SLS-600 FACE January 2025
Canon U.S.A., Inc. (“CUSA”)
One Canon Park, Melville, NY 11747
(800) 613-2228
Salesperson: __________________________ Order Date: _______________ Customer (“you”):
Company:
DBA:
Address:
City: County:
State: Zip: Phone #:
Contact:
Email:
Applicable Terms and Conditions Customer Organizational Information TERMS AND CONDITIONS ARE AVAILABLE AT:
MK1.USA.CANON.COM/CUSTOMERDOCUMENTS
The CUSA customer terms and conditions located at the
above website (“Terms”) form part of this Agreement. The Terms include general terms, and terms for product and
service purchase, maintenance, support and leasing
(pursuant to the terms of Rider G); managed print
services; and quotes. The Terms applicable to each of
your transactions will be referenced in the Order Schedule.
By your initials herein and signature below, you
understand and acknowledge such Terms and agree to
comply with those applicable to each Order Schedule.
____________
Customer Initials
Federal Tax ID Number: _____________________
Organization type:
Address for Notices:
Attn:
Address:
Address 2:
City: State: Zip:
Email:
BY YOUR SIGNATURE BELOW, YOU AGREE TO LEASE, PURSUANT TO THE TERMS OF RIDER G, OR PURCHASE, AS
SPECIFIED IN THIS AGREEMENT, THE ITEMS LISTED IN ANY SCHEDULE, RIDER OR ADDENDA (AS APPROVED BY CUSA) TO THIS AGREEMENT. YOU ACKNOWLEDGE RECEIPT OF A COPY OF THIS AGREEMENT, AND AGREE TO ABIDE BY ALL
OF THE TERMS AND CONDITIONS OF THIS FACE PAGE, APPLICABLE SCHEDULE(S), RIDER(S) AND SUCH ADDENDA, THE
QUOTE, AND THE APPLICABLE TERMS AND CONDITIONS IDENTIFIED ABOVE, ALL OF WHICH IS INCORPORATED HEREIN AND MADE PART OF THIS AGREEMENT.
Customer’s Authorized Signature _____________________________________________________________________________ Printed Name ____________________________________ Title _________________________________ Date ______________ Master Sales & Services Agreement
Customer Information Face Page
#___________________
595 S SAN JACINTO AVE 951-487-7330 Timothy M Cooper CITY OF SAN JACINTO CA 1/13/2025 92583-4134 595 S SAN JACINTO AVE SAN JACINTO [email protected] Jessica Mendez MA58875 SAN JACINTO RIVERSIDE CA SLS-600 FACE January 2025 [email protected] 92583-4134 Jessica Mendez Lease Schedule ("Schedule") - Blended (SER-800) Page of Customer: CFS App #: Salesperson:
Agreement #: Transaction #: Order Date:
Billing Information Customer Account:
Company:
DBA:
Address:
Address 2:
City: County:
State: Zip: Phone #:
Contact: # of Payments in Advance Total Due at Signing
Email:
Shipping: Delivery Date:
Address 2:
City: County: State: Zip:
Primary Customer Contact:
Phone #: Email:
Meter Contact:
Phone #: Email:
IT Contact:
Phone #: Email:
Billing:
Address 2:
City: County: State: Zip:
Billing Contact:
Phone #: Email:
Elevator: Loading Dock: # of Steps: Hrs of Operation:
For CUSA USE ONLY:
Customer Authorized Signature: Printed Name: Title: Date:
