Page 121 - Gulf Coast Division - Training Manual 5 -18

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Keurig Brewer Loan Agreement
Customer Information (PLEASE PRINT)

Business/Store Name: __________________________________________________________________
Customer Contact (First/Last Name): _________________________________ Title: ________________
Billing Address: _______________________________________________________________________

City, State, ZIP: _______________________________________________________________________
Telephone: _______________________________ Fax: _____________________________________
Email Address: ________________________________________________________________________

Management Company (if applicable): _____________________________________________________
Primary Distributor: ________________________ Secondary Distributor: _______________________
# of K150 Keurig® brewer: _______ Requested Delivery Date: ____________________

# of 150P Keurig® brewers Requested: _______ Requested Delivery Date: ____________________
# of K3000SE Keurig® brewers Requested: _______ Requested Delivery Date:____________________
Brewer Ship-to Address & Telephone (if different from above):

Ship-to Address (No PO Boxes): ___________________________________________________________
City, State, ZIP: ________________________________________________________________________
Attn: ___________ _______________ Telephone: _____________________

For multiple locations please provide list of all locations in Attachment A

What We Do
By accepting the terms of this Keurig® Brewer Loan Agreement (“Agreement”), Keurig Green Mountain, Inc.
(“Keurig® ”) agrees either directly, or through a third party, to provide the following goods and services to the
Customer:
Keurig® brewer(s) shipped to Customer’s location(s) in the United States
Keurig® brewer User’s Manual
Toll-free Keurig® brewer help line
Keurig® K-Cup® pods products through Keurig authorized foodservice distributor

What You Do
By accepting the terms of this Agreement, Customer agrees to:
Not sell, lease or move the Keurig® brewers(s)
Use the Keurig® brewers(s) for 2 or more years. Should you fail to keep and use each loaned Keurig®
brewer for at least two (2) years, Keurig reserves the right to cancel the loan agreement and, at Keurig’s
determination either have the Keurig® brewer(s) returned to Keurig or invoice Customer for the full amount
of such Keurig® brewer(s).
For Model 150 and 150P Keurig® brewer(s) purchase through a Keurig authorized foodservice distributor a
minimum of 480 Keurig® K-Cup® pods (5 cases) per month, per each such Keurig® brewer loaned
For Model K3000SE Keurig® brewers(s) purchase through a Keurig authorized foodservice distributor a
minimum of 960 Keurig® K-Cup® pods (10 cases) per month, per each such Keurig® brewer loaned
Maintain the Keurig® brewer(s) according to the instructions in the User’s Manual

All Keurig® Brewers Remain the Property of Keurig Green Mountain, Inc.

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