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04-049 Pitney Bowes DM800 Postage Machine Contract_- PBCC Pitney Bowes Credit Corporation KIMBERLY SMITH CITY OF CUPERTINO 10300 TORRE AVE CUPERTINO CA 95014-3255 Date: June 3, 2004 Rental Account No: 7518591 401 Thank you for your order and the opportunity to serve your company. Pitney Bowes and Pitney 'owes Credit Corporation {PBCC) are dedicated to your ±otal satisfaction and a.re committed to providing you with the finest products, backed by the highest quality care and service. PBCC is pleased to acknowledge acceptance of your. offer to utilize our Term Rental Agreement program for your Pitney Bowes Equipment needs. We are committed to providing fast, accurate and courteous responses to any of your financing questions. Shortly, you will receive your first invoice. C)ur records show that you agreed to the payment schedule (which includes the deferred interest), shown below. Please review this information at your earliest convenience and contact us at 1-800-288-2357, if you have any questions. Equipment Description: MAILING SYSTEM Equipment Location: 10300 TORRE AVE CUPERTINO CA 95014 Deferred Interest: $4, 203.92 Payments Frequency Total Payment First 60 Monthly $591.00 * plus applicable sales and use taxes. Please note that your invoices will be sent to the mailing address of this letter. Return all remittances to: PBI, P. O. Box 856179, Louisville, KY 40285-6179. Our office hours are 8:30 a.m. to 7:00 p.m. E;~stern Time. If you have any questions or comments, please call us at 1-800-288-2357. Sincerely, Richard Gabris Government Operations Manager 2? Waterview Dr. Shelton Connecticut 06484-4361 800-288-2357 DATE: SEPTEMBER 8, 2D04 CITY OF CUPERTINO 10300 TORRE AVE CUPERTINO, CA. 95014-3202 CUSTOMER ACCOUNT NUMBER: UNKNOWIV PLEASE BE ADVISED THAT WE ARE UNABLE TO PROCESS YOUR PURCHASE ORDER/ AGREEMENT FOR THE FOLLOWING REASON (S): ( ) 1. PITNEY BOWES ACCOUNT NUMBER. NEEDED (X) 2. i~1ODEL AND SERIAL NUMBER NEEDEED ( ) 3. PRICE DISCREPANCY ( ) 4. UNABLE TO IDENTIFY EQUIPMENT ( X) 5. OTHER -see explanation- REASON(S): PERIOD OF PERFORMANCE IS NEEDED PLEASE FORWARD THE ABOVE NOTED INFORMATION AND YOUR PURCHASE ORDER TO: 1305 Executive Blvd., Ste 200, Chesapeake VA 23320. WE WILL PROCESS UPON RECEIPT. THANK YOU FOR YOUR COOPERATION. Bobbi Mikiel State Accounts Billing Associate 757-963-5046 City of Cupertino / ~g--6 CITY OF CUPERTINO ^%--~ PURCHASE: ORDER 10300 TORRE AVENUE CUPERTINO, C.A 95014-3202 (408) 77-?-3219 ~ o~ (DAVE) Pi -T-N ~ y ~o w E s , .-~. ~,' C . To: p- o. i3 c x ~`s~ 3~ o -~I~lo~ -b ~O~3b (a~ SPECIAL INSTRUCTIONS ^ CONFIRMING ORDER ^ WILL CALL FOR MERCHANDISE ^ MAKE INQUIRIES TO ITEM NO. QUANT{TY UNIT OF ISSUE DESCRIPTION UN1TPRtCE" _ AMOUNT ~v~t~~/tr"G- /i/IACE-~«:c ~vsT~4(Te= ~ 7~ Ooh ~ /~ A- / ~/ j £ AG' .S T~F ~~ /~E T~/2 /~A-~/~I E ~~/V i ,~ L ~'o ~~O/~ ~U ~d~ ~ nC~- i1nGt~z~+'1~ M ~G1 ~ (~ -~-5.~ Sc; r i G~ ~ ~ 00 ~ d $~ Me~ej y ~~M gv~? Ser~~G I'. aoo~a ~ PURCHASE ORDER NO. ~~~~ G~ [] CITY HALL - 10300 TORRE AVE. -ROOM SHIP ^ SERVICE CENTER - 10555 MARY AVE. T0: ~ pARKAND RECREATION ^ OTHER PLEASE PUl THIS PURCHASE OHDEH NUMt3EH ON YOUR INVOICE, SEND ~4LL INVOICES TO: C--''','" '/ /~~~ PACKING LISTAND PACKAGE. FINANCE DEPARTMENT fJ,' 10300'~ORRE AVENUE VENDOR CUPEFITINO, CA 95014-3202 (PURCHASIN AUTHOR TY) Pitney Bowes ~~ Your Business Information CAN # ORDER # + l ,,...~ ~~ f ! .. , .-P~ 1 ,+ J ~ ~ FULL LEGAL NAME OF RENTER ._ f f %' ''!/ ~ :- ~ %' 2 + ft%:- DBA NAME -- EMAIL ADDRESS BILLING ADDRESS i~.%~ ~` '~'~~} ~ l'`<~,~ ~. ~ ~-~1.~` CITY ~~ ~,/'_ ,%;`/;~' ; ~1 t ~~,.i STATE ZIP+4 ';' , G ~' i ~"-' PHONE # C..'