For Internal Purposes Only:
CFS Authorized Signature: Printed Name: Title: Date:
SER-800 Blended Lease January 2025 **Requires Remote Reporting Agent Item Code Qty
THIS SCHEDULE IS ENTERED INTO PURSUANT TO, AND INCORPORATES THE TERMS OF, THE MASTER SALES AND SERVICES AGREEMENT REFERENCED AS THE AGREEMENT # ABOVE ("AGREEMENT"), INCLUDING THE MASTER LEASE TERMS SET FORTH AS RIDER G THERETO WHICH SHALL CONTROL (THE “LEASE TERMS”). TO THE EXTENT THE TERMS OF AN EXISTING CFS MASTER AGREEMENT ARE REFERENCED ON THIS SCHEDULE (THE “EXISTING MASTER CFS LEASE”) AND ARE APPLICABLE TO THIS SCHEDULE, THEY SHALL CONTROL OVER THE MASTER LEASE TERMS SET FORTH AS RIDER G TO THE AGREEMENT FOR SO LONG AS THE EXISTING MASTER CFS LEASE REMAINS IN EFFECT. STANDARD TERMS AND CONDITIONS AND APPLICABLE RIDERS INCORPORATED HEREIN ARE AVAILABLE AT MK1.USA.CANON.COM/CUSTOMERDOCUMENTS, AND SHALL APPLY TO THE EXTENT NOT MODIFIED BY THE AGREEMENT. THIS SCHEDULE CONSTITUTES A LEASE OF THE LISTED ITEMS, AND IS BINDING ON CUSTOMER UPON SIGNING BY CUSTOMER, AND IS BINDING ON CUSA AND LESSOR AS PROVIDED IN THE LEASE TERMS. THIS SCHEDULE IS NON-CANCELABLE BY CUSTOMER. CUSTOMER REPRESENTS THAT EXECUTION OF THIS SCHEDULE HAS BEEN DULY AUTHORIZED. BY YOUR SIGNATURE, CUSTOMER AGREES TO LEASE THE LISTED ITEMS AND, IF SELECTED, TO PURCHASE THE MAINTENANCE SERVICES DESCRIBED HEREIN. YOU ACKNOWLEDGE RECEIPT OF A COPY OF THIS SCHEDULE.
Additional Requirements:
Listed Items Description Ship To & Maintenance Billing Information CFS Invoicing
Other Transaction Details
Covered Images Included in Payment Excess Per Image Maint Charge(s) Due at Signing
Payment* (*Plus Applicable Taxes)
Total
Listed Items Lease Term
Months
Equipment Maintenance Information
# of Lease Payments
Payment Information
Canon U.S.A., Inc. ("CUSA")
One Canon Park, Melville, NY 11747
(800)-613-2228
STANDARD POWER FILTER 15A/120V 1
INSTALL PAK DX C5870I/C5860I/C5850I/C5840I Jessica Mendez Lease Payment
shall be invoiced
Monthly
OC: UNIVERSITY OF CALIFORNIA PURCHASING AGREEMENT #2020002755 SAN JACINTO HIGH CAPACITY CASSETTE FEEDING UNIT-C1 92583-4134 3 STAPLE FINISHER-AB3 CA Code Area 2248959 2044935 1
No SER-800 Blended Lease January 2025 Excess Per Image Charge invoiced Monthly by CFS $1,133.57 1 9-5 IMAGERUNNER ADVANCE DX C5850I [email protected] 2368V120 3923V843 B&W: $0.00710 Color: $0.04280 Purchase Option: Fair Market Value 1 4395V196
Rider A applies (Maintenance for Office Equip/Cut Sheet Production) RIVERSIDE Pre-Installed Supplies Installed in Machine 92583-4134 S21147070 0 Per Unit Coverage Plan 951-487-7330 CA 1
CITY OF SAN JACINTO 1
