Loading...
2014 Comm Service schedule 21 lease pay request 3 031815 Lease 2014 — Sch # 21 (Community Services Dept.) Payment Request # 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 October I, 2014 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: Amount: 7) tv Description of Equipment Item Cost: /.37 t� J /pAutL Dated: I�� LESSEE: City of Carmel One Civic Square Carmel, IN 46032 • By: ./ t`. Name: +i:na or•ray Title: Clerk Treasurer (Attached duplicate original of Payee's statement) PLEASE PAY VIA WIRE TRANSFER: PAGE I FW: Bank info for Advantage Ford https://owa.carmel.in.gov/owa/?ae°Item&t=IPM.Note&id=RgAA... FW: Bank info for Advantage Ford Stewart, Lisa M Sent:Wednesday, March 18, 2015 9:38 AM To: Sheeks,Cindy L This is what I gave you last time—is this not correct? From: amy cook [mailto:arcook34 @yahoo.com] Sent: Friday, February 20, 2015 10:49 AM To: Stewart, Lisa M Subject: Bank info for Advantage Ford Fifth Third Bank Routing# 074908594 Acct# 74811201 Thanks Amy Cook 1 of 1 3/18/2015 9:47 AM Z176X ' ` EERTIFICATE�OFi4ORIGIRIFOR"A VEH GLEE i. ' r 1 r '"' E`� a D `U P L I C:,A :T E l r , .�, r� �`' " (ORIGINAL LOST AT DEALER) I • k --' ...„„, `.-.DATE: - INVOICE NO, NOVEMBER 12 ,2.014 KG35094 - 2 VEHICLE IDENTIFICATION NO YEAR MAKE 1FTFX1EF2EKG35094 : 2014 FORD BODY TYPE SHIPPING WEIGHT C 145 F150 SUPERCAB 4X4: SS 5241 LBS, H P(SAE.). G V W.R NO CYLS SERIES OR MODEL ' 42 .15 7350 LBS. 8 XlEN NOMINAL TONNAGE 1/2 •INVOICE DATE: :,NOVEMBER 12, 2014 I the undersigned authorized representative of the,company firm or corporation named below, hereby cer= , tlfy that the new vehicle described above,is.the property of the said company,firm or corporation and is transferred on the above date and under;the`Invoice Number indicated to.the"following distributor or.dealer. NAMEOF'DISTRIBUTOR DEALER ETC OWNER: : Advantage FL—Gov' t Sales P O BOX :639 . Connersville IN,' f 47W779 ` It is further certified that this was the first transfer of such new motor vehicle in ordinary trade and commerce. MEMO DATA . FORD :MOTOR..COMPANY FINANCE SOURCE 000001 BY r�� i'� .Yrl• Ford: Motor Credit ".Comp BRADLEY M GAYT *SECRETARY ..$ (AGENT) P.O.. Box. 17.32 , Room 2945 ..y_: Dearborn MI DEARBORN,. MICHi.. GAN ?:—:48121 . :I:.z::CITY,-STATE I VI I I VIII 01111 I II(II 1111111111110111 IIII uiui 111111.110 liii 0111 lUll 0111 III 1111 JII ::':,..:,I!'. i • • Each undersigned seller certifies to the best of his knowledge,information and belief under penalty of law that the vehicle is new and 7i...- as not been registered In ; s this or any state at the time of.delivery and the vehicle is.not subject to any security interests other than those disclosed hereimand warrant.titlato the vehicle t FOR VALUERECEVEDITRANS(ERTHE:VEHICLE'DESGHIBED:ONTHE:FACEOFTt31S'CERTIFICATETO -'_. .. r PURCHA CITY QF CARf1EL wg ADDRESS + ► C-ARtIEL,r J N 4.6032 a 1 cent to'the best of ro k or 1 No T r ',, oz �i y ACIVAlitAGE� F 'R tM.' L , IN a il, , _ .'� I �-! /..�. I m NAME LERSHIP' DEALER'S LICENSE NUMBER Being duly S� /L .ys 1 h 4 ems set �' o gin forth are true J c e ct Subscribed i wgrn to me x n<; State of 1 11 Q ~ - a '; before this je_ da :of pa County of S y Notery PUENIC USE NO"i'ARIZATION bh1LY re REQUIRED IN TITLING JURi501c r on �¢ PURCNASER(S) � v �V: W4 I certify to the best of my.knowledge thatthe'odometen:reading is No.