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Home My WebLink About305294 11/14/16 (9, CITY OF CARMEL, INDIANA VENDOR: 294850 ONE CIVIC SQUARE STOOPS FREIGHTLINER CHECK AMOUNT: $*****1,479.17* CARMEL, INDIANA 46032 27825 NETWORK PLACE CHECK NUMBER: 305294 CHICAGO IL 60673-1278 CHECK DATE: 11/14/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4351000 R302012379 268.94 AUTO REPAIR & MAINTEN 2201 4351000 R302012381 403.41 AUTO REPAIR & MAINTEN 2201 4351000 R302012382 268.94 AUTO REPAIR & MAINTEN 2201 4351000 R302012383 268.94 AUTO REPAIR & MAINTEN 2201 4351000 R302012384 268.94 AUTO REPAIR & MAINTEN VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) STOOPS FREIGHTLINER ALLOWED 20 ACCOUNTS PAYABLE VOUCHER 27825 NETWORK PLACE IN SUM OF$ CITY OF CARMEL An invoice or bill to be properly itemized must show:kind of service,where performed,dates service CHICAGO, IL 60673-1278 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. $1,479.17 Payee # ON ACCOUNT OF APPROPRIATION FOR Purchase Order Street Department Terms Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT R302012379:01 43-510.00 $268.94 1 hereby certify that the attached invoice(s),or 10/25/16 R302012384:01 $268.94 2201 201 2201 201 R302012381:01 43-510.00 $403.41 bill(s)is(are)true and correct and that the 10/25/16 R302012383:01 $268.94 2201 201 materials or services itemized thereon for 2201 1 201 R302012382:01 43-510.00 $268.94 10/25/16 R302012382:01 $268.94 2201 201 which charge is made were ordered and 2201 201 R302012383:01 43-510.00 $268.94 received except 10/25/16 R302012381:01 $403.41 2201 201 2201 201 R302012384:01 43-510.00 $268.94 10/25/16 R302012379:01 $268.94 2201 201 2201 201 Tuesday, November 01,2016 /je- i Dave Huffman Director 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 , 20- Cost 20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer INVOICE NO. R302012379:01 INVOICE DATE 10/25/2016 S�OOpS P.O. NUMBER FJ-4REIGHTLINER-QUfiLITYTRIIILER VIN 1FVHG5CY9FHGS0909 UNIT 210 Diiiis N OF TRUCK UN1RY Service Invoice TRUCK COUNTRY-ANDERSON 6105 COLUMBUS AVE `"°T°N®6C19B ANDERSON, IN 46013 Phone: (800)515-2393 FAX: (765)683-4472 Bill To: Owner: CITY OF CARMEL CITY OF CARMEL 3400 WEST 131 ST STREET 3400 WEST 131 ST STREET CARMEL, IN 46074 CARMEL, IN 46074 WK PHONE: (317)733-2001 HM PHONE: (317)733-2001 CUST# 183553 ADVISOR S1384 ENG COLOR RED SCHED 10/24/16 UNTID 397890 YEAR 15 MAKE FTL MODEL 108SD MILES 5433 INSVC 4/29/15 ACCT CHG JOB#1 