Config: A | 57356949 MID VOLUME CONNECTIVITY 30+PPM UP TO 79PPM RIVERSIDE 0126C001 2/3 HOLE PUNCHER UNIT-A1 SAN JACINTO 951-487-7330 1 595 S SAN JACINTO AVE 595 S SAN JACINTO AVE [email protected] IntSupplies Jessica Mendez 01/13/25 CITY OF SAN JACINTO No 60 6598C002 Fixed Price Plan Consumables: Toner, Staples (excludes clear) 1 5546C002 [email protected] Maintenance elected for all Equipment Jessica Mendez 951-487-7330 60 Auto-Toner Fulfillment** Timothy M Cooper BUFFER PASS UNIT-P2 1 3826C002 4031C002 Meter Method: Remote Reporting Agent B&W: 00 Color: 00 MA58875 1 Lease Schedule - Additional Listed Items Transaction #: ___________________ (SER-801) Page of Customer: Agreement #: Order Date: Salesperson:
Shipping: Delivery Date:
Address 2:
City: County: State: Zip:
Contact: Ph #: Email:
Mtr Contact: Ph #: Email:
IT Contact: Ph #: Email:
Billing:
Address 2:
City: County: State: Zip:
Contact: Ph #: Email:
Elevator: Loading Dock: # of Steps: Hrs of Operation:
For CUSA USE ONLY:
Shipping: Delivery Date:
Address 2:
City: County: State: Zip:
Contact: Ph #: Email:
Mtr Contact: Ph #: Email:
IT Contact: Ph #: Email:
Billing:
Address 2:
City: County: State: Zip:
Contact: Ph #: Email:
Elevator: Loading Dock: # of Steps: Hrs of Operation:
For CUSA USE ONLY:
SER-801 Blended Lease January 2025 **Requires Remote Reporting Agent Covered Images Included in Payment Excess Per Image Maint Charge(s) Item Code Listed Items Description Qty Ship To & Maintenance Billing Information Covered Images Included in Payment Excess Per Image Maint Charge(s) Item Code Listed Items Description Qty Ship To & Maintenance Billing Information Meter Method: Remote Reporting Agent Consumables: Toner, Staples (excludes clear) CITY OF SAN JACINTO 5546C002 [email protected] 3923V843 RIVERSIDE 1 MA58875 Jessica Mendez 951-487-7330 Config: B | 57356950 0 [email protected] 1
1 IntSupplies
B&W: 00 Color: 00 B&W: 00 Color: 00
4395V196 SAN JACINTO IMAGERUNNER ADVANCE DX C5850I 6598C002 B&W: $0.00710 Color: $0.04280
1 HIGH CAPACITY CASSETTE FEEDING UNIT-C1 5546C002 INSTALL PAK DX C5870I/C5860I/C5850I/C5840I 951-487-7330 Meter Method: Remote Reporting Agent 3825C002 [email protected] 1 1 No
Rider A applies (Maintenance for Office Equip/Cut Sheet Production) Finance Area No 1
3 STAPLE FINISHER-AB3 3826C002 1
BUFFER PASS UNIT-P2 RIVERSIDE 2368V120 Auto-Toner Fulfillment** No 4031C002 S21147070 STANDARD POWER FILTER 15A/120V B&W: $0.00710 Color: $0.04280
CA 3923V843 Pre-Installed Supplies Installed in Machine 2/3 HOLE PUNCHER UNIT-A1 IntSupplies PAPER FOLDING UNIT-L1 Jessica Mendez Administrative area 1 92583-4134 Pre-Installed Supplies Installed in Machine 1 595 S SAN JACINTO AVE [email protected] 4031C002 1 1 6598C002 01/13/25 Timothy M Cooper 1
1 Consumables: Toner, Staples (excludes clear) MID VOLUME CONNECTIVITY 30+PPM UP TO 79PPM 1 951-487-7330 No 2/3 HOLE PUNCHER UNIT-A1 1 STAPLE FINISHER-AB3 INSTALL PAK DX C5870I/C5860I/C5850I/C5840I Jessica Mendez 595 S SAN JACINTO AVE 0 0126C001 1
CA Auto-Toner Fulfillment** 2
92583-4134 1
