Checkmate Information Management System
1980 Highland Pike
Fort Wright, KY 41017

Phone: 859-344-1925 FAX: 859-344-1954

/ Order Form
Account Number: CP# / Y# / C# / Requested Install Date: / Proposal Date:
Sales Representative: ?Jeff MastervichRon MatthewsBecky McDanielRick RiveraDavid SanfordBob JohnsonRoger SchroderBryan VanDevenderDrew VanDevenderJeff SmithManuel HerreraBob ClarkRon Van RaamsdonkTim Schneider / Ph: ?520-575-0016401-640-3015256-767-1928954-394-9808256-766-4439859-341-1920859-344-1925256-765-2315256-765-2315780-929-5760859-448-3435512-846-1520250-483-5174859-448-3702 / Business Contact: 1st Name Last Name
Business Name: / Owner: 1st Name Last Name / County:
Installation Address: / City: / State: / Zip:
Billing Address: Same / City: / State: / Zip:
Telephone: / Fax: / E-mail: / Training Requested: ?No38
Payment Information: / Check #: "Sending with Signed Forms" / Amount: $1,650.00 / Balance Due: $1,650.00
Checkmate Information Management System Itemization
Checkmate Information Management System Software, Interchange Support, and
Update Fees – Monthly 1Checkmate Information Management System does not include Advanced Management Reports, Orion Exchange yards, etc. or other services. / Hardware/Software Purchase
& Other One-Time Charges / Software/Interchange
Monthly Service Fees
Description / QTY / Unit / Extend / QTY / Unit / Extend
Checkmate Reinstatement Fee / 1 / $1,250.00 / $1,250.00
0
JR
Internet Checkmate Monthly Support Fees For: Checkmate
(New Cache License Purchase Below Required) Classic / 0 / $160.00
$242.00
$325.00 / $0.00
JR
Legacy Monthly Support Fees For: Checkmate
Classic / 0 / $135.00
$216.00
$324.00 / $0.00
0 / 0
Additional Charges for Internet Checkmate Reinstatement / 0
Cache License Reinstatement (1 required for main CPU and 1 for modem) / 2 / $200.00 / $400.00 / 0
Additional Cache Reinstatement(1required for each workstation or device) / ? / $200.00 / $0.00 / 0
0 / 0
Advanced Management / 0 / ? / $25.00 / $0.00
JR System, Advanced Sales/Inventory / 0 / ? / $27.00 / $0.00
Additional Past Due (Contact Accounting) / $0.00 / $0.00 / 0

Connectors/Cables

/ ??? / $0.00 / $0.00 / 0
Amount Required to Pay Past Due / $0.00 / $0.00 / 0
$0.00 / $0.00 / 0
$0.00 / $0.00
$0.00 / $0.00
Shipping – UPS Ground / ? / $0.00 / $0.00

Totals - All prices do not include sales tax.

Monthly License Fees include use of Checkmate Information Management System application
software and Interchange Support, Basic Maintenance program and application updates.
(Monthly fees are billed and due in advance) (All prices in US dollars unless stated otherwise) / Hardware/Software
Purchase and
One-Time Charges / $1,650.00 / Monthly
Fees / $0.00
100% Payment of $1,650.00due with order. Pricing is valid for 30 days from contract proposal date noted above. Prices exclude 1) all taxes 2) duties, and other fees outside the continental U.S. 3) any other charges not specifically included. Data conversion from existing system is billable, must include a written Statement of Work, and be quoted as “Data Conversion from Checkmate to Internet Checkmate Information Management System.” A minimum 4 to 6 week lead-time is necessary for all Data Conversions (Except Checkmate)
Customerunderstandsthat if it postponesany installationmorethantwoweekspriortoascheduledinstallationdateit will result inacharge equal
to 10% of the total contract price, or 25% if it postponed within two weeks prior to scheduled installation date.This order and the Products and
Services purchased hereunder are subject in all respects to the terms and conditions set forth in the Master Customer Agreement.
This Agreement shall not become effective until signed by an authorized Officer of CAR-PART.
CAR-PART’s Marketing Representatives do not have the Authority to Bind CAR – PART
CAR-PART
By: ______
(signature)
Name/Title: ______
(print or type)
Date: ______ / Customer
Customer Understands and agrees to this order and the products and services acquired under this order are subject to the terms and conditions of the Master Customer Agreement between CAR-PART and Customer
By: ______
(signature)
Name/Title: ______
(print or type)
Date:______

Car-Part.com Checkmate Information Management System Order Form | Version: Reinstatement Order Form 14.5 US 8-24-07.doc