: <br />Return <br />code <br />Item <br />Code <br />Description <br />Serial # <br />Equipment Location <br />Contact Name 8 <br />Phone <br />Email <br />Alt pick up <br />date <br />1JGTR <br />0294CO24 <br />IRADV65651V2 <br />XNF02306 <br />205 W 5TH AVE CLERK RM 210 ELLENSBURG <br />WA 98926-2890 <br />#Aa6Gsreel,ew 599-962-7531 <br />Ext: 624 <br />co.kdi11�5.n•a o <br />Pick Up /Return Information: <br />❑✓ Same Date as Delivery of Listed Items Specified on the Agreement <br />❑ Other Specified Date: / / (but no longer than 30 days after delivery of Listed Items under Agreement <br />Contact Name: Phone: Email. <br />Hours of Operation: Number of Steps: Elevator: Loading Dock: <br />Special Instructions: <br />THIS RETURN SCHEDULE IS ENTERED INTO PURSUANT TO, AND INCORPORATES ALL OF THE TERMS OF, THE MASTER SALES AND SERVICES <br />AGREEMENT REFERENCED AS THE AGREEMENT # ABOVE AND THE APPLICABLE RIDER(S) ("AGREEMENT"), BY YOUR SIGNATURE BELOW, YOU AGREE <br />TO TERMS AS SPECIFIED ABOVE, SUBJECT TO THE TERMS AND CONDITIONS OF THE AGREEMENT. CUSTOMER REPRESENTS THAT EXECUTION OF THIS <br />SCHEDULE HAS BEEN DULY AUTHORIZED. YOU REPRESENT THAT YOU ARE AUTHORIZED TO EXECUTE THIS SCHEDULE ON CUSTOMER'S BEHALF. <br />STANDARD TERMS AND CONDITIONS INCORPORATED HEREIN ARE AVAILABLE AT ESS.CSA.CANON.GOMIC:USTOMERt)p3CUM_ENT_S_, AND SHALL APPLY TO <br />THE EXTENT NOT MODIFIED BY THE AGREEMENT. YOU ACKNOWLEDGE RECEIPT OF A COPY OF THIS RETURN SCHEDULE. <br />Customer's Authorized Signature <br />Printed Name Karen Bowen Title Date <br />SLS-900 June 2023 <br />