Credit Application
Fax to: 800-451-5360
NEC AMERICA, INC.
300 FRANK W. BURR BLVD., TEANECK, NJ 07666 · (877) NEC-FINANCE · (201) 287-8300 · www.neclease.com
EXISTING CUSTOMER YES Ë
NO Ë If yes, Account #
FINANCIAL STATEMENTS MAY BE REQUIRED
Supplier Name and Address
Telephone
TION
Fax
SUPPLIER
INFORMA
E-mail
Sales Rep Name
Contact Name
Equipment Description (Make, Year, Model, Etc.)
Estimated Installation Date:_________________ Contact:_______________________________________________ Lease Signer:___________________________________________ Title:_______________________
TION
Lease Type
Lease Term
NEC Equipment Cost
$ _________________________
Lease Rate Factor
_________________________
Non-NEC Equipment
$ _________________________
Lease Payment
$ _________________________
LEASE INFORMA
Equipment Total
$ _________________________
(Lease Payment = Lease Rate Factor x Total Cost)
Sales Tax
$ _________________________ _______%
Advance Rentals
# ___________= $____________
Sales Tax
Rate
Total Cost
$ _________________________
Security deposit
$ _________________________
Complete Legal Company Name
Telephone
Fax Number
E-Mail
Trade Style/DBA
Nature of Business
Federal Tax ID# (FID)
Headquarters Address
City
State
Zip Code
Installation Address (if different from above address)
City
State
Zip Code
(Corporation Proprietorship General Partnership LTD LLC LLP PC PA Not for Profit Government
Business Start Date: __________________________________________ Bankruptcy History (Circle one): No
Yes/When: __________________________________________________________
Years Business Owned ____________________________ State of Inc./Organization__________________________________________ D & B# _____________________________________________
If you are Tax Exempt Please Attach Certificate/Exemption #
Parent Company (if applicable) Company:
Subsidiary Division Affiliate
Equipment Installation Location:
Name:__________________________________________________________________________________
Landlord/Owner: __________________________________________________________________________
HQ Address: ____________________________________________________________________________
Address:__________________________________________________________________________________
TION ____________________________________________________________________________________ _____
____________________________________________________________Expiration Date:______________
City, State, Zip: __________________________________________________________________________
Contact:_________________________________ Phone No.: ______________________________________
Name/Title : Principal
Owner
Partner
Officer
Member
Email
Email
Social Security #
Social Security #
CUSTOMER INFORMA
Home Address
City
State
Zip
Home Phone
Name/Title (Circle one): Principal
Owner
Partner
Officer
Member
Email
Social Security #
Home Address
City
State
Zip
Home Phone
Name of Bank / Branch
How Long
Contact Name
Telephone
Chkg. Acct. #
Fax
Loan Acct. #
Name of Trade Reference
How Long
Contact Name
Telephone (or City & State)
Account #
I / We grant NEC or its Agent's permission to investigate my/our financial responsibility and credit worthiness, and authorize release of any personal or business information accordingly. I / WE agree to make
available financial statements, tax returns, etc, upon request. I/We acknowledge that any Advance Rental(s) and/or Security Deposit(s) are not refundable if NEC approves our application for credit.
Signature: X_______________________________________________________________________________________________ Print Name:____________________________________________________________________________ Date:_______________
AUTHORIZED SIGNER
TITLE
By execution of the Credit Application and Lease Agreement, I / We warrant that the information submitted herein is true and correct.
Lease Agreement
Lease Number:
NEC AMERICA, INC.
300 FRANK W. BURR BLVD. TEANECK, NJ 07666 · (201) 287-8300 · Fax (201) 287-9555 www.neclease.com
LESSEE (LEGAL NAME AND ADDRESS)
SUPPLIER INFORMATION
CONTACT:
CONTACT:
TELEPHONE: FAX:
TELEPHONE: FAX:
EQUIPMENT:
EQUIPMENT LOCATION:
LEASE TERM
AMOUNT OF EACH PAYMENT"RENTALS"
PAYMENT FREQUENCY
ADVANCE RENTAL
SECURITY
PURCHASE OPTION PRICE
Make Check Payable to NEC AMERICA, INC.
