233850 06/18/14 y w_4�q•M
CITY OF CARMEL, INDIANA VENDOR: 368284
ONE CIVIC SQUARE ROCKMOUNT RESEARCH &ALLOYS INCHECK AMOUNT: S•'""";679.10"
CARMEL, INDIANA 46032 PPO ORTLAND 28 7 97208 CHECK NUMBER: 233850
CHECK DATE: 06/18/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 1197777 679.10 OTHER EXPENSES
ROCKMOUNT RESEARCH ALLOYS, INC.FWCKnimm
0 11909 N.E.95th STREET •VANCOUVER,WASHINGTON 98682
RESEARCH &ALLOYS,INC.
MAIL PAYMENTS TO: INVOICE NO: 1. 197=-'
ROCKMOUNT RESEARCH&ALLOYS, INC.
PO BOX 2807 CUSTOMER NO: 1/0 0 003324S022
www.weldit.com PORTLAND,OR 97208
MAINTENANCE ENGINEERED WELDING&BRAZING PRODUCTS ORD 110 32661/00
SHIP TO SAME AS SOLD TO UNLESS SPECIFIED BELOW
C F�f'IEi._ WASTEWATER S CARNEL. tM1?t-�;a"i"I"WA T ER TREATI'-11"E17,11' PL
609 HAZELDIEL.L PAI?K1,4A H 9' 09 F-lrAZEL—DEL.1 PARKWAY
SOLD I ND T PaNAPOL.1:S 2 i\.t 46280 p TND ANAP 01-1 3 1 t�? A-62BO
TO
T
0
L J [-i T T N: JEFF COOPER
Name set forth above is herein referred to as the'Buyer".
YOUR P.O. SHIPPED VIA SALES REP 90 DATE
WALL.EY- DBA GW ENTERPR! 5 129/J.
NOTICE: NO MERCHANDISE WILL BE ACCEPTED FOR RETURN WITHOUT PRIOR WRITTEN AUTHORIZATION.
ALL CLAIMS MUST BE MADE WITHIN 5 DAYS OF RECEIPT OF MERCHANDISE.
ITEM ®O UCT,DES I CAI ® ® UNITe s a .
I QUANTITY
01 NEPTUNE i'Uiy i k l G 5# Sr'' 01-:1 S S. 00 L_B S. .0 22 7. ?E i
UITUS _ .j-10 6 r. a0 2 S/. 60 i•
i
0033 '11UNG)STEI-:4 _7. `L.ArN-�T;;r�iNIAT_'ED -70341-703413/352'. — 00 PI%� r74. 2
S 5 T4. 25 1—
004 UNG'3T.l 1: 11 L..I.r" C0I'`;3 ATIE'D ';�S{�'�y=i. 3/3_ 1.. 00 PK S5. 6;! 85, 6,2-1 _I
111VO SCE DUE: rte,/2S. 1'-I
V�
lc f VVV
1`1 a'B C: il g 7CS
NIIm IJ e r SALES TAXES 47. 54
1 Z801 aq
176
1 .801 .?:1`^'{.,'35 V.,1 S0280 FREIGHT/ 3�. 4S
HANDLING
TOTAL 72
INVOICE r
This invoice is subject to the following terms and conditions: C `
TO OBTAIN A COPY OF A MATERIAL SAFETY DATA SHEET(MSDS),VISIT WWW.WELDIT.COM
The sale of the goods described above shall be governed by the terms and conditions contained herein. The general terms and conditions on the reverse side of this document are an integral part of
the contract between ROCKMOUNT and the Buyer.
Buyer acknowledges that the provisions in this document constitute a binding,enforceable contract against Buyer in the event that Buyer does not reject this contract by immediately returning Goods to ROCKMOUNT.
Payment of invoice is due on above due date,interest at the rate of 1.5%per month is payable on all past due amounts.
Discrepancies in shipped quantity or part numbers must be reported within 5 days of the item receiving date. Otherwise items will be deemed to have been received.
PHONE (360)254-2020 FAX (360) 254-2332 . FIN #84-0627109
ROCKN-COUNT RESEARCH AND ALLOYS,INC.
