GBS AGENCY EXPERT Full Demonstration System Order Form

This form is used to order a fully operation AGENCY EXPERT system. This “full demonstration system” gives you complete and unlimited access to the AGENCY EXPERT for a period of 30 days from the date of installation. The cost of this fully operational demonstration system is $59 and is non-refundable.

The “full demonstration system” comes 30 days of unlimited technical support.

Once this 30 day period is exhausted, the system can be “unlocked” (and thus purchased in full) for continued use. Furthermore, once you have made the decision to purchase the AGENCY EXPERT the $59 fee will be applied to your purchase and any data you have entered into the AGENCY EXPERT will NOT be lost. Your demo system will simply be unlocked using an internal password and you will be up-and-running.

To purchase the “full demonstration system,” simply complete, sign and submit this form to the GBS, Inc. marketing department via FAX or E-Mail. Contact your GBS, Inc. sales representative with any questions at 800-231-8495 x509.

Scan & Email To:

FAX TO: 303-449-0797

Or Mail to: GBS, Inc., 2100 Central Avenue, Suite #104, Boulder, CO80301

Please Send my “full demonstration system” today!

TERMS OF AGREEMENT:

“I have read and understand the conditions of the ‘full working demonstration system’ review as stated above. My signature below authorizes GBS, Inc. to charge my credit card in the amount of $59 for the AGENCY EXPERT ‘full working demonstration system.’ I understand that this fee is NON-REFUNDABLE under ANY circumstances. I also understand that this $59 fee will be applied towards my purchase of the complete AGENCY EXPERT if/when I wish to finalize said purchase.

Finally, I understand that the review of the AGENCY EXPERT using this ‘full working demonstration system’ is considered, constitutes and replaces any other guarantee offered by GBS, Inc. (i.e. the receipt and reviewing of this full demonstration system replaces the 30 day guarantee period if/when the complete AGENCY EXPERT is subsequently purchased.).”

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Signature of Purchaser/Credit Card Holder Print Name of Card Holder Date

 VISA MasterCard  AMEX Discover Check Enclosed

Card Number: ______Expires: ______Card Security Code: ______

Credit Card Billing Address (to Which Statements are Mailed): ______Zip Code: ______

Name: ______Name of Agency: ______

Shipping Address (No P.O. Boxes): ______

City: ______State: ______Zip Code: ______

Phone Number: ______FAX: ______Email Address: ______

AEDEMO2002.doc (Demo Order Form) – 8/9/2015