EXPRESS SCP (EA)DIAGNOSE AND ADVISE FOR CONDITION INSTALL DUST COVER CAUSE NEEDED CORRECTION INSTALLED DUST COVERS QTY ITEM DESCRIPTION UNIT PRICE EXTD PRICE EXP (EA) DIAGNOSE AND ADVISE FOR TECH NO.S2646 119.00 00 GENERAL REPAIR TECH NO.s2562 119.00 JOB#1 EXPRESS--PARTS:0.00--LABOR:238.00--MISC:0.00 -- SUBTOTAL 238.00 SALES TAX EXEMPTION CERTIFICATE DISCLAIMER OF WARRANTIES ,iii e n AR I—fify that this transaction is exempt from the Indiana Sales Tax because: ANY WARRANTIES ON THE PRODUCTS SOLD HEREBY ARE THOSE .MISC CHARGES 0.00 Purchaser is a common contract carder who will use items purchased or serviced MADE BY MANUFACTURER,IF ANY.THE SELLER HEREBY ♦n exclusively as such carrier. - EXPRESSLY DISCLAIMS ALL WARRANTIES EITHER EXPRESS OR PARTS 0.00 IMPLIED INCLUDING ANY IMPLIED WARRANTY OF MERCHANTABILITY Authority Number. OR FITNESS FOR A PARTICULAR PURPOSE,AND TRUCK COUNTRY Purchaser is engaged in the business of and items will be used for resale. OF Indiana NEITHER ASSUMES NOR AUTHORIZES ANY OTHER LABOR 238.00 PERSON TO ASSUME FOR IT ANY LIABILITY IN CONNECTION WITH Resale Number. THE SALE OF SAID PRODUCTS.WE HEREBY CERTIFY THAT THESE PACKAGES GOODS WERE PRODUCED IN COMPUANCE WITH ALLAPPLICABLE I am authorized to execute this Cerdficate and claim this exception. REQUIREMENTS OF SECTIONS 6,7 AND 12 OF THE FAIR LABOR STANDARDS ACT OF 1938,AS AMENDED AND OF REGULATIONS AND TTT� ORDERS OF THE ADMINISTRATOR OR WAGE AND HOUR DMSION SUBLET 0.00 ISSUED UNDER SECTION 14 THEREOF.TRUCK COUNTRY DOES Business Name Authorized Signature EXPRESS A LIMITED NON-TRANSFERRABLE WARRANTY,TO THE ORIGINAL PURCHASER,ON TECHNICIAN WORKMANSHIP ISSUES FOR MISC SUPPLIES 30.94 30 DAYS FROM THE COMPLETION DATE OF THIS REPAIR ORDER.A FINANCE CHARGE OF ONE AND ONE-HALF PERCENT(11 l/.%) TAX 0.00 Business Address Data MONTH IS APPLIED TO ALL ACCOUNTS 30 DAYS PAST DUE.THIS EQUALS AN ANNUAL PERCENTAGE RATE OF EIGHTEEN PERCENT (18%). RECEIVED TOTAL 268.94 BY: - --PAYABLE IN US DOLLAR-- Please Remit Payment to: Mot1FV.M.I.r 11 pr ld—Rn..S.l.t.dbylh.p—STOP 102,N1.. SIGNATUREBYTHECUSTOMERORCUSTOMERREPRESENTATIVE STOOPS FREIGHTLINER Adm C.d.,G—1—d by M.Bence 0 C-11m.r Prob1B1n, CONSTITUTES AGREEMENT TO PAY REASONABLE LEGAL VAac...1...PLOf Sadcul6U..Tnd.end......rPnblUlq P.O.BeR EXPENCES,INLCUDING ATTORNEY AND COUNT COSTS INCURRED 27825 NETWORK PLACE Sell,—I....Ed....W.extatld811. BY TRUCK COUNTRY FOR PAYMENT OF THIS INVOICE. / CHICAGO,IL 60673-1278 CUSTOMER EMAIL COPY