Ternu and Conditions of Sale
I. As used in this Conti act. Rockmount Research and A]loys,lnc..a Coloradocorporation and al l ofitsafti l iatcs as they may exist from time to time. Forpurposesofthe itninintionsorbability and remedies set
forth by Section 9 of this Contract and the indenmi licit ion provisions set forth by Section 10 of this Contract."ROCKNIOUNT"shall include all shareholders,directors,officers,employocs,agents,and representatives of
ROCKMOUNT. "Buyer'mems the party purchasing the Goods.including tray affiliates,as they may exist Gom time to time "Third Party"means every person,government entity,or other entity other than ROCKMOUNT and
Buyer.Whenevera term defined by the Washington Uniform Commercial Code("Code")is used in this Contract,the definition contained in the Code shall control its meaning.
2. These Terms and Cond niots of Sale together with the provisions on the face hereof constitute a contract("Contract")by ROCK MOUNf RES EA RCI 1 AND ALLOYS,INC.("Rockmount')to sell to Buyer the goods identified on
the face hacofor in documents incorporating this Contract by reference(the"Goods"). Delivery to and acceptance by Buyer orally part ofthe Goods constitutes the contract for ROCKMOUNT to sell and Buycr to buy and pay for
such Goods,expressly and exclusively limited to these terms,conditions and limitations-herein. Buyer can reject this Contract by returning the Goods to Rockmount. This Contract does not constitute an acceptance by
ROCKMOUNTofany Contract orcounter Contract of Buycrand serves as a tcraten rejection ofany additional,different,or inconsistent provisions,temps,conditions or limitations contained in or incorporated by reference in any
forms,purchase orders or other documents of Buyer that already hate been or hereafter shall be prose ted to ROCKMOUNT with respect to this Contract. If notwithstanding the foregoing,this Contract is deemed by a court with
binding legal authority oter the enforcement orthis Contract to be an acceptance by ROCKNIOUN"r of a Contractor counter Contract by the Buyer.that acceptance is expressly made conditional on Buyer's assent to the provisions,
terms,conditions and limitations set forth in this Contract and waiver of the provisions,tcmns,conditions and limitations set forth by the Contract or counter Contract ofBuyer that are inconsistent with the provisions.terms,
conditions and limit tions in this Contract.In any case,upon acceptance oft lie Goods by Buyer,this Contract constitutes the entire agreement betivecn ROC KM OUNT and Mayor with respect to the matters specified in this Contract
and supersedesall ofthcir prior and contemporaneous agreements and understandings,negotiations.inducements,representations or conditions,whether oral or written,whether express or implied,with respect to such matters.The
provisions,terms,conditions,and limitations set forth in this Contract can be modified,altered,or adder)to only by a subsequent written instrument signed by an authorized representative of ROCKMOUNT Failure by
ROCKMOUNT to enforce any ofthe provisions.ternns,conditions and limitations of this Contract shall not constitute a waiver of those provisions,terms,conditions and limitations or a waiver orally other provisions,terms.
conditions and limitations in this Contract,and the failure of ROCKMOUNf In exercise any right arising from default of Buycr or otherwise shall not constitute a waiver of that right or any other rights. No inconsistent course of
dealing or course of performance between ROCKNIOUNT and Buyer,or ustIgc pf trade"br industry custom,iCany,prior to.contemporaneous with or subsequent to the making of this Contract shall waivc.Cary serve to explain or
serve to interpret any ofthe provisions,temps,condi tions and limitations o f til is Con tract..
3. la) Unless otherwise specified on the face of this Contract or agreed to by ROCKMOUNT in writing,prices set forth in ROCKNIOUNT"s current price schedule at the time ofthe Contract shall be ROCKNIOUNT's valid
Contracted sales prices for the Goods,provided that ROCKMOUNT reser a the righj to change the price ufany Goods prior to shipment. ROCKNIOUNT also has the complete and absolute discretion to modify or to discontinue
any goods,including the Goods,at any time. Requests for additional goods c,nnotbc[tccepred as part ofthisorderafter any portion ofthis order has been processed. ROCKIIOUNfreserre,therightlolimitthcquantityofGoods
supplied under-this Contract on the basis ofavailability.
