PRIME COMPUTER SYSTEMS, INC.
Maintenance Agreement

Please complete the following form and our technical support group will respond to you with the appropriate rates!

Date: / / Email Address:

Customer Billing Information:
Company Name:
 Administrative Contact:
Address:
 City:
 State:
 Zip:
Technical Contact:
 Telephone:
( )  -    Ext: 		Fax:
( )  -
Purchase Order No:
 P.O. Date:
/ / 		Inspection Required:
Yes No


Type of Agreement:
Annually (5% Discount if paid annual)
Semi-Annually
Monthly
As Per Need Basis 		Response Type
Standard (9:00 AM - 5:00 PM Monday - Friday)
Extended (9:00 AM - 5:00 PM Monday - Saturday)
Premium (24 Hours 7Days a week)
Response Time


Period of Agreement:
Start Date:
/ / 		End Date:
/ /
Location of Equipment:
Special Instructions:(Equipment Make, Model, S/N, etc.)


Prime Computer Systems, Inc.

 Customer:
By:
 By:
Title:
 Title:

Notes:
1) Normal Business Hours are from 8:30 AM to 5:00 PM Monday through Friday, except legal holidays.
2) All times exclusive of the hours specified in (1) will be considered "Off Normal Business Hours" and if coverage is required,
special emergency rates will be applies.


See Terms and Conditions of this Agreement