CSUS/CSURF Equipment Line of Credit Lease/Purchase Request Form

"The CSURF Lease"

CSUS/CSURF EQUIPMENT LINE OF CREDIT LEASING PROGRAM
LEASE/PURCHASE REQUEST FORM
COLORADO STATE UNIVERSITY

I. Department^*:

Contact Person First Name^*:

Contact Person Last Name^*:

Contact Person Phone^*: ()

II. Equipment Description (general)^*:

Specific Description Unit Cost Quantity Total

^*

Since leases normally result in higher overall cost, please explain why this equipment cannot be purchased directly?^*:

Proposed Use of Equipment^*:

Proposed Address of Equipment^*:

Expected Delivery Date^*:

Is this a part of a start up or retention package?^*: yes no

If yes, Individual's Name, First: Last:

In Service Life of Equipment^*:
Department should estimate in service life of equipment which will be reviewed and approved by the Vice President for Research, Colorado State University. Must exceed term of Lease.

III. Equipment Cost^*: $ (If amount is 0, please enter as .0 in fields as needed.)

Down Payment (Estimated Figures)^*: $

Net Funds^*: $

Estimated Annual Payment Amount^*: $

Source of Repayment^*:

(Account Number(s) and amount (per account) to be used for funding this lease)

If identified funding becomes unavailable, what alternative funding will be used?^*:

Describe the financial impact the lease payments will have on your operations, if any^*:

Requested Repayment
Frequency: Quarterly^*

Length of Lease^*:
1 Year
2 Years
3 Years
4 Years
5 Years
(1-5 years, 5 years maximum, based upon equipment)

*Denotes Required Field

IV. Approval Signatures

Request Originator: ______________________________________

Date _________________

Department Head: _______________________________________

Date _________________

The addition of this lease payment to the total financial obligations of the college or unit can be accommodated within the projected resources of the college or unit.

Dean: __________________________________________________

Date _________________

College or Unit

Vice President: __________________________________________

Date _________________

CSURF USE ONLY:
IF APPLICABLE

Contract and Grant Approval: ___________________________________________________
Contract Administrator

Date _________________

Computer Purchase Approval: ___________________________________________________
Director of ACNS

Date _________________

=====================================================================

Lease Officer: ________________________________________________________________

Date _________________

Equipment acquisition, leasing and financing through CSURF line of credit, on terms negotiated by me and reflected above, approved by:

Vice President for Research, Colorado State University:

___________________________________________________________________________

Date _________________

Vice President of University Operations, Colorado State University:

______________________________________________________

Date _________________

Administrative Fee Policy

Should the lease application be cancelled prior to funding, CSURF reserves the right to collect a minimum fee of $75.00.

Equipment acquired through this lease/purchase agreement is to be for the sole benefit of Colorado State University and is to be maintained by CSU.

The financial terms for lease/purchase agreements are determined by the type of equipment.

Direct all questions to:

Julie H. Birdsall
Chief Financial Officer & Corporate Secretary/Treasurer
CSURF
P.O. Box 483
Room 410, USC Building
Fort Collins, CO 80522
Phone: (970) 482-2916

copyright Copyright © 2006 Colorado State University Research Foundation. All rights reserved.
This page was last updated July 08, 2010.

CSUS/CSURF EQUIPMENT LINE OF CREDIT LEASING PROGRAM LEASE/PURCHASE REQUEST FORM COLORADO STATE UNIVERSITY

CSUS/CSURF EQUIPMENT LINE OF CREDIT LEASING PROGRAM
LEASE/PURCHASE REQUEST FORM
COLORADO STATE UNIVERSITY