(b) Unless otherwise speci fled on the lace ofthis Contract or agreed to by ROCKMO UNTin%writing,payment terns are net 30 days from the date of invoice.All amounts remaining unpaid atexpiration ofsuch 30 days
arc deemed pasrduc mnounts. ROCKMOUNT may assess a 1.5%per month late charge or the nna.xilnu n late charge permitted by applicable law,whichever is greater,on past due amounts. All prices for Goods shall be paid in
U.S.currency. In file event of anticipatory breach of this Contract by Buyer.if Buycr fails to make timely payment ofthe price of any goods,including the Goods,from ROCKMOUNT,or if ROCKMOUNT has any commercially
reasonable doubts at any time regarding Buyer's ability to pay its debts as they become due.ROCK M0UNT may(i)require full or partial payment in advance for any goods,including the Goods in immediately available federal
funds,or(ii)cancel any further del iverics orally order ofgoods,including the Goods. Ifpursuant to this provision.ROCKMOUNT shall defer any shipments or cancel in whole or in part the delivery critic Goods,Buyer shall be
liable forand reimburse ROCKMOUNT for all losses,expenses,and damages,including any and all direct and consequential damages,incurred orsuffered by ROCKMOUNIr as a result of the deferral or cancellation.
(c) For all Goods shipped to Buyer's locations in the United States of Anncrica("U.S.").orders received with less than it currently published net price value of SI00.00 will be invoiced at the minimum order value of
5100.00 or at list price,whichever is greater. For all Goods shipped to Buyer locations outside of the U.S..orders received with less than a published net price value of S 1,000.00 trill be invoiced at the minimum order value of
S 1,000.00 or at list price,whichever is greater.
4. U mess Otherwise speci ficd on the face of this Contract,the purchase price o rthe Goods does not include trnsortationlhandl ing charges and nixes.sales.use,excise.import or any simi[artax or other governmental charge arising in
connection with the sale,purchase,manufacture,processing,fabrication,delivery,storage.use,consumption,or transportation ofthe Goods.The annotmt orally transportation/handling charges and taxes,sales,use,excise,import
or any similar tax or other governmental charge app]icable to this Contract and tothe sale and/or furnish ing ofthe Goods shat I be deemed extra charge;and shal I be invoiced to and paid by Buyer.
5. ROCKNIOUNT shall not be liable for its failure to perfomn underthis Contract due to circumstances beyond its control.including,without limitation.fit e,food,earthquake,pestilence or similar catastrophe:war,insurrection,actor
a governmental agency,act ofterrorism.or strike:lack or failure of transpoa nit ion facilities.shortage of suitable parts,materials or labor:any existing or future law,proclamation,or order of any governmental agency:inability to
secure fuel,materials,supplies,equipment or power at reasonable prices or in sufficient amounts:act of God or other public client),;or any other event or cause beyond ROCKMOUNT's reasonable control,including,without
limimtion,any delay cause by Buyer(each,a"Force Majeure"). ]rally Force rblajeure prevents ROC'KNIOUNT's performance orally cries obligations under this Contract.ROCKMOUNT shall have the right to(a)change,
terminate or cancel this Contract or(b)omit during the period of the Force Majeure all or any portion ofuhc quantity critic Goods deliverable during that period,whereupon the total quaintity deliverable under this Contract shall be
reduced by the quantity omitted. If due to any Force Majeure ROCKMOUNT is unable to supply the total den)ands for any Goods to be delivered under this Contract,ROCKMOUNT shall have the right to allocate its available
supply among its customers in whatever manner ROCKMOUNT deems to be fair and equitable. In no event'shall ROCKMOUNT be obligated to purchase matcriat s from other than its regular sources of supply in order to enable it to
supply Goods to Buyer under this Contract.Noc)nange,cancellationorprorationby ROCKNIOUNTsha]Ibeclcemedtobr:abreachofanyprovision,term,condition,orcovenantofthis Contract.
6. (a) Shipping datesare provided to Buyer on the basis ofROC KN IOU NT's best estimate for i it foruational purposes only and arc not guaranteed.
(b) Unless otherwise specified on the face of this Contract,all domestic and international deliveries of the Goods shall be F.O.B.IROCKNIOUN"f's shipping point. Risk of loss for all of the Goods and responsibility for
insurance coverage therefore shall pass to Buyer upon ROCKMOUNT's delivery to the point o f shipment or upon tender to Buyer's agent,as the case may be.
