Lease Option Agreement Fl

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                                                        SEMINOLE COUNTY PUBLIC SCHOOLS, FL
                                                                    Purchasing & Distribution Services
                                                                    COMPUTER STORE ORDER FORM
                                                                        EMPLOYEE ORDER FORM
                                  INSTRUCTIONS: Use this order form to purchase a computer through payroll deductions.
1. Complete all items highlighted in Green. The electronic form will extend and total your order for you. See the Grand Total for you order total.
2. Complete and sign the District Lease Agreement Form #1227and attach this form along with any down payment.
3. Maill all form to the Purchasing & Distribution Department, ATTN: Computer Store
Your order should be processed within one week and delivery can be expected 2-4 weeks later. You will be notified when your computers arrive.

Employee Name (Please Print)                                                                       Employee Number                   Home Phone Number

Street Address                                                                                      City                     State                   Zip Code

                                                                                    10 Month     11 Month     12 Month
Work Location: School Name or Administrative Department                                 Work Calendar(Circle one)        Work Phone Number
                                  DESKTOP COMPUTER DESCRIPTION                                                UNIT PRICE EXT. PRICE
BASIC DESKTOP COMPUTERS - Dell Optiplex 390; Intel Core i3-2100/3.1GHz, 2 GB DDR3 RAM; 250 GB Hard Drive; Integrated HD Graphics
2000 Video Card, 16x DVD+/-RW SATA Optical Drive; 17" Flat Panel Monitor, 3-Year Warranty through Dell, Keyboard, Windows 7 Home
Operating System, Optical Mouse.
Dell Optiplex 390 DT Basic (589591458)                                                                                                  $ 539.46
Dell Optiplex 390 DT W/Upgrade to Win 7 PRO OS (588605344)                                                                              $ 565.00
Dell Optiplex 390 DT Basic Incl. Office Home & Student 2010 (589591629)                                                                 $ 611.74
Dell Optiplex 390 DT w/ Win 7 Pro and Office Home & Student 2010 (589591818)                                                            $ 637.26
                              LAPTOP COMPUTER DESCRIPTION                                                      UNIT PRICE EXT. PRICE
BASIC LAPTOP COMPUTERS - Dell Latitude E5420, Core i5-2540M/2.6Ghz, 2 GB RAM, 250GB Hard Drive, 8X DVD, 14.0 HD Screen; 3 Year
Warranty through Dell. Internal English Keyboard, Integrated Audio/Video, Standard touchpad, WIN 7 Home Operating System, AC Adapter,
Intel WiFI Link 6205; & Rechargeable Battery.
Dell Latitude E5420 LT Basic (589592229)                                                                                                $ 815.35
Dell Latitude E5420 LT Basic W/ Upgrade to Win 7 Pro OS (589109401)                                                                     $ 839.00
Dell Latitude E5420 LT Basic w/ Office Home & Student 2010 (589595414)                                                                  $ 835.58
Dell Latitude E5420 LT w/ Win 7 Pro and Office Home & Student 2010 (589595538)                                                          $ 859.19
                                           OPTIONS DESCRIPTION                                                                         UNIT PRICE EXT. PRICE
Desktop Option: Add Speakers                                                                                                            $            10
Laptop Accessory: Nylon Carry Case                                                                                                      $            25
                                                                                                 SUB TOTAL COST
                                                                     ADD Sales Tax (Multiply Sub Total x .07):

                                                ADD Administrative Handling Fee ($50.00) Per Computer):                                 $            50
                                                                                      SUB TOTAL (Add all lines):

                                                                           ADD $1.00 Lease Fee (If Applicable):                         $             1
                                                            GRAND TOTAL (ADD Sub Total and Lease Fee) :

                                                                           LESS DOWN PAYMENT ATTACHED:

                                NET AMOUNT LEASE (Subtract the Down Payment from Grand Total):

     The terms and conditions of the "Computer Lease Agreement", SCPS Form 1227, is made part of this order for all
                                         purposes by reference and adoption.
Please deduct the amount of $____________ from ______ checks beginning on _____________________. All deductions
                                    will end with the last paycheck in May 2011.

                                                       Signature                                                                              Date
SCPS Form 1266 (Rev. 110701)

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