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MailFinance <br />A Neopost USA Company <br />Office Information <br />Office Number: / ,,., , i Office Name: <br />Section (B) Billing information <br />C uny Na � (Full I name); (� ,y <br />, <br />DeA: <br />ailing Address: <br />�Oo <br />Billing Chy <br />b <br />Sla <br />9Aling Contact Name: <br />Contact Phone Number. <br />aging Contact Title: <br />Contact Fox Number: <br />Bring Contactessix Address: <br />Purchase Order Number: <br />Product Lease Agreement <br />with Meter Rental Agreement <br />Phone#: I Dafe Submltleo: <br />Section (C) Installation Information (If different than SWIM Information) <br />Company Name (Full teal name): <br />Installation Address (No PO Boxes or Gen ial Delivery}: <br />Installetmn City: <br />state; <br />Zip Cade+4: <br />Instal on Conte tName� <br />Phone Number. <br />fit 5 <br />Installation Contact Tide:` <br />Fox Number: <br />Installation Ciontact a9 Address, 1 <br />l <br />Main Post OHme Name r Mail Drop off. <br />Post of&a 6-Di9114P Code: - <br />Steffen fm Products <br />Quantity <br />Model r Part Number <br />Demuhtion(include Serial Number, if applicable) <br />❑ See additional listed products on attached continuation schedule. <br />1 <br />35" <br />2 <br />3 <br />d <br />Section (E) Lease Payment Information & Lease Payment Schedule <br />#of <br />Monthly Payment <br />Tax Status, <br />Panod <br />Momhs <br />4 Wus applicable taxes) <br />First' <br />❑ Taxable <br />Tax -Exempt <br />Next <br />(CarlMcale attached) <br />Billing Frequency: <br />❑ Monthly <br />Next <br />❑ Quarterly <br />❑ Annually <br />Next <br />Billing Method: <br />❑ Standard <br />Current Lease Number: <br />❑ ACH (Customer to submit authorisnUon form) <br />Section (F) Postage Meter & Postage Funding Information <br />Postage Funding Method: Postage Funding Account: <br />❑ Bill Me ❑ New <br />❑ Prepay By Check ❑ Existing Account <br />❑ ACH Debit lCusoomer to TMS Account # <br />submit authorization form) POC Account#_ <br />Service Products (Check all that apply) <br />❑ Online Postal Rates iMetern-App(SP10) <br />❑ Online Postal Expense Manager iMelernu App(SP20MeoStats) <br />❑ Online ESorvlces IMster-App(SP30) <br />❑ Onlne E-SeMces with Electronic Return Receipt ibleter- App (SP35) <br />❑ NmShip BASIC — Requires NeoFunds/TotalFunds (EP10) <br />❑ NeoShlpPLUS— Requires NeoFundarrotalFunds(EP70PLUS) <br />❑ NeiShip ADVANCED- Requires NeoFLndstTololFunds(NEOSHIPADV)) <br />❑ NeoShip Install& User Guide(EP70GUIDES) <br />❑ RunMyMali <br />Maintenance (provided by your authorized o#Icts) <br />Installation & Training (provided by your au(honzed office) <br />❑ Annual Software Support(Maintenance) <br />Covered Product <br />Section(G) Apptoval <br />Existing customers who currently fund the Postage acmuntby ACH Debitwill not be convened to NooFuids/TotelFunds unless Initialed here <br />This document consists of a Product Lease ("Leese) with MWIFinance Inc.; and a Postage Meier Rental Agreement ('Rental Agreemear). and an Online Services and Software Agreement <br />with Neopost USA Inc; and a Ne n'smisrrotalFurds Account Agreement with Mallreom Flomm, Inc. Yew signature cunstllutes an offer to enter Into the Lease ant, if applicable, the other <br />agreements, and acknrnMedges&l gy♦3q elved, read, and agree to all applicable terms and conditions .(version Deeled-easa-Vg416), which are also available at <br />7Xo:/foortal ne000stlWMAenn dt, and that you are authorized to sign the agreements on behalf of the customer IderMad above. The applicable agreements will <br />become blading on a nti> `pnlavRerga.authorized Individual accepts your offerby signing below, orwhen the equipment s shipped to you. <br />Dale Accepted <br />Farms Road • Milford, CT 06461 • WWW ne000stusa com <br />L51186e-04/16 Terms Revision R-04-16 <br />