DEPOSIT
($, %, FMV, SECURITY DEPOSIT)
_____________
Monthly
First rental and last ______________
___ MONTHLY ___ OTHER
(IN MONTHS)
$ ____________
_________________
Rental totaling $________________
$_________
YMENTAP SCHEDULE ADDITIONAL PROVISIONS:
As used in this agreement the words "We," "Our" and "Us" refer to the Lessor and the words "You" and
OF NEW JERSEY. YOU CONSENT TO JURISDICTION AND VENUE IN THE STATE OR FEDERAL COURTS OF
"Your" refer to the above-named Lessee. You agree to lease the equipment described above and on any
NEW JERSEY. YOU EXPRESSLY WAIVE ANY RIGHT TO A TRIAL BY JURY. EQUIPMENT LOCATION, USE
schedule to this Lease, together with all accessories, additions and attachments thereto and replace-
AND REPAIR: You will keep and use the Equipment only at the location shown above and agree that
ments and substitutions therefore ("Equipment") and agree to the terms and conditions of this Lease
the Equipment cannot be moved without our prior written permission. You shall be responsible for keep-
Agreement ("Lease"). You agree to pay the Rentals to us in accordance with the payment schedule
ing the Equipment in good working order and repair (all work performed by only authorized providers);
shown above. We may adjust your Rentals up or down by up to 20% if our acquisition costs are differ-
and shall protect the Equipment from any kind of loss, damage or destruction and will continue to pay
ent than the amount we used to calculate the Rentals shown above and you authorize us to correct or
Rentals, even if the Equipment is lost, inoperable or destroyed. We are not responsible for any losses or
insert any missing information on the agreement. You are responsible for arranging delivery of the
damages caused by the installation or use of the Equipment, or from any other kind of loss while you
Equipment. The Lease will begin when the Equipment is delivered. Rentals will be payable monthly in
have the Equipment; and you agree to hold us harmless and defend us against any claim for such loss.
advance until all your obligations are paid in full. You unconditionally accept the Equipment unless you
At least 6O but not more than 90 days prior to the expiration of the initial or any renewal term of this
notify us in writing within 5 days after delivery specifying the reason for your non-acceptance. We may
Lease, you shall notify us in writing of your intention to exercise the purchase option above or return the
require you to provide a signed delivery and acceptance certificate to us. NO WARRANTY: YOU AGREE
Equipment to us; and this Lease will automatically renew for successive 60 day periods at the same
TO LEASE THE EQUIPMENT "AS IS" AND THAT WE MAKE NO WARRANTIES, EXPRESS OR IMPLIED, CON-
monthly Rental amount until you exercise an option or provide us such notice. If you exercise a fair
CERNING THE EQUIPMENT, INCLUDING, WITHOUT LIMITATION, ANY WARRANTY OF MERCHANTABILITY
market value purchase option, you agree to purchase all, but not less than all, of the Equipment for its
OR FITNESS FOR A PARTICULAR PURPOSE. YOU WAIVE ANY CLAIM AGAINST US FOR ANY LOSS, DAM-
fair market value considering the Equipment is in place and in use at your location. If you elect to return
AGE (INCLUDING INCIDENTAL OR CONSEQUENTIAL DAMAGES) OR EXPENSE RELATING TO THE EQUIP-
the Equipment to us, it must be returned to the location we designate in good working order and con-
MENT. YOU AGREE THAT YOU HAVE SELECTED THE EQUIPMENT USING YOUR BEST JUDGMENT AND
dition, and you agree to pay us a Restocking Fee equal to one additional Rental payment and be respon-
NOT BASED ON ANY STATEMENTS OR REPRESENTATIONS MADE BY US. YOU UNDERSTAND AND
sible for all expenses incurred in returning the Equipment. INSURANCE: Throughout the term of this
AGREE THAT NEITHER THE SUPPLIER OF THE EQUIPMENT NOR ANY AGENT OF THE SUPPLIER IS
Lease, you will provide and maintain, at your expense, property insurance for full replacement value of
AUTHORIZED TO CHANGE OR RELEASE ANY TERM OR CONDITION OF THIS LEASE AND NO STATEMENT
the Equipment and public liability insurance covering us for all personal injury and/or third-party prop-
BY THE SUPPLIER OR ITS AGENTS WILL AFFECT YOUR DUTY TO PERFORM YOUR OBLIGATIONS AS SET
erty damage claims relating to the Equipment, each naming us as loss payee and additional insured.
