Idris Order Form

Please print out this form, then complete all fields and on completion, sign it, and post it to us complete with your payment and preferred installation time.

To:

Ecobase NZ Ltd.,
41 Ernest Gray Place,
Christchurch 8025.

Tel: 0800 843 747   

From:

Dealer Company Names

Trading Name

Dealer Principal

Physical Address

Postal Address

City/Town

GST Number

Phone

Fax

E-mail

Web

Site hosted by

Search engines used

Finance company

MBI/CCI

Please supply Idris software licenses as follows:

Choice of Web, Host or Gold plans to be indicated here:............... and 2 months fees or Annually in advance plus GST to be paid with deposit above. Installation and training time invoices plus any expenses to be paid STRICTLY as per our standard terms on 7 days from invoice terms.

I warrant that I have received and am satisfied with a demonstration of the features of idris, and have read, understand and accept the terms of the licensing agreement attached and am authorized to sign this agreement for the Dealership.

Signed for the dealer

Signature

Name

Date

Position

Signed for Ecobase NZ Ltd.

Signature

Name

Date

Position

For internal use

Deposit paid

Cheque reference

Reseller name & salesperson

Motor Vehicle Register #

Hosting Charges AP Signed