(c) Unless-otherwise specified on the face of this Contract.ROCKMOUNT may,at its discretion,use any commercial carriers for shipment of the Goods. ROCKMOUNT will use reasonable efforts to comply with Buyer's
requests as to method and route o f transportation,but ROCKMOUNT reserves the right to use an at tomato method or route of trmsortation.whether or not ata higher rate.
(d) Buyer shall pay all insurance costs in connection with delivery ofthe Goods,ifany,and be responsible for filingand pursuing clainns with carriers for loss or damage in transit,unless these obligations are assumed expressly
in writing by ROCKMOUNT.
(e) Unless otherwise specified on the face of this Contract or agreed to by ROCKMOUNT in writing,Buyer shall be responsible for obtaining all necessary transportation licenses and permits for the Goods at Buyer's sole
expense.
(1) If Buyer is unable to receive the Goods t%hen they are tendered,Buyer shall be liable for and reimburse ROCKMOUNT for all losses,expenses,and damages,including any and all direct and consequential damages
incurred or suffered by ROCKMOUNTas a result of Buycr's inability to receive the Goods when they are tendered.
(g) For all Goods shipped to Buyer's locations in the U.S.,claims lar shortages or discrepancies will be deemed waited by Buyer unless made in writing to ROCQvlOUN r within f we(5)days of receipt ofshipment. Far all
Goods shipped to Buyer's locations outside ofthe U.S.,claims for shortages and discrepancies in part number m quantity received versus par number or quantity shown on the packing list will be deemed waived by Buyer unless
made in writing to ROCKMOUNT within thirty(30)days ofthe Goods'shipping date.Otherwise the Goods will be considered"received as listed on the packing list"and the shipment complete.
7. Rocknnount warrants odv that the Goodsw ill conform to the express representations and descriptions contained in ROCKMOUNT's sales literature which has been provided to Buyer in connection with the safe orthe
Goods.THIS CONSTITUTES THE SOLE WA RRANTY MADE BY ROCKD'IOUNTAND TII ER F.ARE NO 0111 ISR WARRANTIES,EXPRESS 012 1111 PLI 1i D,\VII ICM EXTEND BEYOND TI POSE DESCRIBED
IIEREIN OR TO ANYONE OTIIER TITAN BUYER. ROCKAIOUN'r IIEREBY EXPRESSLY DISCLAIMS ANY AND ALL OTIIER REPRESENTATIONS AND R'A RRANTI ES,NVIi ETHER WRITTEN OR
ORAL,WHETII ER EXPRESS OR IAIPLI ED,NVI I LTi I ER ARISI NG BY CONTRACT,ATLANK IN EQUITY,BY STRICT LIABILITY OR OTI IHRWISE.NVII'1l RIS PECI'TOIII E GOODS,INCLUDING BUT
NOT LIMITED TO ANN'WARRANTY OF Al ERCI IANTABILITY.ANY WARRANTY OF FITNESS FOR A PARTICULAR PURPOSE,ANY WARRANTY AGAINST REDHIBITORY DEFECTS,AND ANN'
WA RRANTYAGA INST P VIfENT,COPYRIG I IT,TRADENIA RK,TRADE NAME,TRADE SECRET INFR ING EM LNTAND ANY OTIIER TYPE OF INTELLE CT'UAL PROPERTY ItIGIIT IN FRINGE\IENT'
UNDER THE LAWS OFANY NATION,INCLUDING,WITI IOITI'LIAI ITATION,TI IE LANN'S OFTIIE U.S.
S. Notwithstanding any other renncdics made available by the Code,or ROCKMOUNT's obligations with respect to any Goods subject to warranty under Section 7 hercofshall be limited at ROCKNIOUNT's option to(a)the repair or
replacement ofthe defective components or parts ofthe Goods,or(b)the refund of ROCKMOUNT's actual sale price orally Goods that ROCKMOUNT reasonably determines.upon its examination following its receipt of notice of
it claimed defect or deficiency,to have been defective or to have failed to confonn to the description on its container or label when it left ROCKMOUNT's possession. Returned goods shall be at Buyer's risk and expense. The
remedies hereby provided shall be the sole and exclusive remedies ofBuyer with respect to any breach ofthe express warranty in Section 7 hereof,and ROCKMOUNT authorizes no Third Party ara for Buyer,to assumc'forir any
other obligation or liability in connection with any Goods. ROCKMOUN-1's obligations for any breach of the waranty in Section 7 hereof steal]be void unless ROCKNIOUNT receives written coo fthe alleged breach within
thirty(30)days after Buyer has knowledge of such breach.
