Coverage policy for HiTech Business Systems, Inc.

Coverage Period: (Please make sure coverage dates are in effect.)

HTE Computer Consulting+ will be providing coverage* for HiTech Business Systems, Inc.

*For coverage please do the following:

1.  Call 508-979-7543 and identify yourself as a customer of HiTech Business Systems, Inc.
2.  Please print and fill out this page and fax it to: 508-979-7542.

This authorizes technicians of HTE Computer Consulting+ to act on behalf of HiTech Business Systems, Inc.

*Please Note: Both of these need to be done before coverage can be initiated. Thank you.

Request for Emergency Service (Temporary Release Form)

Company Name   __________________________________________________

Address _________________________________________________________

City_____________________  State ____________  Zip___________________

Telephone #___________________  Fax #______________________________

Requestor___________________________  Date_________________________

Dept____________________________  Phone___________________________

PO #_____________________________  E-mail__________________________ 

SERVICE REQUESTED

Problem description, Be as specific as possible. If needed list specifications: PC/MAC (model),
CPU Speed, RAM, Hard Drive, Monitor, and Network Card.

The undersigned, by the execution of this request for service, agrees that it shall pay for all outstanding balances per terms of credit. Credit terms are net 10 days. This is a temporary request for credit for services rendered by HiTech Business Systems or its subcontractors. Client will be billed at the rate of one hundred dollars per hour portal to portal for services rendered during normal business hours or 8:30AM-5:00PM Monday thru Friday. Services provided after hours normal business hours will be billed at the rate of One hundred and Twenty Five dollars per hour billed in ¼ hour increments with a 1 hour minimum service. In the event this account is referred to any attorney for collection, the parties agree that an additional twenty-five percent (33%) of the outstanding balance due will be paid as attorney's fees.  In the event that additional guarantees are required by HiTech Business Systems, Inc. for the approval of this application, then all parties sign in their individual capacity, thereby giving personal guarantee of the payment of all funds due with the additional attorney fees. Invoices not paid for within 10 days after the invoice date will be assessed interest charges amounting to 1.25% per month. In no case will any balance be tolerated for more than 30 days. By signing this application the Authorized Requester further guarantees that they are authorized to request the above service.

Signature:  _______________________________       Signature:___________________________________

                 HiTech Business Systems or Subcontractor                     "guarantor" Authorized Requestor

Title:          _______________________________      Title:         _____________________________________