FORTH IN THIS LEASE. You agree to continue to pay Rentals to us under this Lease regardless of any
You will provide evidence of such insurance to us on demand; failing which, we may at, our option,
claims you may have against the manufacturer or supplier. We transfer to you for the term of this Lease
either buy such insurance for you and add the cost to your obligations under this Lease or charge you
any warranties made by the manufacturer or the supplier. ABSOLUTE OBLIGATION: YOUR OBLIGA-
a monthly administrative fee for monitoring and administering such insurance coverage. Our purchase
TION TO PAY THE RENTALS AND OTHER SUMS AND ALL YOUR OTHER OBLIGATIONS HEREUNDER
of insurance on your behalf, shall not relieve you of any obligations or release you from any claims we
SHALL BE ABSOLUTE AND UNCONDITIONAL AND ARE NOT SUBJECT TO ANY DEFENSE, ABATEMENT,
may have against you. DEFAULT: If you fail to pay any Rental payment or any other payment when
SETOFF, OR COUNTERCLAIM FOR ANY REASON WHATSOEVER. You agree that the terms and conditions
due, or breach any of the terms of this Lease, you will be in default of this Lease and any other agree-
contained herein are the entire agreement regarding the lease of the Equipment. Any change or termi-
ment you may have with us or any of our affiliates. If you default, we may require you to do any com-
nation of this Lease must be in writing and signed by us. You agree that any delay or failure to enforce
bination of the following: (1) immediately pay all past due amounts plus the present value of the remain-
our rights under this Lease does not prevent us from enforcing any right at a later time. All of our rights
ing unpaid balance of the Lease discounted at 5% per annum, plus the residual value of the Equipment,
and indemnities will survive the termination of this Lease. All collateral and Equipment securing this
if any; or (2) return all of the Equipment or allow us to repossess it. We can use any and all remedies
transaction shall secure any and all of your other obligations at any time owed to us. TITLE, TAXES
available to us under the Uniform Commercial Code or any other law. If we have to take possession of
AND FILINGS: We are the owner of and have title to the Equipment. You will pay, when due, all taxes,
the Equipment, you agree to pay the cost of repossession and you agree to pay us reasonable attor-
fines and penalties relating to the use or our ownership of the Equipment. If any applicable taxes and
ney's fees and costs associated with any legal action we may take in the event you default. Additionally,
fees are not included in the scheduled rentals, we will include and invoice you for those taxes and fees
if you default, we may, but need not, apply any security deposits to your unpaid obligations under this
and you agree to pay them in addition to your scheduled rentals. If we pay any taxes, fees or penalties
Lease. Provided no event of default has occurred, at the end of this Lease, any unapplied security
for you, you will pay us on demand the amount we paid plus an administrative fee. You authorize us to
deposit refunded shall be without interest. ASSIGNMENT: YOU HAVE NO RIGHT TO SELL, TRANS-
sign and record UCC financing statements on your behalf to show our interest in the Equipment. You
FER, ASSIGN OR SUBLEASE THE EQUIPMENT OR THIS LEASE. We may sell, assign or transfer this
agree to pay us a documentation fee of $72.50 to cover our expense in processing this Lease and cred-
Lease or our rights in the Equipment without notice to you. You agree that if we sell, assign or trans-
it application. You shall notify us in writing of any change in your name, state of organization, principal
fer this Lease, the new owner will have all of our rights and benefits and will not be subject to any claim,
place of business or principal residence within 30 days after such change becomes effective. LATE
defense or setoff that you may have against us. NOTICE: If you or we are required under this
FEES AND COLLECTION CHARGES: If any Rental or other amount due is not paid to us within five (5)
Agreement to notify the other of any matter, the notice must be sent by certified first class mail, postage
business days of its due date, you agree to pay us a late charge of the greater of 10% of the amount
prepaid, or by a reputable overnight delivery service, to the address shown at the beginning of this
which is late or $25.00, but no more than the maximum amount allowable under applicable law. You
Agreement. The address for notices may be changed by notice given in like manner. Notices sent by
also agree to pay us thirty-five dollars ($35.00) for each check returned for insufficient funds. FAXED
overnight delivery will be considered effective when received. Notice sent by first class mail will be
AND COPIED DOCUMENTS: You agree that a facsimile copy of this Lease and related documents with
effective on the third business day after deposit in the U.S. Mail. ARTICLE 2A RIGHTS AND REME-
facsimile signatures may be treated as originals and will be admissible as evidence. CHOICE OF LAW:
DIES: You agree that this Lease is a finance lease as defined in Article 2A of the Uniform Commercial
YOU AGREE THAT BECAUSE WE COUNTERSIGNED AND ACCEPTED THIS LEASE IN TEANECK, NEW JER-
Code ("UCC"). You hereby waive any and all rights and remedies granted to you by sections 2A-508
SEY, THIS LEASE SHALL BE GOVERNED BY, INTERPRETED AND ENFORCED ACCORDING TO THE LAWS
through 2A-522 of the UCC.
