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 - PUEBLO

I. Department^*:

Contact Person First Name^*:

Contact Person Last Name^*:

Contact Person Email^*:

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 Finance & Admission, Colorado State University - Pueblo. 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

PLEASE OBTAIN COLLEGE/UNIT SIGNATURES BELOW:

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 _________________

ONCE THE ABOVE FORM HAS BEEN COMPLETED AND COLLEGE/UNIT SIGNATURES HAVE BEEN OBTAINED, PLEASE FORWARD THIS DOCUMENT TO CSURF FOR FURTHER PROCESSING.

CSURF USE ONLY:
IF APPLICABLE

Contract and Grant Approval: ____________________________________________________
Contract Administrator
Date _________________

Computer Purchase Approval: ____________________________________________________
Director of USC-Pueblo Computer Center

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 Finance & Administration at Colorado State University - Pueblo

_____________________________________________________________________________

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 - Pueblo and is to be maintained by CSU-Pueblo.

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
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 - PUEBLO

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