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HomeMy Public PortalAbout2015 Agreement.tif040 Pitney Bowes Dear Valued Customer. Federal law under The USA PATRIOT Act requires us to obtain the (9) nine digit federal Taxpayer Identification Numbers (TIN) from customer that participate in the Pitney Bowes Bank product, notably Reserve Account and/or Purchase Power. Additionally, the Internal Revenue Service (IRS) requires the Pitney Bowes Bank to obtain Taxpayer Identification Numbers (TIN) from our customers in order to report the free postage earned on the Reserve Account. For Partnership, Corporations, Banks, government Agencies, or Non-profit Organizations, the Taxpayer Identification Number is the Federal Employee Identification Number. For Sole Proprietors, the Taxpayer Identification Number is the owner's Social Security Number. Please complete the form below and fax it to us as 1-203-564-2277 or mail it to: The Pitney Bowes Bank • P.O. 571677 Salt Lake City, UT 84157-1677 We appreciate your timely response to this notice. Thank you. INFORMATION REPLY FORM Please indicate if your company is one of the following ❑Partnership State / Gov't Agency El ❑Sole Proprietor Non -Profit 0 i]Corporation Foreign 0 El Bank Other El Organization Name Street Address VILLAGE OF KEY BISCAYNE 88 W MCINTYRE ST City, State, Zip Date KEY BISCAYNE, FL 33149 Pitney Bowes Customer Account # (I I Digits) Postage by Phone Account (8 Digits) I i f 5f 2j I 61 6 7 8 6I f of n 9 Digit Taxpayer Identification Number (TIN): L! 1 Certification- Under penalties of perjury. I certify that- (I) The number shown above is my correct taxpayer identification number(or I am vatting for a number to the issued to me). (2) I am not subject to backup withholding because (a)l am exempt from backup withholding or (b)I have not been not f ed by the Internal Revenue Service(IRS) that I am subject to backup withholding as a result t,fa failure to report all interest or dividends, or (c)the IRS has notified me that I am no longer subject to backup withholding; and (3) tam a US person (including a Ii S resident alien) Ifyou have been notified by the IRS that you are subject to backup withholding, crams out item 2 above. Signature of Princip Title SECAP FINANCE LEASE AGREEMENT STATE & LOCAL FAIR MARKET VALUE LEASE Postalogic Your Business information VILLAGE OF KEY BISCAYNE LA a Agreement Number Full Legal Name of Lessee 88 W MCINTYRE ST Billing Address: Street DBA Name of Lessee City Tax ID # (FEIN/TIN) FL 33149 State ZiP+4 Billing Contact Name Billing Contact Phone # Billing CAN # Installation Address (if different from billing address)- Street City 305-365-5511 Installation Contact Name installation Contact Phone # State ZIP+4 # 15266786860 Installation CAN # Fiscal Period (from — to) Your Business Needs Customer PO # Delivery CAN # Qty Business Solution Description 1 DM400G DIGITAL AUTOMATIC MAIL SYSTEM 1 INTEGRATED 5LB SCALE Check items to be included to customers payment ® Service by Dealer or other Third Party Postalogic DService Level Agreement, service performed by Secap or Affiliate ❑ Software Maintenance (additional terms apply) - Proudos revision updates s technical aosutanco ❑ Soft -Guards Subscription - Provides postal and carer updates If you do not choose Soft -Guard protection with your lease, you will autamaticalty receive updates at Pars current rates ❑ tnteiH4nk° Sulxscnptionfbieter Rental - Provides simplified billing and includes postage resets t O) Value Based Services El) Purchase Power* creek line ❑ Permit Mad Payment Service Allows you to consolidate permit postage with metered postage under one account As a aermit mail user, we t .I USPS forms 6001, 6002 aria 6003 along with the Permit Enrollment form, to activate your Permit Mait Payment service 0 ' tf green products are identified on your Order, the equipment covered by this Agreement includes remanufactured products that have gone through our factory certification testing process Your Payment Plan Number Of Months Monthly Amount* Billing Frequency First 30 $131 Quarterly Next 'Does nor include any applicable taxes Your Signature Below (❑ ) Required advance check of $ received Tax Exempt # State Tax (rr applicable) ( CJ ) Tax Exempt Certificate Attached (❑ }Tax Exempt Certificate Not Required Non -Appropriations. You warrant that you have funds available to pay all payments until the end of your current fiscal penod, and shalt use your best efforts to obtain funds to pay all payments in each subsequent tisoal period through the end of your Lease Term if your appropriation request to your legislative body, or funding authority (' Governing Body') for funds to pay the payments is denied, you may terminate this Lease an the last day of the fiscal period for which funds have