LESSEE
PERSONAL GUARANTY
Legal Name
I/We, jointly and severally, absolutely, unconditionally and irrevocably guaranty to you, your successors and assigns and
of Business ________________________________________________
agree to be directly and unconditionally liable for the due payment and performance of any and all of Lessee's present
and future obligations to you. I/We consent to any agreements with the Lessee and/or others including payment exten-
Billing
Address __________________________________________________
sions and/or restructures, and waive any and all notice(s) to which I/we may be entitled. My/Our liability hereunder is
direct and unconditional and continuing and may be enforced without prior resort to any other right, remedy or security.
City, State,
& Zip ____________________________________________________
This guaranty and all related obligations shall be governed and enforced under the laws of the State of New Jersey. I/WE
WAIVE THE RIGHT TO TRIAL BY JURY AND CONSENT TO THE VENUE AND JURISDICTION OF ANY STATE OR FEDER-
Organizational I.D. /SS# ________________________________________
AL COURT SITTING IN THE STATE OF NEW JERSEY.
Authorized Signature and Title
(Guarantor's Signature) An Individual (No Title)
(Guarantor's Signature) An Individual (No Title)
X
X
X
Lessee Printed Name _____________________________________
Printed Name Date
Printed Name Date
Signer represents they are authorized to execute this Lease Agreement.
Accepted by NEC America, Inc. (Lessor)
Home Street Address
Home Street Address
_________________________________________________
Authorized Signature
Date
City State Zip Code
City State Zip Code
Certificate of Acceptance
Lease Number __________________________
Supplier / Vendor Payment Authorization
Schedule Number _______________________
Lessee Name
We hereby acknowledge receipt of the Equipment described in the above-referenced Lease (the "Equipment") and
of Business __________________________________________
after full inspection of the Equipment have found it to be fully installed and in good working condition and satisfacto-
ry for all purposes of the applicable Lease Agreement or Lease Schedule we both signed. We hereby irrevocably
Equipment
authorize you to pay for and purchase the Equipment.
Location ____________________________________________
TO THE EXTENT THAT THE COST OF THE EQUIPMENT INCLUDES ANY MAINTENANCE/WARRANTY CON-
Authorized Signature (Corporate Officer, Owner, Partner)
TRACT, WE CLEARLY UNDERSTAND AND AGREE THAT YOU HAVE NO RESPONSIBILITY TO US OR ANYONE
ELSE IN CONJUNCTION WITH THE RESPONSIBILITIES AND OBLIGATIONS OF THE SUPPLIER WITH
X____________________________________
RESPECT TO THE MAINTENANCE/WARRANTY CONTRACT AND THAT YOU DO NOT AND WILL NOT ACCEPT
(Please sign upon delivery of equipment)
ANY OBLIGATION OF ANY TYPE TO PERFORM ANY SERVICE, REPAIR, REPLACEMENT OR MAINTENANCE
OF THE EQUIPMENT, AND THAT YOU ARE NOT A PARTY TO THE MAINTENANCE/WARRANTY CONTRACT. IN
ALL CIRCUMSTANCES, WE UNDERSTAND AND AGREE THAT WE WILL ONLY SEEK TO HAVE THE SUPPLIER
PERFORM UNDER THE MAINTENANCE/WARRANTY CONTRACT AND REGARDLESS OF ANY DISPUTE OR
Printed
DISSATISFACTION WE MAY HAVE WITH THE SUPPLIER OR THEIR SERVICES, WE AGREE TO CONTINUE TO
Name: ______________________________________________
PAY YOU ALL THE RENTALS DUE UNDER THE AGREEMENT AND THE PAYMENT DUE UNDER THIS LEASE
SCHEDULE.
Title:_______________________________ Date: __________
We understand that based on representations made by us herein and elsewhere, you are about to purchase the
Equipment and pay the Supplier.
WE HEREBY IRREVOCABLY AUTHORIZE YOU
TO PAY FOR AND PURCHASE THE EQUIPMENT
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