ORDER FORM

Simple. Powerful. Revolutionary.

1 CUSTOMER INFORMATION

Company

Company Name:
Company Address:
Contact Name:
Contact Email:
Contact Phone:

Shipping

Company Name:
Company Address:
Contact Name:
Contact Email:
Contact Phone:

Billing

Billing Contact Name:
Billing Contact Email:
Billing Contact Phone:
PO Number:

Notice

Company Name:
Company Address:
Contact Name:
Contact Email:
Contact Phone:

2 GY6TRAC READER (RENTAL)

Reader Qty:
Pricing: $3,000/year per GY6Trac Reader, annual prepaid.
Minimum Rental Period: 12 Months

3 OPTIONAL SOLAR GATE KIT (RENTAL)

Gate Kit Qty:
Pricing: $1,800/year per Solar Gate Kit, annual prepaid.
Minimum Rental Period: 12 Months

4 RFID TAGS (PURCHASED)

Estimated Monthly RFID Tags: tags/month
Initial RFID Tag Order Qty:
Initial Tag Pricing:
Minimum Tag Purchase Commitment / Month: 250 Tags
RFID Tag Type Selection:

RFID TAG VOLUME DISCOUNTS

Monthly Volume	Price Per Tag
1 - 999	$4.00
1,000 - 2,999	$3.75
3,000 - 4,999	$3.25
5,000 - 9,999	$3.00
10,000+	Custom

5 OPTIONAL SERVICES

6 ACCOUNT PARAMETERS

Onsite Installation & Services: $1,500 per day
Installation Requested?:

Authorized Users: 50

7 TERMS & CONDITIONS

By signing below, Customer acknowledges that it has reviewed and agrees to the pricing, rental obligations, minimum commitments, equipment return requirements, and GY6Trac Terms & Conditions.

Terms Accepted:

Signed by: Mike Michalski

Signed on: October 18, 2026

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GY6Trac Order Confirmation

ORDER FORM

Company

Shipping

Billing

Notice

Please Review & Sign This Document

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