`~ / % s'~ ~ ~' CONTACT NAIyIE '~~ r ; ~' ~ " ~ "'`' SEND INVOICE TO ATTN OF EQUIPMENT LOCATION IF NOT SAME AS ABOVE CITY STATE ZIP+4 CREDIT CARD # EXP DATE NAME ON CARD TYPE TAX SALES TAX FISCAL PERIOD RFWTFR Pfl It ~ Your Business Needs lily Modle/ Ott & Services [-~p~.x ads r~+s aeco;~eared, ~, n~xH ar~edl n :/~.~ r`~ rr?k'' ~ I~L. /(i~%C~3'C'i1 `iY~ f,....,~.'c- ~l~/, ~f~/{~. i ( ! .+ r,f, J`! t ¢ i ~ (, y .+ r;'~ J '~i ~ i F ~ j. I !tea j' ~> : : J p 1 ' Payment Schedule /Billing "~"~ Your Payment Plan Initial Rental Term: >/ ~+ Frequency ~'f(ilonthly ^ Quarterly ^ Other (specify- ~J Frst ~'~ mordhs $ ~ ~permonth Next months $ per month Next months $ per month Fnal Payment $ 100.00 Initial Check Amount $ SIGNATURE ~ ~ ~ r _. iRe~+l Account # 60 4 CNECK I-EMS IU BE INCLUDED IN YOUR PERIOD PAYMENT ®' Equipment Maintenance Agreement On Rental C~'~5ott-Guard Agreement ~f. CI~Software Maintenance Agreement ~n~ i ~J~ "' •. a ~Aeter On Rental ~~~ Rental Terns and Conditions By your signtiture as "Renter" below, you request that we rent to you the equipment described above or on any schedule attached hereto (the "Equipment") for esserdial governmental purposes in wnsideration of your payment to us of the amounts set forth in tl~e Payment Schedule, subject to the terms and conditions provided in this Agreement. For purposes of this Agreement, III payments set forth in the Payment Schedule shall be referred to as the "Total Payments." The payments referred to in the Payment Schedule other than the "Final Payment" shall be referred to singularly as a "Period Payment" and collectively as the "Period Payments." Your offer will be binding on us when we accept it by having an authorized employee sicn it. All payments hereunder shall be payable only to us at our executive offices unless we direct you otherwise in writing. 1. NON-APPROPRIATION. You warrant that you have funds available to pay the Total Payments until the end of your current fiscal period, and shall use your best efforts to obtain funds to pay the Total Payments in each subsequent fiscal period through the end of your Initial Term. If your appropriation request to your legislative body, or funding authority ("Governing Body") far funds to pay the Total Payments is denied, you may terminate this Agreement on the last day of the fiscal period for which funds have been appropriated, upon (i) submission of documentation reasonably satisfactory to us evidencing tl~e Governing Body's denial of an appropriation sufficient to continue this Agreement for the next succeeding fiscal period, and (ii) satisfaction of all charges and obligations under this Agreement incurred through the end of the fiscal period for wI ich funds have been appropriated, including the return of the Equipment at your expense. TITLE PRINT NAME ' ~ DATE PB ACCOUNT REP NAME L j' J ' % ~" /~ ! ~ s't j f+ar;;'t EMPLOYEE # r ~ i~ °~ ~ ~- DISTRICT NAME & #_i ;~ ~ ~,, PB ACCEPTED BY TITLE DATE EXECUTIVE OFFICE.• 27 WATERVIEW DR • SHELTON, CT 06484-4361 • EQUIPMENT VE'VDOR: PITNEY BOWES, INC. • FOR SALES AND SERVICE CALL 1-800-322-8000 WHITE COPY PBCC • PINK COPY PITNEY E~OWES INC. • YELLOW COPY CUSTOMER PAGI.1 PB SLR2 (8/01) SEE PAGE 2 FOR ADDITIONAL TERMS AND CONDITIONS ,~ Pitney Bowes lgineering the flow of communicationTM Account name City Of Cupertino Account number 7518591 Invoice number 7518591-FB07 Questions? If you have questions about your bill ~I ~ Log on to: www.pb.com ° ' and click on My Account. Your enrollment code is: 0718 Call8 a.m to 6 p.m. EST: ' 1-800-288-2357 Summary of your invoice I Term rental charges ~~ ....................................................................................... $591.00 ales tax $0.00 Total due March 6, :!007 $591.00 ~J/~~ Please see reverse sitfe fordetails ofyourinvoice charges. / Make check payable to