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HASLER MailFinance Lease Agreement <br /> Services Provided <br /> •,n * 171 Unlimited • No Meter Reset Charges <br /> Meter Resets • Only pay for what you download! <br /> totalFunds® • Instant access up to$700 postage- <br /> ss Postage without having to prepay! <br /> Payment • Receive a monthly invoice for <br /> IN600 AF Mailing Service postage <br /> b • Online access to account information, <br /> Payment Information statements, &payments <br /> Billing Frequency: ® Quarterly ❑Annually Ii71 Rate Change • USPS®Rate Updates included <br /> Number of Months: Monthly Payment: Protection • Accurate postage prevents returned <br /> 63 $154.99 mail and wasted money <br /> • Online Updates- no chips <br /> Professional Installation Service Included Promotions: Maintenance • Service is provided by one of our <br /> local offices <br /> Online Expense Management Installation Information (if different than billing) <br /> Company Name(Full legal name): <br /> Billing Information <br /> DBA: <br /> Company Name(Full legal name): <br /> CITY OF PEQUOT LAKES <br /> Installation Address(No PO Boxes): <br /> DBA: <br /> Mailing Address: City: State: Zip Code+4: <br /> 4638 County Road 11 <br /> City: State: Zip Code: County: <br /> PEQUOT LAKES MN 56472 <br /> Contact Name: Email Address: Contact Name: Email Address: <br /> Deb Marty cityhallLapequotlakes-mn.gov <br /> Phone Number: Fax Number: <br /> Phone Number: Fax Number: <br /> (218) 568-5222 ® Use my existing TMS Account Number: <br /> Purchase Order#: 189446 <br /> Tax Exempt?(Exemption Certificate is required if Yes) ❑ Yes ® No Postage Payment Option: ®Bill Me ❑Prepay❑ PostageNowT""ACH <br /> ACH Direct Debit (For lease payments only) For Internal Use Only <br /> Bank Name: Previous Lease <br /> Number: New Lease Customer Number(CSN): <br /> Number: <br /> H12101238 60491287 <br /> Bank Contact Name: Bank Routing Number: <br /> Owning Branch/Dealer Owning Branch/Dealer Name: <br /> **Please attach a blank voided check.A deposit slip will NOT be Number: 6970 Neopost Great Plains <br /> accepted.** <br /> Account Manager: Marketing Codes: <br /> Please see attached worksheet <br /> Date Submitted: Date Sent: Replaces Meter 5/N <br /> 8/31/2015 11634927 <br /> This document consists of a Product Lease("Lease')with MailFinance Inc.;Postage Meter Rental Agreement,Maintenance Agreement and an Online Services and Software Agreement with <br /> Neopost and a neoFunds®Account Agreement with Mailroom Finance,Inc.Your signature constitutes an offer to enter into the Lease and,if applicable,the other agreements,and <br /> acknowledges that you have received,read,and agree to all applicable terms and conditions(Version DirectLease-06-13),which are also available at <br /> http://www.neopostusa.com/terms/DirectLease-06-13.pdf,and that you are authorized to sign the agreements on behalf of the customer identified above.The applicable agreements will <br /> become binding on the companies identified above only after an authorized individual accepts your offer by signing below,or when the equipment is shipped to you. <br /> *Customers providing an email address will receive invitations to our educational webinars,product updates and neoNews,our monthly email newsletter. <br /> Customers who are upgrading or renewing an Agreement and currently fund the TMS Postage account by ACH Debit will not be converted to TotalFunds unless initialed here <br /> Authorized Signature Date Accepted <br /> Print Name and Title <br /> MailFinance Authorization Date Accepted Offer valid until 9/8/15 <br /> HASLER Barbara Card <br /> Fax Completed Form To. 478 Wheelers Farms Road <br /> PH: 203-301-3979 Ext. <br /> America's better choicer (203) 301-2776 Fax: (203) 301-2776 <br /> Email: b.card@neopost.com <br /> 8/31/2015 Manager Approval Rev.2015.1 <br />