I need to fill out a format with information from approximaly 18 contracts

Thank You!

Service Address

JOHN TO GO

21 VAN NATTA DR

RINGWOOD, NJ 07456

Ph: 845-362-2300 Fax: 845-362-4622

Phone: (305) 463-9000 x333 Fax: 0

Page 1 / 1

Billing Address

COLOURREPU 18705 11/15/2023 BI F-224817

Cust # Site # Date Clerk Terms P.O.# Invoice # Page

Invoice

COLOUR REPUBLIC FLOWERS

SUITE 100

8901 NW 33RD ST

DORAL, FL 33172

Email: [email protected]

COLOUR REPUBLIC FLOWERS

SUITE 100

8901 NW 33RD ST

MIAMI, FL 33172

DESCRIPTION RATE QTY TAX% TAX AMOUNT

1/12/2024- 2/12/2024

1 280.00 7.0 4,280.00 4,000.008 STATION RESTROOM TRAILER

Ladies: 4 individual stalls, 2 sinks, 1 towel paper dispenser, double roll toilet paper in each room

Men: 2 Individual Stalls, 2 Urinals, 1 Sink, 1 Towel Paper Dispenser, Double Roll Toilet Paper In Each Room

Air Condition, Heat, Large Mirrors, Sound System, Occupied/Vacant Indicator, Full Cherry Wood Interior, Walls & Ceiling Lighting, Exterior Above

Door Safety Light, 175 Gallon On Board Fresh Water Tank, 700 Gallon Waste Tank Capacity

1/12/2024- 2/12/2024

4 70.00 7.0 1,070.00 250.00/EACHSERVICE ONCE A WEEK - FREE

2ND SERVICE $250.00 PER TIME

Total Tax 350.00

5,350.00

Paid Amt 0.00

Adjustment Amt 0.00

Balance

EMAIL 5,350.00

From

To

If paying by Credit Card, please fill out below Invoice Balance

Card Number

Exp. Date

Signature Amount Paid

CVC Code

Please detach here and return the bottom portion with your payment.

5,350.00

0.00 Previous Balance

Total Due

5,350.00

If credit card address different from billing address above, please write in below.

Check Enclosed

Do we have your correct

email? [email protected],mfernandez@colourre

COLOUR REPUBLIC FLOWERS

SUITE 100

8901 NW 33RD ST

DORAL, FL 33172

Choose One: 1 Time Charge Charge Monthly

_ AMEX _ VISA _ M/C _ Discover

JOHN TO GO

21 VAN NATTA DR

RINGWOOD, NJ 07456

Div:F Cust #: COLOURREPU Site #:18705 Invoice #: 224817

Statement as of 11/21/2023 Future: 0.00 Current: 5,350.00 30 Day: 0.00 60 Day: 0.00 90 Day: 0.00 Total Due: 5,350.00

Thank You!

11/21/2023 9:09:20AMTERMS AND CONDITIONS

Acceptance. Customer shall be considered accepting these terms and conditions (“Agreement”) upon: (i) Paying deposit for use of

equipment; (ii) Equipment delivered to the Customer’s site by and or through their delegated person (“Site”) and use of equipment; (iii)

acknowledgment or action of typical Customer; or (iv) Company’s performance services at customer request. This Agreement supersedes

any prior or other terms of any purchase order or other Customer documents. All agreements must be reviewed and approved by “John to

Go, VIP to Go, John to Go Florida, Restroom to Go” or designated operating entity's

Access to Site. Customer agrees to provide the company with access to job site (the site) to perform normal business services such as:

Deliveries, Service or restrooms, and or pickup of equipment through (i) Open access to site during specified operating hours (ii) Provide

company with gate code, combination, or key (ii) Contact phone number to open specific site in reasonable time period.

Placement of Porta John. Suppliers can only place the porta john up to 40' from where the delivery/service truck can park.

Rental Rate and terms. Customer agrees to pay all charges due to the company during the rental period outlined in the quote or invoice

from the company. All invoices are deemed “due on receipt”. Customer will be responsible for all collection expense rising out of the

company’s efforts to collect due money.

Damages to Equipment. Customer is liable for all loss or damage to the Equipment, regardless of cause or fault, except for reasonable wear

and tear. Customer shall pay Company the actual cost of repair or replacement of the Equipment and, in addition thereto, for Company’s

loss of use of the Equipment. Customer shall promptly notify Company of any loss or damage to equipment.

