CORPORATE SERVICES

CSUS/MUNICIPAL LEASING PROGRAM
LEASE/PURCHASE REQUEST FORM
COLORADO STATE UNIVERSITY – PUEBLO

*Denotes Required Field

I. Department:*
Name:*
Contact Person First Name Contact Person Last Name
Contact Person Email:*
Enter Email Confirm Email
Contact Person Phone:*
II. Equipment Description (general):*
Item 1:*
Specific Description Unit Cost Quantity Total
Item 2:
Specific Description Unit Cost Quantity Total
Item 3:
Specific Description Unit Cost Quantity Total
Item 4:
Specific Description Unit Cost Quantity Total
Item 5:
Specific Description Unit Cost Quantity Total
Item 6:
Specific Description Unit Cost Quantity Total
Item 7:
Specific Description Unit Cost Quantity Total
Item 8:
Specific Description Unit Cost Quantity Total
Since leases normally result in higher overall cost, please explain why this equipment cannot be purchased directly?:*
Proposed Use of Equipment:*
Proposed Address of Equipment:*
Expected Delivery Date:*
MM slash DD slash YYYY
Is this a part of a start up or retention package?*
- Yes
- No
If yes, Individual's Name:
First Last
In Service Life of Equipment:*

Department should estimate in service life of equipment which will be reviewed and approved by the Property Accountant, Business & Financial Services for University Operations, Colorado State University-Pueblo.
III. Equipment Cost: $*

(If amount is 0, please enter as 0 in fields as needed.)
Down Payment (Estimated Figures): $*
Net Funds: $*
Estimated Annual Payment Amount: $*
Source of Repayment:*
(Account Number(s) and amount (per account) to be used for funding this lease)
If identified funding becomes unavailable, what alternative funding will be used?:*
Describe the financial impact the lease payments will have on your operations, if any:*
Requested Repayment Frequency: Semi-Annual*
Length of Lease:*
- 1 Year
- 2 Years
- 3 Years
- 4 Years
- 5 Years
- 6 Years
- 7 Years
- 8 Years
- 9 Years
- 10 Years

Administrative Fee Policy

Should the lease application be cancelled prior to funding, CSURF reserves the right to collect a minimum fee of $75.00.

Equipment acquired through this lease/purchase agreement is to be for the sole benefit of Colorado State University – Pueblo and is to be maintained by CSU-Pueblo.

The financial terms for lease/purchase agreements are determined by the type of equipment.

Direct all questions to:

Amanda L. Walker
Leasing Administrator, CSURF
Phone: (970) 492-4526
amandal.walker@colostate.edu