9. ROCKMOUNT's total liability to Buyer and any Third Party with respect to the Goods(whethcras to Goods delivered or for delayed delivery or for non-delivery ofgoods and whether the claim is based on warranty,on contact.on
negligence,on ton.on strict liability,on products defects or otherwise),shall not exceed the amount ofthe purchase price of the Goods with respect to which the claim is made,and Buyer hereby releases ROCKNIOUNT front arty
—- ciaim an excess-of the aggregate Purchase price of those Guuds purchased by Buyer from ROCKNIOUNT-during the most ascent twelve months immediately-prior to the date such claim4s male—IN—NO EVENT SHALL
ROCKNIOUNT BE LIABLE TO BUYER FOR ANY CIRCUMSTANTIAL,CONSEQUENTIAL.CONTINGENT.EXEMPLARY,INCENDE•NTAL,INDIRECT,LIQUIDATED,MATERIAL.PUNITIVE,SPECIAL,
SPECULATIVE OR OTHER DAMAGES,INCLUDING,WITHOUT LIMITATION,DAMAGES FOR LOST PROFITS OR REVENUES,LOST BUSINESS OR BUSINESS INTERRUPTIONS ARISING IN ANY MANNER
IN CONNECTION WITII TI I IS CONTRACT AND TI I E SALE,DELIVERY AND USE OF TIT E GOODS.Without limiting the generality ofthe foregoing,Buyer assumes any and all risks and liability for operation costs,general
efrecliveness,success or failure ofthe Goods. Except as otherwise expressly provided in Section 17,hereor,,no legal action,regardless ofform,arising out oral in connection with the transactions under or occurrences arising out of
this Contract and/or use of the Goods may be brought by either party hereto more than one(I)year afer the cause of action has accrued,except that an action for nonpayment for Goods purchased hereunder may be brought by
ROC KMOUNTwith in one(1)year after the date ofl3 uyer's last payment on its account with ROC K NI O U NI'.
10. Buyer hereby does indemnify,hold harmless and agrees to defend ROCKNIOUNT from and against any and all damages.liabilities,losses,costs,expenses and fees(including reasonable attorneys'fees and court costs),including,
but not limited to.aI I losses related to property damage,loss o f profits or retenucs,loss cruse o racy property,cost of capita h cost of purchases or replacement goods or temporary equipment.personal or bodily injury,or death,and/or
for arising from any suits,clainns,counterclaims,leotards,judgments and other actions(each,a"Claim"),regardless of whether a Claim is based on theories of contract_tort,negligence,strict liability,warranty,indemnity,
contribution,statute,orothenvise,including without lint i talion,all Claims relating to injury to and/or death ufany and all persons and for loss of and/or damage to property arising from or in connection with(a)Buyer's efforts and
activities to promote market,sell and distribute the Goods,including,without lim itation,any acts or omissions of every ki cul and character of its employees,representatives and agents arising in connection with or pursuant to those
sales efforts,(b)the use,handling,repair,alterati on,adj ust ment,operation or modi fication ofthe Goods by Buyer and any of Buyer's employees,representatives or agents,and(c)any clai ons of patent,trademark or other intellectual
property infringement for Goods manuflcturcd in accordance with Buyer's specifications. Buyer's ON igaliun to indenmi fy,do fend and hold hamdcss ROCK MOUNT extends to instances where ROCK N40U NT is alleged or found
to be negligent. For any Claim with respect to which it has an indemnification I ighunder this Section 10,ROCKMOUNT'sltall have the option to defend such Claim with counsel ol'ROCKMOUNT's own selection at the sole cost
and expense of-buyer.If ROCKNIOUNT,at its option,chooses to defend a Claim.Buyer agrees to cooperate with and assist ROCKMOUNT in its defense in whateverrcasonable v:ays ROCKNIOUNT chooses.