Damage Wavier Program. The Company offers a Damage Wavier that protects the customers from damages to equipment. If customer is

current on invoices that has the Damage Wavier on it, they will not be responsible for damages to unit. The Damage Wavier does “NOT”

protect against; Willful neglect of equipment, theft of equipment, Hazardous material contamination, and excessive or repeat damages.

Contamination of Equipment. Customer agrees and will be responsible for all Hazardous Materials found in equipment. Hazard Materials

includes: Oils, Gas, Flammable liquids, Biohazardous wastes (Excluding normal toilet wastes), explosives, paints, or other non-toilet wastes

found in equipment. Customer will be responsible for cleanup and containment of these wastes at the customer’s expense. Further any fines

or penalties issued by state, federal, or local authorities. Lastly, the equipment will be considered on rent until the clean process is

completed.

Cancellations: All cancellations need to be submitted in writing. Supplier will cancel any reservation and return all money paid up to 48

hours prior to delivery.

Returned Checks: Customer agrees to pay a $50.00 charge for any check returned by a bank for insufficient funds, closed account(s) or for

any other reason.

Risk and Liability. Customer assumes all risk and liability for injury(ies) including death to any person and all risk and liability from the

rental, delivery, use, condition, maintenance of equipment.

Liability and Indemnification. The Lessee will indemnify and hold harmless the Lessor against any and all claims, actions, suits,

proceedings, costs, expenses, damages, and liabilities, including attorney's fees and costs, arising out of or related to the Lessee's use of the

Equipment.

Termination. The company hold the rights to terminate this agreement and remove equipment if: (i) Customer fails to pay invoices when

due, (ii) Equipment is damaged (iii) or company deems customer to be in breach of this agreement.

Application # Vendor Code: 06QUF

ACQUA FRESCA, INC.

12011 S.W. 129th CT #3

MIAMI, FL 33186

TEL: (786)249-4635

FAX: (305)234-3911

CUSTOMER INFORMATION Customer Legal Name

COLOUR REPUBLIC, LLC

Customer Billing Address (if different)

Address

8901 NW 33 ST. #100

Address

City

DORAL

County

MIAMI-DADE

City

County

State

FLORIDA

Zip

33172

State

Zip

Location Contact

Phone

305-463-9000

Location Contact

Phone

RENTAL TERMS NEW USED RECONDITIONED

The undersigned customer does hereby agree to rent the equipment described below at a monthly rate of $899.90

plus applicable taxes for a term of 36 months. Payments will be made on a (circle one) monthly, quarterly, or annual

basis. It is the customer’s responsibility to contact Acqua Fresca at the telephone number above for service or repairs.

QTY UNIT DESCRIPTION RATE PER UNIT TOTAL

12 LG AF 5000 HOT AND COLD-WATER SYSTEM $74.95 $899.90

SUBTOTAL $899.90

PLEASE READ BEFORE SIGNING

The customer agrees to rent from the vendor the equipment listed

above. The customer agrees to the terms and conditions contained in the

rental agreement. The customer agrees this rental agreement is for the

term indicated above and cannot be cancelled for any reason.

COLOUR REPUBLIC, LLC ______________________________ _______ _ COMPANY’S FULL NAME (PLEASE PRINT) _________________________________________ _______________________ AUTHORIZED SIGNER DATE ____________________________________________ __________________ AUTHORIZED SIGNER PRINTED NAME TITLE _____________________________________________ _________________ DEALER SIGNATURE DATE

CFONatalia Flor

DELIVERY AND ACCEPTANCE FORM

This Delivery and Acceptance form makes reference to the attached Rental Agreement bearing

Application Number ________________. The attached Rental Agreement is incorporated herein by reference.

Equipment Description: 12- LG AF 5000 HOT AND COLD-WATER SYSTEM, particularly defined in the attached

Rental Agreement.

Customer Initials Required

I agree that the Equipment has been delivered as I requested, I have inspected the Equipment, it is in good

working condition, and I unconditionally accept same. I understand my obligations under this agreement become

irrevocable upon my acceptance of the Equipment. _______________X

Customer Initials

This Agreement is a NON- CANCELABLE Rental Agreement between the Customer and Vendor. This Agreement is

for 36 months, and the base monthly payment is $899.90 (Plus applicable taxes, tax processing fee and loss or

destruction waiver).