`Ferrths - F fJ Q Dw • DEALER $Y F NAME OF 0EALERSH 1.. DEALER'S LICENSE NUMBER Being duly sworn upon oath says that the statements set :f LL tG-C Z-j State pf '� " a ". forth are;true and correct'Subscribed acid sworn tome W F q/V1 before this dey:of 20_ . Z Z oa Countyof_ r Notary Public ;j W `. USE:NOTARIZATION ONLY 1F REQUIRED IN TITLING JURISDICTION . f Q J w.;, PURCRASER(S) w ADDRESS tL o� al z z. f certify to.the best of my knowledge that the odometer reading is - No Tenths 17 OI mow:. DEALER H Stn mail -::FJAFdE OF:DEALERSHIP 'DEALERS LICENSr:NUMBER: .�': •eemg duly,sworn upon oath nays that the statements set 0. ¢ State Df. for h area true and correct Subscribed and sworn to;rile Z v m before this dayof 2U. V - ,Counryof `Notary Public Q f� USE NOTARIZATION ONLY IS REOUtRED W TITLING JUAISDIETIOM :J —` m NAME OF. �..:G ',O w2 ADDRESS tv on '?Z •z z.;,,.. I certify,to:the,best of my•knowledge that the_odometer reading,is NaaTeoths Z--. DEALER NAiME OF DEAj_ERSHR DEALERS LICENSE.NUMBER Being duty sworn upon Oath Says that the Statements eat ' U � State of_ forth are true and;correct Subscribed andsworh to me u O 17)..'7' . before this day of 20 r O 'o 'n.a;. County.of `"Notary Pubic _1 $_ " USENOYARIZATIONONLYIF REOUARED INTITLINOJURIS01CT10N F„ Federa6Lkw requireS::you to state:the odometer in ileage n-i connection:with the transfer of ownership.Failure to complete or prowiklg a false statement may result O' in fines and/or inlprisonrTtent ._ ?;: 'i .-i ... s: i ''n w I certify to the best of y knowledge that the odometer reading is the actual mileage of the vehicle unless one of the following statements Is checked Odometer t t ".J Reading No Te ha J The •`teage stated Is In excess of Its mechanical limits, ..t The:Odometer readlrlg is not the actual m leage r <; ® WARNING ODOMETER ptSCR£PAHCY r� �y. B gnatute(s)otSlier(b) '11 z:::..;....: �- J_or ,I• / aptivpTEtatement Lathof:,Sale 1 r I2�30/1 1230 4 Vµ Ban dui swop n S� s that the statements set ` d ¢.. ; Printed•Name(s)of yiI b6 A N+A6E—Fe RIYvfs TA C�1fr :I9 ,flare true� �r1r t bscribed Fyrd ports to roe 0 I . • flU._i:ilk V J77[[77 LL �.`'RSlgnatbre(s)of Purchasers) T r� I-A M '20 °- Printed Name(s)of Purchaeerisl:`' 1 i t u r l.l►'—...-• - - Notary_Publrc. o . companyName(If Appllcabrer �C^I:V'I-C .SQ IARE EARMEL�61 —46432 Address'of Purcheser(c) County of r'7 USE.NOTARIZATION ONLY IF REQUIRED IN TIRLiNG JUAISOtCTIOLs ' -1st llan in favor of r 7w ) U :.r 1 whose address is s: — I p iJr C_I� N 61.1 ,..5,e2 0 2— N xUI' 2nd lienrin favor of." whose address is CC Each undersigned seller certifies to the best Of his knowledge,information and belief under penalty of law that the vehicle is new and has not been registered in - this or any,stale at the tinie,of.delivery and.the vehicle is notsUbeGt to any secert(y interests other di khan those sclosed herein and warrant title to the vehicle .. FOR VALUEf-fECE1VED. T8ANSFER PE.VEH ICLE,DESCRIBEDOfJTh FACE OFTHISCERTIFICATE TO; 71 I URCHA C IT.Y OF'".;CARMEL �'}oe fyURGHASEfl(Sj .. it `z'a: I eert to the best of m k o t !:.9-t y 'A�� 'T�IA'�E' `E�7F�tt`'�� :' ..® ef,`� � ive TAB N A toDEALER ����� r nts set r,.