Page 1 of 1 INVOICE NO. R302012381:01 INVOICE DATE 10/25/2016 Sfo ops P.O. NUMBER FREIGHTLINER-QUALITY TRAILER VIN 1 FVHG5CY8GHHG0544 UNIT 214W DIVISION IGF TRUCK UNTAC' Service Invoice TRUCK COUNTRY-ANDERSON 6105 COLUMBUS AVE ANDERSON, IN 46013 Phone: (800)515-2393 FAX: (765)683-4472 Bill To: Owner: CITY OF CARMEL CITY OF CARMEL 3400 WEST 131 ST STREET 3400 WEST 131 ST STREET CARMEL, IN 46074 CARMEL, IN 46074 WK PHONE: (317)733-2001 HM PHONE: (317)733-2001 CUS,T# 183553 ADVISOR S1384 ENG COLOR RED SCHED 10/24/16 UNTID 430311 YEAR 16 1 MAKE FTL MODEL 108SD MILES 1731 INSVC 1/1/00 ACCT CHG JOB#1 EXPRESS SCP (EA) DIAGNOSE AND ADVISE FOR CONDITION INSTALL DUST COVER CAUSE NEEDED CORRECTION INSTALLED DUST COVERS QTY ITEM DESCRIPTION UNIT PRICE EXTD PRICE EXP (EA)DIAGNOSE AND ADVISE FOR TECH NO.S2582 119.00 00 GENERAL REPAIR TECH NO. S2643 0.00 00 GENERAL REPAIR TECH NO.s2562 238.00 JOB#1 EXPRESS--PARTS:0.00--LABOR:357.00--MISC:0.00 -- SUBTOTAL 357.00 SALES TAX EXEMPTION CERTIFICATE DISCLAIMER OF WARRANTIES I certify that this transaction is exempt from the Indiana Sales Tax because: ANY WARRANTIES ON THE PRODUCTS SOLD HEREBY ARE THOSE MISC CHARGES 0.00 Purchaser is a common contract carrier whowill use items purchased or serviced MADE BY MANUFACTURER,IF ANY.THE SELLER HEREBY exclusively..such Cartier. EXPRESSLY DISCLAIMS ALL WARRANTIES EITHER EXPRESS OR PARTS 0.00 IMPLIED INCLUDING ANY IMPLIED WARRANTY OF MERCHANTABILITY Authority Number: OR FITNESS FOR A PARTICULAR PURPOSE,AND TRUCK COUNTRY Purchaser is engaged in the business of and items will be used for resale. OF Indiana NEITHER ASSUMES NOR AUTHORIZES ANY OTHER LABOR 357.00 PERSON TO ASSUME FOR IT ANY LIABILITY IN CONNECTION WITH Resale Number. THE SALE OF SAID PRODUCTS.WE HEREBY CERTIFY THAT THESE PACKAGES GOODS WERE PRODUCED IN COMPLIANCE WITH ALL APPLICABLE I am authorized to execute this Certificate and claim this exception. REQUIREMENTS OF SECTIONS 6,7 AND 12 OF THE FAIR LABOR STANDARDS ACT OF 1938,AS AMENDED AND OF REGULATIONS AND TTT� ORDERS OF THE ADMINISTRATOR OR WAGE AND HOUR DIVISION SUBLET 0.00 ISSUED UNDER SECTION 14 THEREOF.TRUCK COUNTRY DOES Business Name Authorized Signature EXPRESS A LIMITED NON-TRANSFERRABLE WARRANTY,TO THE ORIGINAL PURCHASER,ON TECHNICIAN WORKMANSHIP ISSUES FOR MISC SUPPLIES 46.41 30 DAYS FROM THE COMPLETION DATE OF THIS REPR ORDER. FINANCE CHARGE OF ONE AND ONE-HALF PERCENT(N1'M%)P R A TAX 0,00 Business Address Data MONTH IS APPLIED TO ALL