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Computer Lease Program - Phase 4: New Item
   
Please Note ... Do NOT print this form and use a typewriter to complete. Simply type in your information
while on the web and click on the "Save and Close" button above. If you do not follow this procedure we
will not have a record of your order.
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Authorized Purchasing Requestor *  
Authorized Purchasing Requestor E-mail *
CED/Dept Head *  
User Names
(Individuals who will be
using the computers.)
 
Lease/Purchasing Information *
Method of Payment *
Account Numbers
  Fund Order (RIO/SIO)  
     
  (8 digits) (10 digits)  
County/Dept *
Address To *  
Street Address *  
City *  
State *  
Zip code *  
   
Order Item & Quantity Annual Lease Price
(Note: still estimates; waiting for final rate)
Desktop PC - Qty.
Desktop PC (19" Monitor)
$400 per Year (for 4 years) 

Desktop PC w/two 19" Monitors
Desktop PC w/two 19" Monitors
$450 per Year (for 4 years)

Desktop PC w/one 24" Monitor
Desktop PC w/one 24" Monitor
$510 per Year (for 4 years)

Laptop PC - Qty.
 
Laptop PC
$600 per Year (for 3 years) 

Laptop PC with Docking - Qty.
 
Laptop PC with Docking (19" Monitor ONLY)
$720 per Year (for 3 years) 


*  indicates a required field