Mou/Moa - 2016 - Pitney Bowes Lease Agreement - 11/9/2016WSCA/NASPO FMV Lease Agreement Account #10 State of Idaho
Fu el& WIT W
Agreement Number
Your Business Information
CITY OF EAGLE03o���
Full Legal Name of Lessee / DBA Name of Lessee Tax ID # (FEINMN)
PO BOX 1520 EAGLE ID 83616-9102
Billing Address : Street City State ZIP+4
Sharon Bergmann 2089396813 0017048597
Billing Contact Name Billing Contact Phone # Billing Account #
660 CIVIC LN EAGLE ID 83616-0833
Installation Address (if different from billing address) : Street City State ZIP+4
.5h&7- Ar-kn AW 2089396813 Pj aOO 0011676235
Installation Contact Name Installation Contact Phone # Installation Account #
., 2017-01-29
PO # Quote Expiration Date
Your Business Needs — • ., .. _.•
Qty
Item
Business Solution Description
1
DM400C
DM400C Digital Mailing System
1
1 FAL
INVIEW 50 DEPT Accounting
1
1FY9
DM400 70 LPM
1
1FZO
Differential Weighing
1
1GW9
101b Integrated Weighing Feature
1
4CES
US LIVE DM400C BASE - ES2
1
G900
Meter for DM300/DM400/475 Series
1
G9SS
USPS Tracking Services Activation
1
MPDX
Differential Weigh 2, 5, & 101b scale
1
MP9G
Integrated Weighing Platform
1
SBTA
DM400C Digital Meter System
1
SJ40
SoftGuard for DM400
1
STDSLA
Standard SLA -Equipment Service Agreement (for DM400C Digital Mailing System)
1
SVSA
DM Series Analytics (50 Accounts)
U8356023-1 10115
0 2015 Pitney Bowes Inc- All rights reserved. Page 1 of 2 See Pitney Bowes Terms for additional tonne end conditions
Your Payment Plan
Toss not Include any applicable sales, use, orpropeny taxes which win be arced separately
( ) Tax Exempt Certificate Attached
( ) Tax Exempt Certificate Not Required
(X) Purchase Power® transaction fees included
( ) Purchase Power® transaction fees extra
Your Signature Below
By signing below, you agree to be bound by your State's/Entity's/Cooperative's contract, which is available at .,.a...y The terms and conditions of this contract will
govern this transaction and be binding on us after we have completed our credit and documentation approval process and have signed below.
Pitney Bowes Signature
Print Name
Date
Sales Information
Account Rep Name 1 Split Sales Rep ID District Office
Account Rep Name 2 Split Sales Rep ID District Office
US355023.1 10115
C 2015 Pitney Bowes Inc. All rights reserved. Page 2 o1 2 see Pitney Boma Tema for additional tonna and conditions
ST -101 Idaho State Tax Commission
9SALES TAX RESALE OR EXEMPTION CERTIFICATE
9-27-07 7-��
Sellers Name
Buyers Name
Pitney Bowes
City of Eagle, Idaho
Address
Address
27 Waterview Dr.
660 E. Civic Lane/P.O. Box 1520
City
State
Zip Code
City
State
Zip Code
Shelton
CT
06484
Eagle
I ID
183616
1. Buying for Resale. I will sell, rent, or lease the goods I am buying in the regular course of my business.
a. Primary nature of business Describe the products you sell, lease, or rent
b. Check the block that applies: ❑ Idaho registered retailer. Sellers permit number
❑ Wholesale only, no retail sales (required - see instructions)
❑ Out-of-state retailer, no Idaho business presence
2. Producer Exemptions (see instructions). I will put the goods purchased to an exempt use in the business indicated below.
Check the block that applies and complete the required information.
❑ Logging Exemption
❑ Broadcasting Exemption
❑ Publishing Free Newspapers
❑ Production Exemption (check one): ❑ Farming ❑ Ranching ❑ Manufacturing ❑ Processing ❑ Fabricating ❑ Mining
List the products you produce:
3. Exempt Buyer. All purchases are exempt, and no permit number is required. Check the block that applies.
❑ American Indian Tribe ❑ Emergency Medical ServiceAgency ❑ Nonprofit Children's Free ❑ Senior Citizen Center
❑ American Red Cross Federal/Idaho Government Entity Dental Service Clinic ❑ State/Federal Credit Union
❑ Amtrak ❑ Forest Protective Association ❑ Nonprofit Hospital ❑ Survivors of Domestic Violence
❑ Blind Services Foundation, Inc. ❑ Idaho Foodbank Warehouse, Inc. ❑ Nonprofit Museum and Sexual Assault, Inc.
❑ Center for Independent Living ❑ Nonprofit Canal Company ❑ Nonprofit School ❑ volunteer Fire Department
❑ Qualifying Health
Organization (see instructions for list)
4. Contractor Exemptions (see instructions).
a. Invoice, purchase order, or job number to which this claim applies
b. City and state where job is located
c. Project owner name
d. This exempt project is: (check appropriate box)
❑ In a nontaxing state. (To qualify, materials must become part of the real property.)
❑ An agricultural irrigation project.
❑ For production equipment owned by a producerwho qualifies for the production exemption.
5. Other Exempt Goods and Buyers (see instructions).
❑ Aircraft used to transport passengers or freight for hire ❑ Livestock sold at a public livestock market
❑ Aircraft purchased by nonresident for out-of-state use ❑ Medical items that qualify
❑ American Indian buyer holding Tribal I.D. No. This ❑ Pollution control items
form doesn't apply to vehicles or boats. See instructions. ❑ Research and development goods
❑ Church buying goods for food bank or to sell meals to members ❑ Snow making or grooming equipment, or aerial tramway component
❑ Food bank or soup kitchen buying food or food service goods ❑ Other goods or entity exempt by law under the following statute
❑ Glider kits for IRP -registered vehicles (required: )
❑ Heating fuel
Buyer: Read and sign./ certify that all statements/ have made on this form are true and correct to the best of my knowledge. l understand that
falsification of this certificate for the purpose of evading payment of taxis a misdepWanor. Other penalties may also apply
Buyers Name (please print) Bt S' at Title
Tracy E. Osborn Sr Deputy Clerk/Treasurer
Buyers Federal EIN and Drivers License No. and State of Issue Date .�
State tax exempt #: 11/09/2016
Seller: Each exemption a customer may claim on this form has special rules (see instructions). It's your responsibility to learn the rules. You must charge
tax to any customers and on any goods that don't qualify for a claimed exemption and are taxable by law.
9 This form may be reproduced. • This form Is valid only if all information is complete. 9 The seller must keep this form.