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Xerox Document Binder 120-D (DB120-D)

5. Customer Agreement Form

I have reviewed the solution expectations and understand the specifications and

limitations for each of the modules that will be installed: (Signature and Date)

Customer

Xerox Sales Representative

Xerox Analyst Representative

Xerox Service Representative

Coverbind Representative

For installations made in the US and Canada, a copy of the signed Customer Agreement must

be:

A) Attached to the XOA / Customer purchase order and faxed to SPA: 1-800 –407-8430.

B) Scanned and emailed to [email protected], or faxed to Phil Schmelzlen (585)

427-3140 (8*227-3140).

As a final step in the install planning you must complete the

Customer Agreement form.

Check off the modules that will be part of this install:

•

Xerox Document Binder 120-D

•

DocuPrint / DocuTech 75 / 90 Bypass Transport

•

A4 / 115V Conversion Kit

•

Letter size / 230V Conversion Kit

•

1021 Height Kit (Nuvera)

Record the primary customer applications:

Record any special considerations and / or limitations identified

by Xerox and agreed to by the customer:

5-1