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HomeMy WebLinkAbout2015 Police Schedule 24 pay request 26 112315 Lease 2015 — Sch # 24 (Police Dept.) Payment Request # 26 EXHIBIT A PAYMENT REQUEST FORM/ACCEPTANCE CERTIFICATE The Escrow Agent is hereby requested to pay from the Acquisition Fund established by the Escrow Agreement dated as of February 5, 2015 by and among the Escrow Agent, the Lessee and Lessor, to the person or corporation designated below as Payee, the sum set forth below in payment (of all/of a portion) of the Acquisition Costs described below. The amount shown below is due and payable under a purchase order or contract with respect to the Equipment described below and has not formed the basis of any prior request for payment. In addition, the undersigned acknowledges delivery, installation and receipt in good condition, and hereby accepts the Equipment described on the attached invoices. Payee: Bell Techlogix Inc Amount: $5,004.80 Description of Equipment Item Cost: Lap Top Computers Dated: 11/20/15 LESSEE: City of Carmel One Civic Square Carmel,EN -6032 Name: Diana Cordray Title: Clerk Treasurer (Attached duplicate original of Payee's statement) Make check payable to: Bell Techlogix Inc PO Box 823342 Philadelphia,PA 19182-3342 I Edg TechIogix PAGE:1 INVOICE:BI 392072 REMIT TO: INVOICE DATE: 10/2 3/15 BELL TECHLOGIX INC DUE DATE: 11/22/15 P.O. BOX 823342 PHILADELPHIA PA 19182-3342 TERMS:Net 30 317-333-7777 Net 30 Days 866-782-2355 SHIP TO: BILL TO: 1201825 Carmel Police Department CITY OF CARMEL 3 Civic Square ONE CIVIC SQUARE T.Crockett PO #33171 ATTN: ACCOUNTS PAYABLE Carmel IN 46032 CARMEL IN 46032 USA ORDER: 727685 ORDER DATE: 09/30/15 CUSTOMER PO: 33171 CARRIER: FREIGHT TERMS: FREIGHT CHARGE 121 METHOD: UNITED PARCEL GROUND TRANSPORTATION ID: SALESPERSON: JUANA YOUNCE CURRENCY: United States Dollars ITEM t - ;QUANTITY at LINE " n „ z UNIT PRICE NET AMOUNT • DESCRIPTION �, s Carmel Police Department Terry Crockett 317-571-2567 tcrockett@carmel . in.go Cust PO Num: 33171 BELL TO INSTALL MEMORY AND EXCHANGE DVD-DRIVE WITH BLURAY DRIVE BELL SO 727685 - 20117208 HP ProBook 440 G2 Notebook PCTPR: Promo otion pricing ends on 9/30/20150peratin system - Windows 7 Professional 64 (av ilable through downgrade rights from Wi dows 10 Pro) Processor - Intelx Core 5-5200U Processor (2 . 2 GHz with Turbo, MB L3 Cache) with HD Graphic 5500 Ener Y Efficiency - ENERGY STARx qualified isplay - 14 . 0-inch diagonal LED HD SVA nti-Glare (1366x768) Integrated camera - Integrated 720p HD Webcam Graphics - Intelx HD Graphics 4400 Memory - 4 GB 600 DDR3 SDRAM (1D) Internal Storage - 500GB 7200 rpm 2 .5-inch hard drive Opt cal Drive Bay - DVD+/-RW SuperMulti DL rive Pointing Device - Touchpad Wirel ss LAN - Intel 802 . 11 abgn ac (lxl) + B Bluetooth - Bluetoothx 4 . 0 Wireless T chnology Security - TPM Battery - 4-c 11 (44 WHr) Lithium-Ion battery Warran y - 1/1/0 Limited 1 year standard parts and labor warranty 1 ISR-760-0007 4 EA 200 . 00 HARDWARE CONFIGURATION 50 . 00 EA FREIGHT CHARGE: GROSS AMOUNT: INVOICE DISCOUNT: NET AMOUNT: TAX AMOUNT: DOWN PAYMENT: NET AMOUNT DUE: Techiogix PAGE:2 INVOICE:BI 392072 REMIT TO: INVOICE DATE: 10/23/15 BELL TECHLOGIX INC DUE DATE: 11/22/15 P.O. BOX 823342 PHILADELPHIA PA 19182-3342 TERMS:Net 30 317-333-7777 Net 30 Days 866-782-2355 SHIP TO: BILL TO: 1201825 Carmel Police Department CITY OF CARMEL 3 Civic Square ONE CIVIC SQUARE T.Crockett PO #33171 ATTN: ACCOUNTS PAYABLE Carmel IN 46032 CARMEL IN 46032 USA ORDER: 727685 ORDER DATE: 09/30/15 CUSTOMER PO: 33171 CARRIER: FREIGHT TERMS: FREIGHT CHARGE 121 METHOD: UNITED PARCEL GROUND TRANSPORTATION ID: SALESPERSON: JUANA YOUNCE CURRENCY: United States Dollars ITEM-' ' , QUNTTY UNIT PRICE NET;AMOUNT , DESCRIPTION 2 P2C39UT#ABA 4 EA 2, 516 . 00 HP PROBOOK 440 G2 14IN CORE I5 629 . 