951-487-7330 2368V120 4395V196 BUFFER PASS UNIT-P2 Config: C | 57356951 5549C002 MID VOLUME CONNECTIVITY 30+PPM UP TO 79PPM IMAGERUNNER ADVANCE DX C5860I 1 SAN JACINTO HIGH CAPACITY CASSETTE FEEDING UNIT-C1 STANDARD POWER FILTER 15A/120V Jessica Mendez Rider A applies (Maintenance for Office Equip/Cut Sheet Production) 0126C001
Lease Schedule - Additional Listed Items Transaction #: ___________________ (SER-801) Page of Customer: Agreement #: Order Date: Salesperson:
Shipping: Delivery Date:
Address 2:
City: County: State: Zip:
Contact: Ph #: Email:
Mtr Contact: Ph #: Email:
IT Contact: Ph #: Email:
Billing:
Address 2:
City: County: State: Zip:
Contact: Ph #: Email:
Elevator: Loading Dock: # of Steps: Hrs of Operation:
For CUSA USE ONLY:
Shipping: Delivery Date:
Address 2:
City: County: State: Zip:
Contact: Ph #: Email:
Mtr Contact: Ph #: Email:
IT Contact: Ph #: Email:
Billing:
Address 2:
City: County: State: Zip:
Contact: Ph #: Email:
Elevator: Loading Dock: # of Steps: Hrs of Operation:
For CUSA USE ONLY:
SER-801 Blended Lease January 2025 **Requires Remote Reporting Agent Covered Images Included in Payment Excess Per Image Maint Charge(s) Item Code Listed Items Description Qty Ship To & Maintenance Billing Information Covered Images Included in Payment Excess Per Image Maint Charge(s) Item Code Listed Items Description Qty Ship To & Maintenance Billing Information Meter Method: Remote Reporting Agent Consumables: Toner, Staples (excludes clear) CITY OF SAN JACINTO 0126C001 [email protected] RIVERSIDE 1 MA58875 Jessica Mendez 951-487-7330 Config: C | 57356951 0 [email protected]
B&W: 00 Color: 00 B&W: 00 Color: 00
2368V120 SAN JACINTO IMAGERUNNER ADVANCE DX C5860I 4921C001 B&W: $0.00710 Color: $0.04280
1 HIGH CAPACITY CASSETTE FEEDING UNIT-C1 5546C002 951-487-7330 Meter Method: Remote Reporting Agent 5961C002 [email protected] 1 1 No
Rider A applies (Maintenance for Office Equip/Cut Sheet Production) No 1
3 STAPLE FINISHER-AE1 3825C002 BUFFER PASS UNIT-P2 RIVERSIDE 3923V843 Auto-Toner Fulfillment** No 4031C002 S21147070 MID VOLUME CONNECTIVITY 30+PPM UP TO 79PPM B&W: $0.00800 Color: $0.04490
CA IntSupplies MID VOLUME CONNECTIVITY 30+PPM UP TO 79PPM 2/3 HOLE PUNCHER UNIT-A1 Jessica Mendez 1 92583-4134 1 160 W 6th Street [email protected] 4917C002 1
1 6598C002 01/13/25 Timothy M Cooper 1
1 Consumables: Toner, Staples (excludes clear) INSTALL PAK DX C5870I/C5860I/C5850I/C5840I 1 951-487-7330 No STANDARD POWER FILTER 15A/120V 1 STAPLE FINISHER-AB3 Pre-Installed Supplies Installed in Machine Jessica Mendez 270 BISSELL PL 0 4395V196 1
CA Auto-Toner Fulfillment** 3
92582-3110 1
951-487-7330 IntSupplies 4286V645 2/3 HOLE PUNCHER UNIT-A1 Config: D | 57356952 0126C001 Pre-Installed Supplies Installed in Machine IMAGERUNNER ADVANCE DX C3935I 1 SAN JACINTO CASSETTE FEEDING UNIT-AW1 IR ADV DX C3935/3930/3926 INSTALL PAK Jessica Mendez Rider A applies (Maintenance for Office Equip/Cut Sheet Production) 2368V120