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I<ONICA MINOLTA

January 30, 2013 Purchase Order Renewal Notice

DHHS
MARK MCGEE
DBA FOOD AND DRUG ADMINISTRATION HFA 720
12345 PARKLAWN DR
ROCKVILLE MD 20857

Dear Valued Customer:

Please be advised that your Purchase Order CREDIT CARD with Konica Minolta Business Solutions will expire on 09/30/2012. In order to avoid an interruption in the provision of service and supplies, please provide a renewal purchase order prior to expiration. Your Renewal Purchase Order should reflect an expiration date of 09/30/2013, as well as reference the data below. If your purchase order includes units that are not referenced below, please include them on your renewal. The pricing below does not include tax, if applicable:

Model Serial#

Meter
Type

Meter
Freq.

Freq Annual Allowable Ovg. Base Copies Rate Rate

Base
Freq

**BIZHUB C353 PRINTERIC A02E014000343 Black
Color

MON MON 4000 0.01100 528.96 No minimum 0.08460 0.00

MON MON

In the event your Purchase Order lapses, all service and supplies will be charged at then current Konica
Minolta rates and will require a credit card for processing.

To avoid a lapse in coverage, please complete this form and return to the address, fax, or Email listed below.

If you are renewing, please check one of the following and include your Purchase Order, if required:

1 PO for maintenance coverage is attached.

2 Process renewal- Maintenance PO is not required.

3 Maintenance is not desired- agree to pay for service and supplies at then current Konica Minolta rates. Signature is required for option 2 or 3.

Customer Signature Title Date

Mail: Konica Minolta Business Solutions
ATTN: PO Specialist
500 Day Hill Road
Windsor CT 06095

Fax: [phone]

email: [e-mail]

Phone: [phone]

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