Laserfiche WebLink
Fp* <br />Customer Agreement <br />FP Mailing Solutions <br />140 N, Mitchell Ct, Ste 200 <br />Addison, lL 60101-5629 <br />Tel: (800) 34'1-6052 <br />www.fp-usa,com <br />CUSTOMER INFORMATION <br />RENTAL INFORMATION <br />Billing Address <br />Customer: Upper Kittitas District Court <br />Department: <br />Skeet 700 E. 1st Street <br />City:Cle Elum County: <br />State: WA zip:98922 <br />Teli 509-674.5533 Fax: <br />E-mail: diana.mackenzie@co.kittitas.wa.us <br />Contact Name: Diana MacKenzie <br />Deliver To: E Dealer E Customer E] Fulfilled from Dealer lnventory <br />A Existing Customers Only: check box if Bilting Address has changed. <br />Shipping & lnstallation Address (if differentthan Bilting) <br />Customer: <br />Department: <br />Street: <br />City:County: <br />State:zip: <br />Tel:Fax: <br />E-mail: <br />Conlact Name: <br />Mailing Address: EI Same as Billing <br />E Existing Customers Only: check box if Shipping & /nsia//Address has changed. <br />Quantity Item #Item Description Monthly Rate Rental Billing Delivery (se/ecf one) <br />1 P400c PostBase Vision Meter included @ Electronic Billing <br />1 UNL Unlirnited Resets included ! Paper Billing <br />1 RG Rate Guard included Rental Billing Frequency (se/ecf one) <br />@ AnnualBilling <br />E Semi-Annual <br />D Quarterly Billing <br />Note: lf a payment option is not selected, FP <br />will default to Quarterly Paper Billing.Term ofContract: 6o months*TotalMonthly Payment $48.00 <br />TermsandCondilions: Bysigningbelow,l.herebyacknowledgeandagreethatFP'sstandardshippingratesandtheadditionaltermsandconditionsavailableontheFpwebsiteat <br />800.341.6052 and we will provide you with a copy for your records.) - 36 Month lnitial Term w1] apply unlesi otherwise indicated above, <br />ER ANCE <br />DEALER& INTERNAL USE ONLY <br />all <br />Customer Acceptance of Terms Dealer lnformation <br />Print Name of Auhorized Diana MacKenzie Selling Dealer Nam. APS, lnC.nr4r1x,.225-0 <br />Ter. 509-674.5533 4661s55.933 W. 3rd, Suite 208, Spokane, WA 99201 <br />Tax rD: 91-6001349 WA Tel.509.299 .6144 Fax: <br />Authorized Signature: <br />ssls'W (It xrru. Ron CookSales Reoresentative <br />Servicing Dealer Nm. APS, lnC.Svc. Deater #: 225-0 <br />E NewCustomer <br />EI Upgrade / Model Change <br />fl Renewal (no change ofequipment) <br />E Coterminous Ad6-9n. Postbase Vision <br />I ChangeofOwnership <br />Existing AccountNo.: 600058317 <br />fl Lease Company: _ <br />E MajorAcmunt <br />E GSR/State ContractNo.: _ <br />Master Billing Acct No.: <br />Master Postage Acct. No.: _ <br />Promo Code: <br />Package Code: <br />E Price or Terms Exception Approva I (Form Aftached) <br />E USPS@ Locati on: (CPIJ Lefter Aftached) <br />E Tax-Exempt (Ce rtifrcate Aftached) <br />FM-IVG-RENTAGR-1 2 Page 1 revised 4i 3/201 8