No written or verbal alteration or this Rental Agreement is Valid. _______________X

Customer Initials

Signature Required

________________________________________

Authorized Signature 1 Date

NF

NF

Method of Payment Authorization Form

Customer Automatic Payment Authorization: By signing below, you authorize your Bank, credit card company or other financial institution sown below to: A) debit my checking account if I have selected EFT Direct Payment – Option A; or B) charge my credit card if I have selected Option B, for the purpose of paying the amount(s) owed under the agreement together with any other amounts you owe including past due amounts or default charges. You agree that if a payment cannot be made for any reason when due that continued attempts to debit or charge your designated account for the monies owed may be made until payment in full has been received. You represent that the following information is correct. Complete and Sign A or B.

A: EFT Direct Payment: - ATTACH COPY OF VOIDED CHECK

Name on Checking Account: __________________________________________________ Routing #: __________________ Account #: _________________________________

B: Credit Card-Direct Debit Charge to My Credit Card (ALL FIELDS REQUIRED)

VISA MasterCard AMEX Discover Name as it appears on the Card: ______________________________________________

CVV: __________ Zip Code: ____________ Account #: ______________________________ Expiration Date: __________________

Automatically deduct payable at signing? Yes No

Customer Signature: ________________________________________Date: _____________ Print Name: _________________________________________________________________

JD Title (if applicable): ___________________________________________________________

METHOD OF PAYMENT AUTHORIZATION FORM TPC‐DD AF 04/2013

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TERMS OF CONTRACT: THE ADDITIONAL TERMS AND CONDITIONS ON THE REVERSE SIDE HEREOF ARE INCORPORATED IN AND MADE PART OF THIS AGREEMENT. NO ONE IS AUTHORIZED TO CHANGE, ALTER, OR AMEND THE TERMS OR CONDITIONS OF THIS AGREEMENT UNLESS AGREED TO IN WRITING BY BOTH PARTIES.

SUBTOTAL

DELIVERY,

TAX

FREIGHT

TOTAL

B I L L T O : S H I P T O : LEASING COMPANY ACCOUNT NUMBER DEPARTMENT

COMPANY COMPANY

CONTACT EMAIL CONTACT EMAIL

ADDRESS ADDRESS

CITY COUNTY CITY COUNTY

STATE ZIP+4 PHONE STATE ZIP+4 PHONE

1.

2.

3.

4.

5.

6.

7.

8.

E Q U I P M E N T QTY. MODEL # DESCRIPTION SERIAL # ID # UNIT PRICE EXTENDED PRICE

PURCHASE o Cash Net Due on Delivery TERMS

o Other ________________________________________________

o LEASE

o RENTAL TERMS

Total Number of Months ______________________________________________

Monthly Payments of $________________________________________________, plus applicable taxes.

Advance payment(s) of first and last ________________________ months.

Downpayment $_______________________________________________________

Amount $ Date

$ ________________________________ ___________/___________/___________

$ ________________________________ ___________/___________/___________

$ ________________________________ ___________/___________/___________

P.O. #___________________________________ $__________________________

Check #_________________________________ $__________________________

DELIVERY INSTRUCTIONS

Delivery Date ___________/___________/___________

o AM o PM

o Sales Rep o Delivery Service

PAYOFF Amount $______________________________________________________

Good Until ___________/___________/___________

Payable to: ____________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

Account # ______________________________________________________________

o Lead

Originator _______________________________

o Internet

o Call In

o Self Generated

SUPPLIES

o Delivered by Rep

o Delivered with Equipment

CORPORATE USE ONLY

AFFIX BAR CODE STICKER HERE

ACCEPTANCE: This agreement is not valid unless signed by an authorized manager.

MANAGER APPROVAL

AUTHORIZED CUSTOMER SIGNATURE X

PRINTED AUTHORIZED CUSTOMER NAME

DELIVERY ACCEPTANCE SIGNATURE DATE X

RESTORED DIGITAL SOLUTIONS

CUSTOMER AGREEMENTServing the State of Florida Tel: 888-242-4242 Fax: 786-206-0145 [email protected] or [email protected] DATE M/A SALES REP NAME SALES REP # SALE TYPE ORDER #

ACCOUNT o NEW o EXISTING INSTALL DATE INSTALL METER—B&W INSTALL METER—COLOR NATURE OF BUSINESS

o Y o N

w w w . r d s t e a m . c o m

12/6/23 ✔ David Martin ✔

Colour Republic LLC

Mayre Gamero [email protected]

8901 NW 33rd Street, Suite 100

Miami Miami - Dade

FL 33172 786-836-0475

Colour Republic LLC

Fernando Mujica / IT Dept [email protected]

