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HomeMy WebLinkAboutContract 45231-S3 Application No. �'� ✓ Contract No. - Supplement Decu-td 20*Amw maw/ Afew Softitknw. Supplement No. a Full LegatN'ame: City of Fort Worth Address: 275 W 13th Street City: Fort Worth State: TX Zip: 76102 Phone: 817-392-6689 Fax: DBA: Billing Address: 275 W 13th Street City: Fort Worth State: TX Zip: 76102 EQUIPMENTADDED: Qty. Make Item Description(or Accessories) 17 Ricoh MP 301 SPF 2 Ricoh SPC 830DN 17 Ricoh MPC 306SPF AL RECO 5 Ricoh MPC 401 SP 2 Ricoh MPC 4504SP '-CITY—SEcRETARy 2 Ricoh MPC 6004SP • 9 26 Kyocera FS 420ODN 1 Kyocera 6130CDN EQUIPMENT DELETED: Qty. Make Item Description(or Accessories) 7 Ricoh SPC 44ODN 1 Ricoh MP 2852SP 1 Ricoh MPC2051SP Ricoh SP351ON 'RENTAL PAYMENT FOR NEW EQUIPMENT ONLY. ental Payment for New Equipment ONL` B&W Images Allowance 0 Excess B&W Images Over Allowance* @$0.00000 $2,722.00 Color Images Allowance 0 Excess Color Images Over Allowance' $0.00000 Scans Allowance 0 Excess Scans Over Allowance' $0.00000 Linear Footage Allowance 0 Excess Linear Footage Over Allowance* $0.00000 This Agreement is to be billed together with Agreement(s) Please check one of the following: All payments and images are consolidated: 0 Yes NO METER READINGS VERIFIED Quarterly plus applicable taxes Balance of applicable term.Termination date of this supplement coincides with the termination date set forth in the DOCUMANAGE RENTAL Agreement or previous supplement mos. New term for equipment referenced above only. Such term begins upon supplement endorsement and acceptance by Owner. The term of the original Agreement shall remain in full force and effect for the remaining©figrnel eq,ipment TERMS / CONDITIONS You have requested this supplement to the DOCUMANAGE RENTAL Agreement(or supplement)as set forth above. Except for the specific provisions set forth above,the original terms and conditions set forth in the DOCUMANAGE RENTAL Agreement shall remain in full force and effect and are incorporated herein. ACCEPTANCE OF YOU HEREBY ACKNOWLEDGE THAT THE EQUIPMENT SET FORTH ABOVE HAS BEEN RECEIVED,HAS BEEN PUT IN USE,IS IN GOOD WORKING ORDER AND IS SATISFACTORY AND ACCEPTABLE.INITIAL METER READING:UNIT 1: UNIT 2 UNIT 3: Signature: X Date: Print Name: For: City of Fort Worth CUSTOMER ACCEPTANCE� Print Name: Susan V ture: X 's Title: Asst City Mgr Date: City f rt Worth RENTOR Signature: Date: For: 24557- APPROVED 1 APP TO FORM AND LEGALITY: JUN 16 2016 Allison Tidwell,Assistant to the City Assist t c41A A i_ty A ey