Pitney Bowes. Your last payment of $Ei91.00 was credited to your account on Jan 31, 2007. Any payments received after Feb b, 2007 may not be reflected on this invoice. If ou have an " "" Y y questions regarding your account, please call the telephone number listed on this invoice. Thank you for choosing Pitney Bowes. ,>~ We hope you like our new look! Wehave redesignedyour Pitney Bowes invoice to make it easier to read. The new invoice is just another way Pitney Bowes is fulfilling its brand promise to you: Engineering the flow of conl-nunicationT"". Page 1 of 2 TAX ID 06-0495050 TearoNhere 007575 X Pitney Bowes Term rental payment coupon Account number: 7518591 -Amount you owe: $591.00 2225 American Drive Please make your check payable to Invoice number: 7518591-F607 Neenah, WI 54956-1005 P/tneyBoWes 0131 01 007535 00001 001 0213 2 007 Invoice date: Feb 13, 2007 Due date: Mar 6, 2007 Amount paid $ . 60 7518591 401 6'40 00059100 1 00000 0 0 PITNEY BOWES PO BOX 856179 LOUISVILLE KY 40285-6179 ~ I "I ' II I I' II I'I 'I' I ' I CITY OF CUPERTINO ' " ""' ' " "' " '~~~~ ~~~ ~ ~~ r~ ~ 10300 TORRE AVE CUPERTINO CA 95014-3255 ^ Change of contact information? Check here and fill in the information on the back, Your terrn rental invoice February 13, 2007 Form $~3$-GC Information Return for Small Tax•Exempt Governmental Bond Issues, Leases, and Installment Sales OMB No. 1545-0720 (Rev. November 2000) - Under Internal Revenue Code section 149(e) Department of the Treasury Caution: if the issue rice of the issue i.. $100,000 or more, use Form 8038-G. Internal Revenue Service P ' Re ortin Authorit __ Check box if Amended Return - I-I 1 Issuer's name ~:fy of ~~~~,-~~~o 3 Number and street (or P.O. box if mail is not delivered to street address) /U 300 To ire Avenue 4 City, town, or post office, state, and ZIP code Cuoert/~o, ~A 950/~F -3ZSS 2 Issuer's employer identification number rfY ; dd'27368 Room/suite 6 Name and title of officer or legal representative whom the IRS may call for more information Carn / Aa ust.~c Fi'~a~cc Di~c>ar Descri tion of Obi ations Check if reporting: a single issue ' Report number . GC Z00 y - l 7 Telephone number of officer.or legal representative ( X08 ) 771-328D or on a consolidated basis ^ 8a Issue price of obligation(s) (see instructions) . 8a /7 2 ~ to •00 b Issue date (single issue) or calendar year (consolidated) (see instructions) - -Qf,30~0-~ 9 Amount of the reported obligation(s) on line Sa: 'I a Used to refund prior issue(s) 9a b Representing a loan from the proceeds of another tax-exemF~t obligation (e.g., bond bank) 9b 10 If the issuer has designated any issue under section 265(b)(31(B)(i)(III) (small issuer exception), check this box . - ^ / 11 If any obligation is in the form of a lease or installment sale, ~~heck this box . - ~~ 12 If the issuer has elected to a a enalt in lieu of arbitra a rebate, check this box - ^ Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and [o the best of my knowledge Sign and belief, they are [rue, correct, and complete. ,/ Here Cd/7JI AU~ ttS~n¢. ' to / O'{ ' F~~a~c~ Direc.~r er's authorized repres alive Date Type or print name and title General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Purpose of Form Form 8038-GC is used by the issuers of tax-exempt governmental obligations to provide the IRS with the information required by section 149(e) and to monitor the requirements of sections 141 through 150. Who Must File Issuers of tax-exempt governmental obligations with issue prices of less than 5100,000 must file Form 8038-GC. Issuers of atax-exempt governmental obligation with an issue price of 5100,000 or more must file Form 8038-G, Information Return for Tax-Exempt Governmental Obligations. Filing a separate