ACCOUNTS 30 DAYS PAST DUE.THIS EQUALS AN ANNUAL PERCENTAGE RATE OF EIGHTEEN PERCENT (18%). RECEIVED TOTAL 403.41 BY: - --PAYABLE IN US DOLLAR-- Please Remit Payment to: Motor v.Mcl.m Wr prec9c.v w 1.9.1.Nd by h.p-STOP 132,Wlv. SIGNATURE BY THE CUSTOM ER OR CUSTOM BR REP...ENTATIVO Aden God.,.dMM—d by N.S....f Coeloms P---d n, CONSTITUTES ADMEN ENT TO PAY REASONABLE LEGAL STOOPS FREIGHTLINER To....d.n.FL.fAad—,Tmd..RU Cor,m,,,,.r Pm.—S,P.O.Bo. DEFENCES,INLCUDING ATTORNEY AND GOUnT COSTS INCURRED 27825 NETWORK PLACE Bp11,Mvdivon,YAvc.nvin B])OB-0911. BY TRUCK COU NTRY FOR PAYMENT OF THIS INVOICE. CHICAGO,IL 60673-1278 CUSTOMER EMAIL COPY Page 1 of 1 INVOICE NO. R302012382:01 INVOICE DATE 10/25/2016 SfOOpS P.O. NUMBER 476MIGH111HER VIN 1FVHG5CYXGHHG0545 UNIT 218 DIttisio of IRUCK UNIC� Service Invoice TRUCK COUNTRY-ANDERSON 6105 COLUMBUS AVE ANDERSON, IN 46013 Phone: (800)515-2393 FAX: (765)683-4472 Bill To: Owner: CITY OF CARMEL CITY OF CARMEL 3400 WEST 131ST STREET 3400 WEST 131ST STREET CARMEL, IN 46074 CARMEL, IN 46074 WK PHONE: (317)733-2001 HM PHONE: (317)733-2001 CUST# 183553 ADVISOR S1384 ENG COLORRED SCHED 10/24/16 UNTID 430268 YEAR 16 MAKE FTL MODEL 108SD MILES 1799 INSVC 1/1/00 ACCT CHG JOB#1 EXPRESS SCP (EA) DIAGNOSE AND ADVISE FOR CONDITION INSTALL DUST COVERS/PARTS IN TRUCKS CAUSE DUST COVERS CORRECTION GARAGE FULL WORKED OUTSIDE AND TAPPED ALL THE REAR AXLE DRIVE DUST SHIELDS MOUNTING BOLT HOLES AND INSTALLED DRIVE AXLE DUST SHIELDS.AND SECURED QTY ITEM DESCRIPTION UNIT PRICE EXTD PRICE EXP (EA)DIAGNOSE AND ADVISE FOR TECH NO. S2643 0.00 00 GENERAL REPAIR TECH NO. S2643 238.00 JOB#1 EXPRESS--PARTS:0.00--LABOR:238.00--MISC:0.00 -- SUBTOTAL 238.00 SALES TAX EXEMPTION CERTIFICATE DISCLAIMER OF WARRANTIES N,ii I cerfiy that this transaction is exempt from the Indiana Sales Tax because: ANY WARRANTIES ON THE PRODUCTS SOLD HEREBY ARE THOSE MISC CHARGES 0.00 Purchaser is a common contract carrier who will use items purchased or serviced MADE BY MANUFACTURER,IF ANY.THE SELLER HEREBY exclusively as such carer. EXPRESSLY DISCLAIMS ALL WARRANTIES EITHER EXPRESS OR PARTS 0.00 IMPLIED INCLUDING ANY IMPLIED WARRANTY OF MERCHANTABILITY Authority Number. OR FITNESS FOR A PARTICULAR PURPOSE,AND TRUCK COUNTRY Purchaser is engaged in the business of and items will be used for resale. OF Indiana NEITHER ASSUMES NOR AUTHORIZES ANY OTHER LABOR 238.00 PERSON TO ASSUME FOR IT ANY LIABILITY IN CONNECTION WITH Resale Number. THE SALE OF SAID