2153 NW 86th Avenue

Miami Miami - Dade

FL 33122 954-394-9632

1 1 Month Rental (1/12/24 - 2/12/24 ) $ 499.00 $ 499.00

Equipment: (1) Recon Ricoh MPC 4504

1 Refundable Security Deposit $ 750.00 $ 750.00

$ 1,249.00

$ 299.00

$ 34.93

$ 1,582.93

Rental includes 6,000 BW and 3,000 Color for rental period. BW overages billed at $0.01 and Color overages at $0.075

Security Deposit will be refunded at end of rental or used against overages that have accumulated during the rental period. If the security deposit is exhausted, then the balance due will be invoiced. Rental includes all service labor, parts and toners Rental includes all service labor during weekday hours M-F

Any after hours & weekend hours are billable $235/per hr for service calls.

Install & Pick Up

TERMS AND CONDITIONS OF TRANSACTION

Customer hereby agrees to the following terms and conditions:

This order shall become binding once approved and accepted by an authorized representative of Restored Digital Solutions, LLC. (hereafter “Company”) at its home office and may not be cancelled or altered after acceptance without Company consent.

All right, title and interest in the equipment or supplies described on the front page shall remain the property of the Company until paid in full. Any default under this Agreement as outlined below, shall result in Company's right to declare the entire sum remaining unpaid to be immediately due and payable. Thereafter, with or without legal process using such force as may be necessary in accordance with the laws of the State of Florida, the Company may enter upon the premises where such equipment or supplies, or any part thereof, maybe located and repossess the same. Thereafter the company shall hold such equipment or supplies absolutely free from all claim of the Customer and retain all payments made by the Customer as reasonable rental of said equipment and for the use, wear and tear thereof, or as much as may be permitted by law. The customer waives, so far as is consistent with public policy, the benefits of any statutes of the state that may conflict with the conditions of this provision, or with any causes of action which may arise hereunder.

The Company shall have a right to declare default under this Agreement if: the Customer fails to pay the agreed net purchase price under the terms and conditions outlined on the front page hereof; a receiver is appointed for the Customer or the Customer shall make an assignment for the benefit of creditors; a petition in bankruptcy shall be filed by or against the Customer; or the Customer breaches any material aspect of this Agreement.

All invoices are due and payable on the date of delivery. Customer agrees to pay interest at the rate of 2% per month on any amount not paid on the date of delivery.

The Customer shall provide a suitable place of installation suitable for operation of the equipment sold hereunder and shall protect the equipment from electrical fluctuation.

THERE ARE NO OTHER WARRANTIES, EXPRESS OR IMPLIED, INCLUDING THE WARRANTIES OF MERCHANTABILITY OR FITNESS F0R A PARTICULAR PURPOSE, AND THE COMPANY SHALL NOT BE RESPONSIBLE FOR ANY CONSEQUENTIAL OR INCIDENTAL DAMAGES WHATSOEVER .THE COMPANY WILL ONLY BE LIABLE FOR PERSONAL INJURY OR PROPERTY DAMAGE WHEN CAUSED SOLELY BY THE COMPANY'S NEGLIGENCE.

The Customer shall pay the Company all costs and expenses, including reasonable attorney's fees, the fees of the collection agencies and other expenses such as telephone and telegraph charges, incurred by the Company in enforcing any of the terms, conditions, or provisions hereof. Florida law shall govern any dispute, and venue shall be in Miami-Dade County.

This is a binding Agreement, and not a transaction on approval or trial basis. The Agreement shall constitute the entire agreement between the Company and any purchaser of equipment hereunder. Customer’s leasing or renting equipment from the Company or from a third-party leasing company shall also be bound by the terms of a Lease Agreement or Rental Agreement, which shall be submitted to customer hereafter for his or her signature and the two Agreements shall constitute the entire understanding of the parties and shall be read in pari material. These Agreements supersede all other written or oral communications between the parties. THE COMPANY IS SPECIFI- CALLY NOT BOUND BY ANY ORAL OR WRITTEN REPRESENTATION MADE BY ITS EMPLOYEES, SALES AGENTS, OR SALES PERSONS TO THE CUSTOMER WHICH DO NOT APPEAR HERE IN WRITING AND HEREBY DISCLAIMS AND DISALLOWS SAME UNLESS HEREAFTER AGREED TO IN WRITING BY THE COMPANY.

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