ELARASYS INC.
180 Corporate Drive
Elgin, IL 60123
TEL: 847. 468. 8900
FAX: 847. 468. 0100
online@elarasys.com
 LEASE QUOTE

Company: ________________________________ Contact: ________________________________
Address: _________________________________  
Phone No: ________________________________ Fax Number: ____________________________
Equipment: ________________________________  

 Lease Term:  12 Monthes___  24 Monthes___  36 Monthes___  48 Monthes___  60 Monthes___

  Amount to be Financed (Total Cost): _____________________________________________

$1 Purchase Option: ____________________________
Fair Market Value: _______________________________

 Monthly payments may additionally include state tax (depending upon state).