HomeMy WebLinkAboutAgr 2009-01-29 (Shred-It)hredwit
A SECUR/X COMPANY
Type
❑ Standard Console
Every: ❑ 1 ❑ 2
Client Information
Ship To Locatigp, (service location
Multiple service locations ❑ (check here and attach location list)
Company Name: ~L7 0 1-4 ~
144 90 ezz
Contact Name:
{ Ca! 1/1 l"- I~di~1C ~si
Address:
i Cb m.) ,n Unit:
_
`b, 1 73 7f A i I:
Tel: 7iJ . 1~U•~o~
City: C ron State/Prov.: Zip/Postal Code:q~
Sold To Location: Same as Ship to
Company Name:
Contact Name: Position:
Tel: Email:
Address: Unit:
City: State/Prov.: Zip/Postal Code:
Bill To Location: ® Same as Ship to
Tax Type: ❑ Exempt (check here and attach exemption certificate)
® Same as Sold to
Company Name:
Contact Name: _ Position:
Tel: Email:
Address: Unit:
City: State/Prov.: Zip/Postal Code:
Are invoices paid at this location? (payer): Lp'/Yes
❑ No Same as:
❑ Ship to ❑ Sold to
Payer (if different from
7
Contact Name:: , ) /117 ~j
Address: .5 y,~ iIt?TA &1J Unit:
Email:
City: State/Prov.: Zip/Postal Code/.
Security Consoles:
Service Frequency:
Estimated Service Duration:
Billing Rate
/ Mie► Charge
Invoice Type: Local t` Consolidated
Payment Method: S~l'Qp-l~ `+~'~U~~ v`' i.'~s(✓~~/`~,~~ ~l.~~C f
❑ Check ❑ E.F.T (attach E.F.T information form) ❑ Visa ❑ MC ❑ AMEX Card Holder:
Card Exp. Date:
Agreed to oy (Terms and Conditions on reverse):
Shred-it S I c..("Shred-it")
Signed
Print Name
Position
Date
CLIENT AUTOMATIC SERVICE AGREEMENT
Qty Type Qty Type
Junior Console c ❑ Other
Y4 weeks, or /wk 1-04 desc.
Company r",N 7-/ IJ V XPN
Signed
Print Name
!E? Position
~~~D
Date
Qty.
4J We4 -CA-V,(0_
co
U
co
_o
2
U)
1 s
hredwit
A SECUR/T COMPANY
Ship To Locatio (service ti
Company Name il ` b"no -A0 /'Cf?_~
Contact Name: ~Z- Position:
Address: lteS T ! a !'yn / (f1. Unit:
CLIENT AUTOMATIC SERVICE AGREEMENT
Multiple service locations ❑ (check here and attach location list)
City: l State/Prov.: 614- Zip/Postal Code:
Sold To Location: 1~( Same as Ship to
Company Name:
Contact Name: Position: Tel: Email:
Address: Unit: City: State/Prov.: Zip/Postal Code:
Bill To Location: Ix Same as Ship to
[j~ Same as Sold to
Company Name:
Contact Name:
Address:
City:
Email:
State/Prov.:
Are invoices paid at this location? (payer): ❑ Yes
No Same as: ❑ Ship to ❑ Sold to
Payer (if different fro ve):
Contact Name: / l / ?0 i IAddress: Email:
City: State/Prov.
Zip/Postal Code:
Zip/Postal Code:
Security Consoles:
Service Frequency:
Estimated Service Duration:
Type
)4 Standard Console
Every: ❑ 1 ❑ 2
Qty Type Qty Type
❑ Junior Console,_ _ ❑ Other
4 weeks, or /wk fROIV7'1'04~ desc.
Invoice Type: Local ❑ Consolidated
Payment Method:
❑ Check ❑ E.F.T (attach E.F.T information form) ❑ Visa ❑ MC
Card
Agreed to by (Terms and Conditions on reverse):
Shred-it U A Inc. ("Shred-it")
Signed 2C..
Print Name
Position
Date 7
Tax Type: ❑ Exempt (check here and attach exemption certificate)
Position:
Unit
❑ AMEX Card Holder:
Exp. Date:
Company JO(A)AI le TI 13 V)U
jJsL
Signed n
Print Name / J
Position 4< V Atit otIlf 1-16'
Date r/"•Z--091/ICF~' U)
Tel:
Qty.