been appropriated, upon (i) submission of documentation reasonably satisfactory to us evidencing the Governing Sody's denial of an appropriation sufficient to xintinue this Lease for the next succeeding fiscal penod, and (ii) satisfaction of alt charges and obligations under this Leese incurred through the end of the fiscal period for which funds have been appropriated, ncluding the return of the Equipment at your expense 3y signing below you agree to be bound by all the terms and conditions of this Agreement, including those contained on cage 2 and those located in the Secap Finance Terms for Dealers (Version Se3) which are available at xygypo ocr soo ppturnns and are incorporated by reference in the event of a o,onrlict between the terms of ends Lease Agreement and the provisions of the Secap Finance Terms for Dealers the terms of his Lease Agreement will control The tease will be binding on Secap Finance only after Secap Finance has completed its credit and d00 umentehon approval caress and an authorized Secap Finance employee signs below The lease requires you to provide proof of insurance ;ustomer Signatu 'nnt Name Title Email Address dales informati tostalogiC Secap Finance Acceptance Page 1 of 2 See Secap Finance Terms For Dealers for additional terms and conditions Daler Name ;©148822.2 } soap Finance SLG FMV Lease Agreement (Version 7115) 2013 Pitney Bowes Inc All rights rasanred Sacco the Secap design Pitney Bowes Connects Soft -Guard, inreiiitmk, and Purchase Power are registered trademarks owned by Pitney Bowes Inc Pitney Bowes Taken By: TD Sieber Order Date: ORDER AGREEMENT Rep ID#: Customer PO: Customer Information: Ship -to: Village of Key Biscayne ❑x Current Customer El New Customer 88 W McIntyre St Key Biscayne, FL 33149 Contact: PH: 305-365-5511 Email: FX: Bill -to: ❑ New Location Tax ID #: Attn: PH: FX: Order Type: ❑ Purchase 0 Lease Co: Pitney Bowes/Secap El Rental ❑ Demo Special Instructions: Per my Ok, give my local city govt office where i live a free upgrade machine QTY PART NUMBER DESCRIPTION UNIT PRICE EXT. PRICE 1 DM400G Digital Automatic Mail System 1 Sib Integrated Scale Includes: Delivery, installation and re-training (if needed) All maintenance calls & labor (excluding parts) All USPS rate changes and updates Transfer of postage from old machine to new one Removal and ship back of old machine back to Pitney warehouse $131/month (same monthly rental rate for state & local govt account) Subtotal Customer Name: Shipping/Handling Please Part Nan' rJhartyi Tax Signature:., \ .—,.� WAv� Total Title: Date: 12jar— J 0 S 7 a SERVICE CONTRACT Pitney Bowes Taken By: TD Sieber Rep ID#: Date: Customer PO: Customer Information: Village of Key Biscayne 88 W McIntyre St Key Biscayne, FL 33149 Contact: PH: 305-365-5511 FX: Email: Date: 12/7/14 Equipment: DM400G Digital Mail System & 51b Scale Serial Number: Equipment JD#: Rate: Included For Period: Term of lease Mailing Systems, Folder/Inerters, Software & mail processing Equipment Maintenance Agreement Terms and Conditions: I. Postalogic will perform all service calls and will replace, when necessary, any parts to ensure that you equipment functions at factory quality standards. This contract does not include consumable items, such as: ink cartridges, ribbons, meter tapes, ad plates, software, sponges, brushes, sealer plates, guide plates and print heads. It does not include downloading or adding postage. Updating your system due to a new location, or moving the system is not covered. Overhauls are not considered to be regular maintenance and are not covered by maintenance agreements. Comprehensive service will be performed during regular service calls. It is understood that all service is to be performed during normal working hours and does not include weekends or 2. holidays. This contract does not cover damage by fire, lightning, flood, abuse, accident, or theft. Postalogic will not be held 3, responsible for repairs made necessary due to misuse, abuse, neglect, vandalism, or service performed by personnel other than those of Postalogic. Postalogic will not be held responsible for delays or inability to provide service caused, directly or indirectly, by 4. strikes, accidents, embargoes, acts of God, or any other event beyond its control. This Contract is payable upon receipt. It is not transferable to a third party or refundable. Postalogic reserves the $' right to withhold service if the customer's account is delinquent. 6. if order is placed for a customer and then refuses delivery, there will be a 20% restocking fee charged. 7- Customers that go beyond recommended usage for a given product design may incur additional service charges. BY: p' SrAIOcICREPRFSFYTATIVFiIGN,n {,fE, TD Sieber BY: ;Pie), -rint r4dn.e Clearly rn NdrI e Clearly`