PRODUCTS.WE HEREBY CERTIFY THAT THESE PACKAGES GOODS WERE PRODUCED IN COMPLIANCE WITH ALL APPLICABLE I am authorized to execute this Certificate and claim this exception. REQUIREMENTS OF SECTIONS 6.7 AND 12 OF THE FAIR LABOR STANDARDS ACT OF 1938,AS AMENDED AND OF REGULATIONS AND T T ORDERS OF THE ADMINISTRATOR OR WAGE AND HOUR DIVISION SUBLET 0.00 ISSUED UNDER SECTION 14 THEREOF.TRUCK COUNTRY DOES Business Name Authorized Signature EXPRESS A LE WARRANTY,TO THE ORIGINAL PURCHASER,ONTED E CHNICIANBOWORKMANSHIP ISSUES FOR MISC SUPPLIES 30.94 30 DAYS FROM THE COMPLETION DATE OF THIS REPAIR ORDER.A FINANCE CHARGE OF ONE AND ONE-HALF PERCENT(i%%)PER TAX 0.00 BusinessAddress Date MONTH IS APPLIED TO ALL ACCOUNTS 30 DAYS PAST DUE.THIS EQUALS AN ANNUAL PERCENTAGE RATE OF EIGHTEEN PERCENT (18%). RECEIVED TOTAL 268.94 8V: --PAYABLE IN US DOLLAR-- Please Remit Payment to: Metor1--rop.ir pectic..Pn reaulotod By—p-ATOP 133,W. SIGNATURE BY THE CUSTOMER OR CUSTOMER REPRESENTATIVE STOOPS FREIGHTLINER Adm Cod.,odmml—md By NO B.—of Cu.tem.r Pre—de - CONSTITUTES AGREEMENT TO PAY REASONABLE LEGAL Iffix—el.IM Lof ASd..HG-,Tr.d.end Comm—ProbcUen,P.O.BOX EXPENCES,INLCUBING ATTORNEY AND COURT COSTS INCURRED 27825 NETWORK PLACE Bell,—J..,VA.canaI.B11-11. BY TRUCK COUNTRY FOR PAYMENT OF THIS INVOIC& CHICAGO,IL 60673-1278 CUSTOMER EMAIL COPY Page 1 of 1 INVOICE NO. R302012383:01 INVOICE DATE 10/25/2016 1; StOOpS P.O. NUMBER fRf/GNTLINER-QUALIfYTRAILER VIN 1FVHG5CY5FHGS0907 —rUNIT 207W DIVISION OF if U Service Invoice TRUCK COUNTRY-ANDERSON 6105 COLUMBUS AVE ANDERSON, IN 46013 Phone: (800)515-2393 FAX: (765)683-4472 Bill To: Owner: CITY OF CARMEL CITY OF CARMEL 3400 WEST 131ST STREET 3400 WEST 131ST STREET CARMEL, IN 46074 CARMEL, IN 46074 WK PHONE: (317)733-2001 HM PHONE: (317)733-2001 CUST# 183553 ADVISOR S1283 ENG COLOR RED SCHED 10/24/16 UNTID 395471 YEAR 15 MAKE FTL MODEL 108SD MILES 3048 INSVC 11/20/14 ACCT CHG JOB#1 EXPRESS SCP (EA)DIAGNOSE AND ADVISE FOR CONDITION INSTALL DUST COVERS-PARTS IN TRUCK CAUSE NEEDED CORRECTION INSTALLED DUST COVER QTY ITEM DESCRIPTION UNIT PRICE. EXTD PRICE EXP (EA)DIAGNOSE AND ADVISE FOR TECH NO. S2646 238.00 JOB#1 EXPRESS--PARTS:0.00--LABOR:238.00--MISC:0.00 -- SUBTOTAL 238.00 SALES TAX EXEMPTION CERTIFICATE DISCLAIMER OF WARRANTIES MSC I certify Mat this transaction is exempt from the Indiana Sales Tax because: ANY WARRANTIES ON THE PRODUCTS SOLD HEREBY ARE THOSE MISC CHARGES 0.00 Purchaser is a common contract carrier