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C <br />ll 6u� <br />! r:at� <br />,%ormation Systems <br />F, V- usavinanx <br />® Purchase <br />❑ Monthly Term Plan <br />(3 month minimum) <br />❑ 12 Month Term Plan <br />L-ustomer Name <br />Tndian R <br />Address <br />1 Z4D_� s t 1 <br />City, State <br />❑ 24 Month Term Plan <br />❑ 48 Month Term Plan <br />k <br />BOOP( 6 f mJF. 64 7 <br />Computer Systems AIsI <br />Amendment <br />❑ 72 Month Term Plan <br />❑ Software License Only <br />❑ Other: <br />A I & I -IS Branch Code <br />No. Address - <br />Contract No. QQ <br />- 1}t1'tiYstt��'i$ <br />No. <br />No. <br />m No. Floor No. <br />Code <br />Customer Requests The Provision Of The Following Products Subject To The Terms And Conditions Of The Above -Referenced ContractjAs Amt.- <br />Supplemented By The Terms And Conditions Set Forth On The Reverse Hereof.'ed An( <br />Item Product Description <br />Price Element Quantity Total Price/License Fee tnsta; :, -,n <br />Code (One- i erne <br />Monthly Purchase Charge ) <br />1 (One -Time Ch .i <br />2724-28G 1 78.00 5.00 <br />2 <br />3E T <br />4 <br />5 <br />2853 WEATHER CARD 93065 1 <br />6 614.00 58.00 <br />7 <br />8 <br />9 <br />10 <br />11 <br />12 <br />Maintenance Coverage <br />- <br />Equipment <br />Software <br />Total This Page <br />❑ Mail In/Depot <br />❑ Remote Only 8-5 Mon. -Fri <br />212 00 <br />128.00 <br />❑ 8-5; Mon. -Fri. <br />❑ Remote Only 24 Hrs., 7 Days <br />Sub Total(s) From <br />Attached ( ) Additional Pages <br />❑ 24 Hours; 7 Days <br />❑ Dispatch 8-5, Mon. -Fri. <br />Less Advance Payments, <br />❑ Dispatch 24 Hours, 7 Days <br />Credits And Allowances <br />Shipping <br />tstallation/Delivery Date: <br />All prices and rates are Grand Total <br />11/15 exclusive <br />10 00 <br />86 <br />of sales/use taxes. <br />2138.001 <br />128.00 <br />ustomer Signat}ire poWJn(Uc;#ejLrpstomer hag read and agrees to the terns and conditions set forth on the <br />reverse hereof. <br />i'U'-FURK <br />S <br />ANDUVE <br />I NCY • '.� <br />AT&T Information Systems Inc. <br />qames <br />i <br />sst. <br />i son i. <br />Co. <br />Received by: <br />Atty ; <br />I r "' _ <br />Accepted <br />P by: <br />(Authorized Signature) <br />Indian Rvr <br />(Custom <br />my Dpmt of Emgncy Mgmt <br />l w.. <br />(Typed Name) <br />y -C <br />(Authorized Signature) <br />Don C. Scurlock T -r <br />Title) <br />(Typed Name) <br />At: <br />Cha i rmah <br />(Address) <br />(Title) <br />,. December 1601986 <br />(city. State, zip) <br />(Date) <br />--- <br />— On: <br />8 (Date) <br />