return. Issuers have the option to file a separate Form 8038-GC for any tax-exempt governmental obligation with an issue price of less than $100,000. An issuer of atax-exempt bond used to finance construction expenditures must file a separate Form 8038-GC for each issue to give notice to the IRS that an election was made to pay a penalty in lieu of arbitrage rebate (see the line 12 instructions). Filing a consolidated return. For all tax-exempt governmental obligations with issue prices of less than 5100,000 that are not reported on a separate Form 8038-GC, an issuer must file a consolidated information return including all such issues issued within the calendar year. Thus, an issuer may filE~ a separate Form 8038-GC for each of a number of small issues and report the remainder of small issues issued during the calendar year on one consolidated Form 8038-(~C. However, a separate Form 8038-GC rnust be filed to give the IRS notice of [he election to pay a penalty in lieu of arbitrage rebate. When To File To file a separate return, file Form 8038-GC on or before the 15th day of the second calendar month after the close of the calendar quarter in which [he issue is issued. To file a consolidated return, file Form 8038-GC on or before Fet~ruary 15th of the calendar year following the year in which the issue is issued. Late filing. An issuer may be granted an extension of time to file Form 8038-GC under Section 3 of Rev. Prot. 88-10, 1988-1 C.B. 635, if it is determined tha: the failure to file on time is not due to willful neglect. Type or print at [he top of the form, "This Statement Is Submitted in Accordance with Rev. Prot. 88-10." Attach to the Form 8038-GC a letter briefly stating why the form was not submitted to the IRS on time. Also indicate whether the obligation in question is under examination by the IRS. Do not submit copies of any bond documents, leases, or installment sale documents. See Where To File below. Where To File File Form 8038-GC, and any attachments, with the Internal Revenue ~~ervice Center, Ogden, UT 84201. Other Forms That May Be Required For rebating arbitrage (or paying a penalty in lieu of arbitrage rebate) to the Federal government, use Form 8038-T, Arbitrage Rebate and Penalty in Lieu of Arbitrage Rebate. For private activity bonds, use Form 8038, Information Return for Tax-Exempt Private Activity Bond Issues. Rounding to Whole Dollars You may show the money items on this return as whole-dollar amounts. To do so, drop any amount less than 50 cents and increase any amount from 50 to 99 cents to the next higher dollar. Definitions Obligations. This refers to a single tax-exempt governmental obligation if Form 8038-GC is used for separate reporting or to multiple tax-exempt governmental obligations if the form is used for consolidated reporting. Tax-exempt obligation. This is a bond, installment purchase agreement, or financial lease, on which the interest is excluded from income under section 103. Tax-exempt governmental obligation. A tax-exempt obligation that is not a private activity bond (see below) is atax-exempt governmental obligation. This includes a bond issued by a qualified volunteer fire department under section 150(e). Private activity bond. This includes an obligation issued as part of an issue in which: • More than 10% of the proceeds are to be used for any private activity business use, and Cat. No. 641086 Form 8038-GC (Rev. 11-2000) PBcc Pitney Bowes Credit Corporation CITY OF CUPERTINO 10300 TORRE AVE CUPERTINO CA 9501.4-3255 Dear KIMBERLY SMITH Account Number: Schedule Number: Equipment Description: Your organization recently entered into .a Pitney Rental Agreement. According to the terms of that of the Internal Revenue Code, you are. required to the Internal Revenue Service. 