who will use items Purchased or serviced MADE BY MANUFACTURER,IF ANY.THE SELLER HEREBY .LnT exclusively as such carrier. EXPRESSLY DISCLAIMS ALL WARRANTIES EITHER EXPRESS OR PAR PARTS 0.00 IMPLIED INCLUDING ANY IMPLIED WARRANTY OF MERCHANTABILITY Authority Number. OR FITNESS FOR A PARTICULAR PURPOSE,AND TRUCK COUNTRY n Purchaser is engaged in the business of and items will be used for resale. OF Indiana NEITHER ASSUMES NOR AUTHORIZES ANY OTHER LABOR 238.00 PERSON TO ASSUME FOR IT ANY LIABILITY IN CONNECTION WITH n Resale Number. THE SALE OF SAID PRODUCTS.WE HEREBY CERTIFY THAT THESE PACKAGE'S GOODS WERE PRODUCED IN COMPLIANCE WITH ALL APPLICABLE I am authorized to execute this Cerfificate and claim this—pfion. REQUIREMENTS OF SECTIONS 6,7 AND 12 OF THE FAIR LABOR STANDARDS ACT OF 1938•AS AMENDED AND OF REGULATIONS AND ORDERS OF THE ADMINISTRATOR OR WAGE AND HOUR DIVISION SUBLET 0.00 ISSUED UNDER SECTION 14 THEREOF.TRUCK COUNTRY DOES Business Name Authorized Signature EXPRESSA LE WARRANTY,TO THE ORIGINAL PURCHASER,ON TED TECHNICIANBWWORKMANSHIP ISSUES FOR MISC SUPPLIES 30.94 30 DAYS FROM THE COMPLETION DATE OFTHIS REPAIR ORDER.A FINANCE CHARGE OF ONE AND ONE-HALF PERCENT(I%%)PER TAX 0.00 Business Address Date MONTH IS APPLIED TO ALL ACCOUNTS 30 DAYS PAST DUE.THIS EQUALS AN ANNUAL PERCENTAGE RATE OF EIGHTEEN PERCENT (18q. RECEIVED TOTAL 268.94 BY: --PAYABLE IN US DOLLAR-- Please Remit Payment to: N.brv.McN opal.........n nSWab,I dy ch-pbEATCP I]],VAe. SIGNATURE BY THE CUSTOMER OR CUSTOMER REPRESENTATIVE STOOPS FREIGHTLINER AEn.C.d.,AO W—d by M.Bu—or C—t-m-r P—d-, CONSTITUTES AS REEMENT TO DAY REASONABLE LEGAL Yr1.n.naln PnPL-r AEd..IM..,T-d..nd Gon-Am.r Pm--,P.D.B" EXPENSES,INLCUDINO ATTORNEY AND COURT COSTS I NCURRED 27825 NETWORK PLACE AS11,NAAlaon,YAan-nolo 8]TOBde11. BY TRUCK COUNTRY FOR PAYMENT OF THIS INVOICE. CHICAGO,IL 60673-1278 CUSTOMER EMAIL COPY Page 1 of 1 INVOICE NO. R302012384:01 INVOICE DATE 10/25/2016 StOOpS P.O. NUMBER —4 fREIGHILINER-pU/JLITYIR/ULER VIN 1FVHG5CYOGHHG0540 UNIT 213W DIVISION OF Service Invoice TRUCK COUNTRY-ANDERSON 6105 COLUMBUS AVE ANDERSON, IN 46013 Phone: (800)515-2393 FAX: (765)683-4472 Bill To: Owner: CITY OF CARMEL CITY OF CARMEL 3400 WEST 131 ST STREET 3400 WEST 131 ST STREET CARMEL, IN 46074 CARMEL, IN 46074 WK PHONE: (317)733-2001 HM PHONE: (317)733-2001 CUST# 183553 ADVISOR S1384 ENG COLOR RED SCHED 10/24/16 UNTID 430312 YEAR 16 MAKE FTL MODEL 108SD MILES 2267 INSVC 12/15/15 ACCT CHG