11. Any tern or provision of this Contract held to be invalid,illegal or unenforceable shall be incffcctiwc to the extent of such invalidity,illegality or unenforceability without a0ccting the validity,legality and enforceability of the
remaining provisions hereof.
12. The validity,interpretation and performance of this Contract shall be governed by the laws afWashineton,without reference to any con nicts or law provision of Washington and expressly excluding the United Nations Convention
on Contracts for the International Sale ofGoods. Buyerexpressly submits tothe exclusivejurisdiction brand venue in the state and/or Federal courts located in Vancouver.Washington with respect to all lawsuits arising under or in
connection witli this Contract. Buyer hereby consents to extra-territorial service of process with resect to all lawsuits arising under or in connection with this Contract and waives any defenses pertaining tothe inconvenience of
venue ofthe litigation being at Vancouver,N1'ashingtun. IN THE EVENT'OF LITIGATION PE'RT'AINING TO,ARISING UNDER OR IN CONNECTION WITH THIS CONTRACT,BUYER ITLREBY WAIVES ANY RIGITT
IT JA'IT MAY HAVE TO A JURY TRIAL OF ANY OR ALL OP THF ISSUES THAT MAY 13E RAISED IN THAT LITIGATION. Nothing contained in this Contract shall be construed to limit or waive any rights of
ROCKM OUNT under appl icable Federal.state or local laws.
13. Buyer may not.by operation oflaw or otherwise.assign this Contract,its rights hereunder or delegate its obligations hereunder to any Third Party without the prior written consent of ROCKMOUNT,and any purported or attempted
assignment or delegation without consent shall be unit and void.
14. This Contract shal l inure tothe sole and CXClnS ive benefit orROCKMOUNT,Buyer and their respect i ver successors and permiuedassigns.This Contract steal l have no Third Party beneficiaries.
15. Diversion of all Goods contrary to U.S.taw is prohibited. Buyer will not supply,tranship or re-export any Goods to any country curentty or that in the future may be subject to embargo under the laws of the U.S.,including Cuba.
Iran.Sudan,Syria and Burma(Myanmar).
16. Any notices or other communications required ot Permitted u rider this Conti act to be given to ROCK M OUNT or Buyer shall be in writing and shall be given to ROC KNIO UNT or Buyer at the to]lowi ng address arid tclefax'lumber,if'
to ROCKMOUNT:Rockmount Researchand Alloys,Inc.Box 2909 Vancouver,WA98668 Fax(360)254-2332. Ifto Buyer:At the address and/or tole fax unmoor set forth on the face horco for such other address or telefax number
as one party may provide in writing tothe other party.Such not ice or comm unication shall be effective(i)i fgiven by telefax,when such tclefax is transmiuedto the tele fax number specified above and appropriate acknowledgement
ofreceipt ofsuch telefax is received by Buyer,or i fgiven by other means.when delivered at ROCKMOUNT's or the intended addressee's address seri rtcd in this Section 16.
17. Notwitlnslanding anything to the contrary contained in this Contract,the provisions of Sections S.,9..10.,12.,and any other provision that by its nature shall survive in order to effectuate the manifest intent ofthe Contract,shall
survive shipment of Goods to Buyerand Buyer's payment for such Goods indefinitely.
VOUCHER # 138228 WARRANT # ALLOWED
368284 IN SUM OF $
ROCKMOUNT RESEARCH &ALLOYS,
PO BOX 2807
PORTLAND, OR 97208
r
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
'i
1197777 01-7202-06 $679.10
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Voucher Total $679.10 f
Cost distribution ledger classification if
claim paid under vehicle highway fund
Prescribed by State Board of Accounts City Form No.201 (Rev 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show, kind of service, where
performed, dates of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
368284
ROCKMOUNT RESEARCH &ALLOYS, INC. Purchase Order No.
PO BOX 2807 Terms
PORTLAND, OR 97208 Due Date 6/12/2014
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/12/2014 1197777 $679.10
I hereby certify that the attached invoice(s), or bill(s) is(are)true and
correct and I have audited same in accordance with IC 5-11-10-1.6
G�,���/ �--�-�C'.1'1�,.,✓1'1,x,-..�
Date Officer