Memorandum Of Understanding
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1NEW PLACEMENT CODE: ______________________ CONTRACTOR: ___________________
(To be entered by DAS only)
MEMORANDUM OF UNDERSTANDING
If replacing an existing CPC machine, please enter Placement Code here. _______________________ ____________.
It is located on your MOU (example of placement code; DAS001-NA-3).
Existing CPC device expires on: ____
/
____ /________
When would you like your new device delivered? __________________________
(Please see delivery requirements on the bottom of the page.)
This Memorandum of Understanding (MOU) is entered into this _______ day of ___________________, 20_____,
between the ordering state agency or cooperative purchasing member and the Ohio Department of
Administrative Services (DAS). The purpose of this MOU is to detail out the process for DAS and any other state
agency or co-op member procuring print device cost-per-copy services from DAS contract number RS904315.
3 Year Term
or 5 Year Term
:
:
OAKS Department Code (
): __________________________________________________
co-op membership number
Billing Address: ________________________________________________________________________________
Delivery Address #1 (street): ______________________________________________________________________
Delivery Address #2 _________________________ City & Zip: ___________________________________________
(Section and/or Floor)
Category: _____ Monthly Minimum (b/w): ___________ Networked: Yes No : Machine Brand: ________________
Monthly Minimum (color): __________Accessories: Yes No : Machine Model: _______________
Base CPC B/W Cost: $__________________ Base CPC Color Cost: $__________________
Accessory name: _____________________________________________________ CPC cost: _________________
Accessory name: _____________________________________________________ CPC cost: _________________
Accessory name: _____________________________________________________ CPC cost: _________________
Total B/W CPC: $_____________________ Total Color CPC: $_____________________
State Agency (
): ________________________________________________________________________
co-op member
State Agency Contact (
): ___________________________________________________________
co-op member contact
Phone Number: ____________________________ Email Address: __________________________________________
Meter Read Contact: _____________________________________
Phone Number: ____________________________ Email Address: __________________________________________
Authorized Fiscal Signature: _____________________________________________________Date: _______________
Authorized State Printing Signature: _______________________________________________ Date: _______________
Delivery Requirements:
Categories 1-5 – ten (10) working days ARO
Categories 6-10 – fifteen (15) working days ARO Categories 11-14 – twenty (20) working days ARO
Categories 15-32 – ten (10) working days ARO
ACCESSORIES MUST BE REQUESTED ON THE ORIGINAL ORDER OR AN INSTALLATION FEE WILL BE CHARGED (See contract for
Individual costs)
ORDER SUPPLIES WELL IN ADVANCE
MOU-0001 Revised 03/31/15
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