7518591 401 MAILING SYSTEM 10-02-04 Bowes State & Local Term agreement and Section 149 file Form 8038-GC with For your convenience, enclosed is Form 8038-GC and below is the information that you need to complete the Form. You need to indicate on the Part II line by checking the appropriate. box whether you are .reporting this as a "single issue"( due at the IRS within 45 days after the quarter in which the deal commenced) or on a "consolidated basis", which consolidates this transaction and any other similar transactions entered into during the year you entered into this transactivon (due at the IRS no later than February 15th of the following year). For commencement date, please see line 8b below. Lines 1-4 List your employer name and :Federal ID number Line 5 The "Report Number" refers to the number of 8038-GC Forms your agency-has already filed in 2004 for 2004 transactions.. This filing would be the next number. If this is the .first for 2004 activity, put "GC2004-1". Line 6 Name 'o f.-the person the IRS would call with questions Line 7 Phone number of-the person listed on line 6 Line 8a $17216.08 Line 8b 08/30/04 Lines 9z,9b, cYdinarily left blank, confirm th is with yo ur tax advisor 10 , 12 ~~ ~~ ~~ ~~ ~~ -~ ~- Line 11 Check the box Also enclosed, in question anal answer format, is additional information that you may find helpful. We at Pitney Bowes Credit Corporation administer your agreements for Pitney Bowes. If you need. any assistance, please call us at 1-800-288-2357. However, specific technical questions, including your responsibility to file, should be directed to your tax advisor. Please use the enclosed envelope to mail your completed Form 8038-GC. Thank you for your cooperation. Sincerely, Pitney Bowes Government Account Management 1305 .Executive Blvd, #200 Chesapeake VA 23320 C~uestions and Answers Q: What is this letter all about? A: The Tax Reform Act of 1986 requires all state and local governmental agencies entering into leases and other obligations after December 31, 1986 to file Form 8038-GC. Q: When does it need to be filed? A: • You are required to file this Form with the Internal Revenue Service within 45 days after the end of the quarter in which the' transaction commenced. Q: Does the Form have anything to do with sales tax exemption? A: No, whether your agency is subject to or exempt from sales taxes has nothing to do with your need to file this Form. Q: How do I fill in the Form? A: Instructions for completing the Form are on the Form itself. You need only fill in the highlighted areas, if applicable. Specific technical questions, including your responsibility to file the Form, should be directed to your tax advisor. The identification numbe~.r (question #2 on the Form) can be obtained from your Payroll department. Q: What happens if I don't file the Form? A: The law requires you to file this Form. Failure to do so may result in penalties. Q: If I have more than one obligation do I file a Form for each? A: If you do not file a separate Form for each obligation, you would have to consolidate your agreements with Pitney Bowes Ir.c., and any similar financing agreements you entered into with other companies duri~ig the year. Q: Where do I file the Form? A: Please file the Form directly with the Internal Revenue Service at the IRS Service Center, Ogden, Utah, 84201. An envelope is enclosed for your convenience. Q: Who should I contact at Pitney Bowes ~Nith questions on the 8038 filing? A: Please call 800-288-2357 for assistancf;. Do not call your Pitney Bowes sales representative. Q: Will this form have to be filled out each year? A: No, it is only required for the year in which the obligation commenced. 4/03