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Carr$n <br />Canon U.S.A, lnc, ("CUSA") <br />one canon Park, Melville, NY 11747 <br />(8oo)-6 1 3-2228 <br />Customer ("You")Customer Account: 1 846609 <br />ompany: CountY of Kittitas <br />901 E 7TH AVE STE 2, WSU EXTENSION SERVICE <br />Trade in, Upgrade, Return, Buyout Schedule ("Schedule") (SLS-900) Page 1 of 1 <br />Return Schedule, Rider B ofAgreement <br />Customer: CountY ol Kittitas <br />Agreement fl; PO lN LIEU <br />ervice Requested <br />Salesperson William Thompson <br />Transaction #i s.21 527923 <br />Order date: 1112112025 <br />Trade ln <br />Lease lnformation (if applicable) <br />Leasing company name Lease NumberCity: ELLENSBUFIG county: KITTITAS <br />Phone: 509-962-7507WA Zip: 98926 <br />name: Andrea Morse <br />Email: amorse@wsu.edu <br />Gontact <br />Phone: <br />lf "Buyout Reimbursement" is selected above, the following MUST be.c-ompleted: <br />To be paid upon delivery / acceptance pursuant to Rider B, Section 1 <br />I <br />Pavable to:Reason for check issuance: <br />Select <br />one: <br />If transaction includes a Lease u e-s:eg : g t _1yl9u!! L" !9 | 19ryjry jvl u -sr !e _co1 p I eted :, <br />I ruot Applicable: No Equipment pick up required <br />/ cusn will pick up the Equipment <br />! Return Equipmentto CFS <br />[] Return Equipment to CUSA Original order Date <br />I you will return Equipment to leasing company according to the terms and conditions of your lease agreement <br />I You will retain the equipment. <br />Will retained equipment remain under a GUSA Maintenance Agreement? <br />nruo <br />! Yes: SELECT ONE: under an Existing Contract Ll Or New Contract n <br />in Equipment Condition: Good Wolkjng <br />Equipment tor TradeJn, Upgrade, or Return <br />ff transection includes a Lease retuln the following MUST be completed: <br />Conlact Name & <br />code Item code Descriplion Serial #Equipment Location Phone <br />w 98996 <br />Email date <br />- -*----Miti6iqeitffi-.'--- ' --1- .'- - - <br />i <br />i <br />I <br />lnformation: <br />Delivery of Listed lbms Specified on the Agreement <br />i*-l other Specified Date:-/ <br />- <br />/(but no longer than 30 days after delivery of Ljsted ltems under Agreement <br />Contact Name:Phone:Email <br />Hours of Operation:Number of Steps:Elevator: <br />lnstructions / Additional Requirements: <br />lPrinted Name <br />Dock: <br />48028003 uson uner <br />ELLENSBURG WA 98926 <br />SLS-900 Ja uatv2o2S <br />Tille Date