00 EA 5200U Line Lot/Serial Details: CND5410YTV EA 1 CND5410YV3 EA 1 CND5410YV4 EA 1 CND5413HKD EA 1 3 UK748E 4 EA 1, 116 .80 ELECTRONIC HP CARE PACK NBD 279 .20 EA 4 H6Y75UT#ABA 4 EA 216 . 00 MEMORY 4 GB SO DIMM 204-PIN 54 . 00 EA DDR3L 6 768051-001 4 EA 956 . 00 HP OPTICAL DRIVE BLU-RAY AND 239 . 00 EA DVD/RW SUPERMULTI DUAL-LAYER **************************************** PAST DUE ACCOUNTS CARRY INTEREST AT THE LESSER OF 1.5% PER MONTH OR THE MAXIMUM LEGAL RATE IN THE JURISDICTION IN WHICH THE CUSTOMER'S PRINCIPAL PLACE OF BUSINESS IS LOCATED **************************************** ALL DELIVERY TERMS ARE F.O.B. ORIGIN **************************************** TO REQUEST A STATEMENT OF ACCOUNT PLEASE CONTACT 866-782-2355 EXT 7787 **************************************** FEDERAL TAX ID# 26-3683994 **************************************** FOR SERVICE CALL 1-800-999-9813 * * * * BACKORDER SUMMARY * * * * FREIGHT CHARGE: GROSS AMOUNT: INVOICE DISCOUNT: NET AMOUNT: TAX AMOUNT: DOWN PAYMENT: NET AMOUNT DUE: Techiogix PAGE:3 INVOICE:BI 392072 INVOICE DATE: 10/23/15 REMIT TO: 11/22/15 DUE DATE: BELL TECHLOGIX INC P.O. BOX 823342 PHILADELPHIA PA 19182-3342 TERMS:Net 30 317-333-7777 Net 30 Days 866-782-2355 SHIP TO: BILL TO: 1201825 Carmel Police Department CITY OF CARMEL 3 Civic Square ONE CIVIC SQUARE T.Crockett PO #33171 ATTN: ACCOUNTS PAYABLE Carmel IN 46032 CARMEL IN 46032 USA ORDER: 727685 ORDERDATE: 09/30/15 CUSTOMER PO: 33171 CARRIER: FREIGHT TERMS: FREIGHT CHARGE 121 METHOD: UNITED PARCEL GROUND TRANSPORTATION ID: SALESPERSON: JUANA YOUNCE CURRENCY: United States Dollars ITEM`sQUANTITiYtr fiA �; ' t 's LINE UNIT PRICE ' NET AMOUNT _ ' DESCRIPTION , " �i5. 1 ISR-760-0007 4 HARDWARE CONFIGURATION 2 P2C39UT#ABA 4 SMART BUY - HP PROBOOK 440 G2 3 UK748E 4 ELECTRONIC HP CARE PACK NBD 4 H6Y75UT#ABA 4 MEMORY 4 GB SO DIMM 204-PIN 6 768051-001 4 HP OPTICAL DRIVE BLU-RAY AND FREIGHT CHARGE: 0 . 00 GROSS AMOUNT: 5, 004 . 80 INVOICE DISCOUNT: 0 . 00 NET AMOUNT: 5, 004 . 80 TAX AMOUNT: 0 . 00 DOWN PAYMENT: 0 . 00 NET AMOUNT DUE: 5, 004 . 80 AccoRE)® CERTIFICATE OF LIABILITY INSURANCE 1/13/2015TE(MM/ DnvrY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Marianne Uban Hylant Group O (A/C.No.Ext):317-817-5136 FAX No:317 817 5151 301 Pennsylvania Parkway,#201 E-MAIL ss:marianne.ubanla� lant.com Indianapolis IN 46280 ADDRESS:marianne.uban@bylant.com AFFORDING COVERAGE NAIC# INSURER A:Charter Oak Fire Insurance Co 25615 INSURED CARME80 INSURER B: City of Carmel INSURER C: One Civic Square INSURER D Carmel, IN 46032 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:682333440 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTRR ADDL TYPE OF INSURANCE NSR SUER WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS (MM/DD/YYYY) (MMIDDIYYYY) A GENERAL LIABILITY Y ZLP14T62033 1/1/2015 1/1/2016 EACH OCCURRENCE $2,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES(Ea occurrence) $50,000 CLAIMS-MADE X OCCUR MED EXP(Any one person) $0 PERSONAL&ADV INJURY $2,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY PRO- JECT A AUTOMOBILE LIABILITY H8103036P64ACOF15 1(1/2015 1/1/2016 (CEaaBINEDtSINGLELIMIT 000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS _ AUTOS (Per accident) X Comp X Coll Comp/Coll Ded $2,500 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is required) ADDITIONAL NAMED INSUREDS: CARMEL CLAY PARKS BUILDING CORPORATION;CARMEL CLAY BOARD OF PARKS& RECREATION; CARMEL REDEVELOPMENT COMMISSION; CARMEL REDEVELOPMENT AUTHORITY;CARMEL CITY CENTER COMMUNITY DEVELOPMENT CORPORATION Certificate Holder is an Additional Insured re:Various Police Equipment/Vehicles CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN The Huntington National Bank& It's Assignors&Assignees ACCORDANCE WITH THE POLICY PROVISIONS. do American Lease Insurance 654 Amherst Rd., Ste. 335 AUTHORIZED REPRESENTATIVE Sunderland MA 01375 r _t �Z IO�Y ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD