LEASE Please bundle the hardware and maintenance pricing into the Unit Price. i.e. Monthly Hardware Cost + Monthly Maintenance Cost = Unit Price
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1 ORDERING INSTRUCTIONS COMPANY: TOSHIBA AMERICA BUSINESS SOLUTIONS, INC. FEDERAL IDENTIFICATION NUMBER: CONTRACT CONTACT INFORMATION Primary contact person responsible for answering questions regarding contract is: Name: Mike McKinley Title: National Account Manager Address: Toshiba c/o GEM Dept.,, Phone Number: Cell Number: Fax Number: After hours Emergency Number: ORDERING INFORMATION Please provide the following information on the Purchase Order: Contract Number: Purchase Order Number Supplier/Vendor Name Bill To/Ship To Acquisition Type (Purchase, Lease - 36M/48M/60M) Quantity Description Unit Price (Bundled Hardware & Maintenance, applicable to lease only) IMPORTANT NOTES PURCHASE Please remember to create a maintenance purchase order once the maintenance period expires (90 days after initial purchase). LEASE Please bundle the hardware and maintenance pricing into the Unit Price. i.e. Monthly Hardware Cost + Monthly Maintenance Cost = Unit Price COUNTY COVERAGE Please select the dealer/reseller based upon the appropriate Coverage. Once a dealer/reseller is selected, please select the appropriate Remit To based upon acquisition type. For Purchase/Lease Remit To information, see the following pages for detailed information. i.e. Address, Name, FEIN and etc. ARIBA ORDERS Before fulfilling an order through Ariba, please begin by selecting the appropriate reseller. Toshiba offers the qualifying entity the ability to acquire the equipment directly from Toshiba or through the local dealer/reseller. To order, please refer to the following pages for important Coverage and Remit To information. Page 1 of 11
2 DEALER/RESELLER: TOSHIBA BUSINESS SOLUTIONS/COPYCO FEDERAL IDENTIFICATION NUMBER: FEIN: CENTRAL REGION Contact: Paul Frost 2815 Directors Row Suite 700 Orlando, FL Phone: Fax: Contact: Paul Frost 151 SW Port Saint Lucie Blvd. Port Saint Lucie, FL Phone: Fax: SOUTHERN REGION Contact: Paul Frost 6401 Nob Hill Road Tamarac, FL Phone: Fax: Contact: Paul Frost 1601 Belvedere Road, Suite 106E West Palm Beach, FL Phone: Fax: US Bancorp Equipment Finance, Inc. P.O. Box St. Louis, MO Tax ID: FEIN: Page 2 of 11
3 DEALER/RESELLER: ADAMS REMCO INC FEDERAL IDENTIFICATION NUMBER: FEIN: NORTHERN REGION Contact: Stan Bagby Address: 3611 St. Johns Bluff Rd South Ste 7 Jacksonville, FL Phone: FAX: stanb@adamsremco.com Page 3 of 11
4 DEALER/RESELLER: ADVANCED BUSINESS SYSTEMS FEDERAL IDENTIFICATION NUMBER: FEIN: WESTERN REGION Contact: Brian Snow 1236 North Montroe Street Tallahassee, FL Phone: Fax: Advanced Business Systems 1236 North Montroe Street Tallahassee, FL Tax ID: FEIN: Advanced Business Systems 1236 North Montroe Street Tallahassee, FL Tax ID: FEIN: Page 4 of 11
5 DEALER/RESELLER: AMERICAN BUSINESS SYSTEMS FEDERAL IDENTIFICATION NUMBER: FEIN: NORTHERN REGION Contact: Fred Klusmeier 9637 Hood Rd Jacksonville, FL Phone: Fax: Page 5 of 11
6 DEALER/RESELLER: BORING BUSINESS SYSTEMS FEDERAL IDENTIFICATION NUMBER: FEIN: CENTRAL REGION Contact: Dean Boring 938 East Main Street Lakeland, FL Phone: Fax: Page 6 of 11
7 DEALER/RESELLER: COASTAL BUSINESS PRODUCTS INC FEDERAL IDENTIFICATION NUMBER: FEIN: WESTERN REGION Contact: Kieran May 1855 Huriburt Road Ft Walton Beach, FL Phone: Fax: Contact: Kieran May 2688 Chapman Dr Panama City, FL Phone: Fax: Contact: Kieran May 4700 Bayou Blvd, Ste 1-B Pensacola, FL Phone: Fax: Page 7 of 11
8 DEALER/RESELLER: COPY CONCEPTS INC FEDERAL IDENTIFICATION NUMBER: FEIN: CENTRAL REGION Contact Person: Mike McBride 407 Interstate Blvd Sarasota, FL Phone: Fax: Contact Person: Mike McBride Th Street North St Petersburg, FL Phone: Fax: SOUTHERN REGION Contact Person: Mike McBride Metro Parkway Fort Myers, FL Phone: Fax: Contact Person: Mike McBride 600 Goodlette Road North #101 Naples, FL Phone: Fax: Page 8 of 11
9 DEALER/RESELLER: DANKA OFFICE IMAGING FEDERAL IDENTIFICATION NUMBER: FEIN: F WESTERN REGION Contact: TJ Carrender 3200 W Fairfield Drive Pensacola, FL Phone: ext 2 Fax: TJ_Carrender@Danka.com Contact: Ron Schofield 1891 Capital Circle Ne Unit 4 Tallahassee, FL Phone: Fax: Ronald_Schofield@Danka.com Contact: TJ Carrender 750 Lakeside Drive Mobile, AL Phone: Fax: TJ_Carrender@Danka.com Contact: Bill Hammer 3721-B NW 40th Terrace Gainesville, FL Phone: Fax: William_Hammer@Danka.com Page 9 of 11
10 DEALER/RESELLER: SKYWAY TECHNOLOGY GROUP INC FEDERAL IDENTIFICATION NUMBER: FEIN: F CENTRAL REGION Contact: Byron Norrie, Jr Tampa West Blvd Tampa, FL Phone: Fax: Page 10 of 11
11 RESELLER: TOSHIBA AMERICA BUSINESS SOLUTIONS INC FEDERAL IDENTIFICATION NUMBER: RESELLER INFORMATION ALL REGION Contact: Mike McKinley Phone: Fax: Same as Reseller Same as Reseller US Bancorp Equipment Finance, Inc. P.O. Box St. Louis, MO Tax ID: FEIN: Page 11 of 11
STATE OF FLORIDA CONTRACT NUMBER: ORDERING INSTRUCTIONS
ORDERING INSTRUCTIONS COMPANY: TOSHIBA AMERICA BUSINESS SOLUTIONS, INC. FEDERAL IDENTIFICATION NUMBER: 33-0865305 CONTRACT Primary contact person responsible for answering questions regarding the contract
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