Portal | Indigo Payments

Clover Care Addendum Form

Merchant DBA Name

Merchant E-mail

Merchant Phone

Quantity	Equipment Type	Fee
	Clover Compact	$
	Clover Flex 3	$
	Clover Flex 4	$
	Clover Flex Pocket	$
	Clover Mini	$
	Clover Duo, Tablet, Mini, and Printer	$
	Clover Solo Tablet, and Printer	$
	Clover Kitchent Display 14	$
	Clover Kitchent Display 24	$
	Clover Care Total:	$

Client's Email

Client's Name