Equipment For Sale Inventory Sheet Endoscopy Specialists, Inc. (Complete one form for each piece of equipment) Equipment Owner's Name(Required)Alternate Contact Name(Required)Address(Required)City/ST/Zip(Required)Phone(Required)Fax(Required)E-mail address(Required)Equipment Manufacturer(Required)Model(Required)Year Manufactured(Required)Description(Required)(List all accessories/software or enhancements that will increase the value of this item)Why do you want to sell this equipment?(Required)Cosmetic Condition(Required) Excellent Good Marginal List Damage(Required)Operational Condition(Required) Excellent Good Marginal List problems and estimated cost to repair(Required)Are ALL accessories and/or parts included(Required) Yes No List missing components(Required)Operators Manual included(Required) Yes No Do you own this piece free & clear(Required) Yes No Are you able to email digital pictures of the equipment(Required) Yes No Transaction Type desired Cash Sale(immediate payment, no risk)(Required)Amount you’re asking: $Consignment:(shared risk, paid when sold)(Required)Amount you’d like to sell for: $ (Consignment fees range from 10%-30% based upon marketability and warranty)Are you willing to personally warranty this piece:(Required) Yes No If yes to above, for what length of time 30 days 90 days (Required)Trade:(Required)List equipment you’re interested in trading forDo you know our team? Jake Glaser has 22+ years in the field of Endoscopy Sales and Service. Over the years, Jake has traveled nationally and internationally attending all of the major G.I. meetings, Colo-rectal Symposiums, and veterinarian conferences.