JOB#1 EXPRESS SCP (EA)DIAGNOSE AND ADVISE FOR CONDITION INSTALL DUST COVERS CAUSE SHIELDS CORRECTION INSTALLED NEW DUST COVERS ON DRIVE WHEELS QTY ITEM DESCRIPTION UNIT PRICE EXTD PRICE EXP (EA) DIAGNOSE AND ADVISE FOR TECH NO. S2663 119.00 00 GENERAL REPAIR TECH NO.s2651 119.00 JOB#1 EXPRESS--PARTS:0.00--LABOR:238.00--MISC:0.00 -- SUBTOTAL 238.00 SALES TAX EXEMPTION CERTIFICATE DISCLAIMER OF WARRANTIES I caniythatINS transaction is exempt from the Indiana Sales Tax because: ANY WARRANTIES ON THE PRODUCTS SOLD HEREBY ARE THOSE MSC CHARGES 0.00 Purchaser is a common contract carder who will use items purchased or serviced MADE BY MANUFACTURER,IF NY.THE SELLER HEREBY exclusively as such canner. EXPRESSLY DISCLAIMS ALL WARRANTIES EITHER EXPRESS OR PARTS 0.00 IMPLIED INCLUDING ANY IMPLIED WARRANTY OF MERCHANTABILITY S FOR A PARTICULAR PURPOSE,AND Purchaser is engaged in theAuthority siness of and items will be used for resale. OF Ine OR dianaNEITHERTRUCK NEIH R ASSUMES NOR AUTH R17ESNH YO ER LABOR 238.00 PERSON TO ASSUME FOR IT ANY LIABILITY IN CONNECTION WITH Resale Number. THE SALE OF SAID PRODUCTS.WE HEREBY CERTIFY THAT THESE PACKAGES GOODS WERE PRODUCED IN COM PUANCE WITH ALL APPLICABLE I am authorized to execute this Certificate and claim this exception. REQUIREMENTS OF SECTIONS 8,7 AND 12 OF THE FAIR LABOR STANDARDS ACT OF 1938,AS AMENDED AND OF REGULATIONS AND ORDERS OF THE ADMINISTRATOR OR WAGE AND HOUR DIVISION SUBLET 0.00 ISSUED UNDER SECTION 14 THEREOF.TRUCK COUNTRY DOES Business Name Authorized Signature EXPRESS A LIMITED NON-TRANSFERRABLE WARRANTY,TO THE ORIGINAL PURCHASER,ON TECHNICIAN WORKMANSHIP ISSUES FOR MISC SUPPLIES 30.94 30 DAYS THE COMPLETION DATES REPAIR ORDER. FINANCE CRHARGE OM OF ONE AND ONE-HALLFFPERCENT(1•h%)PER A TAX 0.00 BusinessAddress Date MONTH IS APPLIED TO ALL ACCOUNTS 30 DAYS PAST DUE.THIS EQUALS N ANNUAL PERCENTAGE RATE OF EIGHTEEN PERCENT (18%). RECEIVED TOTAL 268.94 BY: --PAYABLE IN US DOLLAR-- Please Remit Payment to: Rotor blcl.mp.lr pectic..•n MSWnt.e by cb.pW MCP 113,VA.. SIGNATURE BY THE CUSTOMER OR CUSTONER REPRESENTATIVE Aa...coA•,Admi..I.—by In.Em..0 of cu•t.m.r P-I..Gon, CONSTITUTES AGREEMENT TO PAY HER-11tH LE- STOOPS FREIGHTLINER W.c.n.In D•pL.fAo.ute—,T-d..nd COO•w,.r P..—g—,P.O.Bo. EXPENCES,IN LCU ING ATTORNEY AND COURT COSTS INCURRE D 27825 NETWORK PLACE Bell.N•A..nr VA.conaln B31-11. BY TRUCK COUNTRY FOR PAYMENT OF THIS INVOICE CHICAGO,IL 60673-1278 CUSTOMER EMAIL COPY Page 1 of 1