•NAME of LERSHIP• DEALERS LICENSE NUMBER B itI1 re m 1 forth are tru •c Oct Subscribed•y wpm to me 1 4 ¢y State of �� � beforeth+s dayof 20� 3 a s Gcun y of Notary Public :.:. .';! .. '� USE NOTARIZATION ONLV.iF REOUIRED:IN TITLfN6 JURISDICTION : ,V NAME OF - �'K PURCHASEP(Sl W I>! :W ADDRESS OI certify to the best of my knowledge thatThe.odometerreading Is • Na Tenths BY: DEALER NAME OF DEALERSHIP DEALERS LICENSE NUMBER ,,.Being duly sworn upon oath says that the statements net Z :E .State pt 1prth are trite end correct Subscribed acid swamio me W before this day di 20 ._ • I �rn Notary Pubtic a a County9t ,: USE:NOTARIZETION DNLY EF REfaUIRFO IN TITLING JURISDICTION • ,vjy m NAME;OF p? ADDRESS 4• 0 I certify to the best of my knowledge that the odometer reading is No Tenths I m _ DEALER NAME Of'•UEgLERSii[f' DEAL RSUCENSENUMBER Being duty o m swornupon athsaysthatthe'Stateerdsset to ¢ .State of fgrth are true and correct Subscrtl?ed and sworn tame Y t=_ before this dayot 20T tl Z n s County of Nola y Pubhc ,q ::a ' _. '. .USE NOTARIZATION ONLY IF.REOUIREDIN TITIING JURISDICTION Z a NAME'OF ;:R F ¢ PURCHASER(S) .. p O la 2- ''ADDRESS :..... Q 'O .. -Na:Tenths' certify,io the best of my knowledge that the odpmeterreadfrtg is u �. ifEALfR NAME OF DEA[_ERSHIP DEALERS LICENSE NUMBER Being citify sworn,upon oath says that lhe:statements;set forth-are .true nd.correct. SubserlbedanBSworrt to:rpe t). U aa• 'i $fate Qj before t{irs day of '20 OO O N.in O -ovr Qnunty'of Notary,PubAc O U) Q 4: .. USE NOTRRVATlON ONLYiF REDUtRED INTQLING JURISDICTION y J • Federal,Law requires you to state thel ddmeter mileage in connection with the transfer of ownership.Failure to complete or providing a false statement may result = certify to Me bestrisonment certity.to the best of y knowledge that the odometer reading is the actual mileage of the vehicle unless one of the following statements is checked.Odometer g_ t �> Reading A No Tentl'IS 7 The leage stated Is In excess of Its mechani ilwits U The.odometer reading Is net theactuel rr Ieage r J WARNING ODOMETER(DfSCREPANCY 04 441,- 12/30/lm 12/30/ uo' $Ignature(sj ai Selfer(s) ®` - . DA TStatement at of Sale 9.,_., Beln duly swo ggppqq i'- ys that thestat@ments set r�'a Pnnied-.Name(s)of I + + .s are,lrue:� Fyrj • . bscribed orRtome � ,� GEAt'I{�c6 N, I 2014. �, �¢ Signature(S)otPurchaser(5)- before this ' dayof 20 7 �� CITY OF..CARMEL: NotayPudkcl O Printed Names)of PurcneserSs) sY w a C0mpanyName(If Applicabte). CIVIC SQUARE; CAM IN 46032 a Address of Purchaser(s) :' County'vf +{a USE:NOTARIZATION ONLYFF RSOUIREDIN TITLING JURISRtCTION �r ! 'w Sst lien in favor 4t 1 whose address is a t i 2nd lien to favor of who'se'addrees is • « x ,l { . 2350 Park Road ` `` /` f ^ It o [;.7'!‘u� `, • -, . 765-825-0594 Connersville, IN 47331, _; www.advantagefordsales.com .- - 4:11 f � �r .- �= 41598 BO I herby agree to purchase from you,under the terms and 571-2418 conditions specified,one motor vehicle as herein described. CONTROLNO. 1.1.1-INgOLIN HOUSE SALESPERSON PURCHASER'S CITY OF CARMEL 12/30/14 NAME DATE ADDRESS 1 CIVIC SQUARE CITY CARMEL CO. STATE IN ZIP 46032 E-MAIL • PHONE NO. SERIAL NO. MILEAGE STOCK NO. • 1FTFX1EF2EKG3SO94 10 J8559 MAKE YEAR NEW i%MODEL BODY STYLE COLOR FORD 2014 USED F150 PICKUP OXFORD WHITE •TRADE IN YEAR MAKE MODEL CASH DELIVERED PRICE $ 27QA -n 2008 FORD ESCAPE ACCESSORIES: __ SERIAL NO. MILEAGE 1FMCU59H68K84 55032 P.O.B. USED CAR ALLOWANCE NAME • $ 6500.00 • STREET $ DEALER INSTALLED OPTIONS CITY 1 • BY ' TIL ( AI/4 ) 2 NET EQUITY USED CAR $ t1 Eno nn 3 DEPOSIT-REC.NO. $ FORD'REBATES $ Ai/A TOTAL CREDIT $ �r,n� nn BALANCE DUEpN DELIVERY. - SUB-TOTAL(Price of Unit,Accessories&Freight) 9'1'700,/ill NON-REFUNDABLE REC.NO. . . •' - $ Q DOCUMENTARY FEES $ TOTAL-,f - t '14' r k. ;• ;I':' r t, " $ A LAC) fill n ;t -'Contract to be paid to ' 't l TAX(Sales) $ 9 I A I , Li:- 4' %i1 , „ ,:fIf/ ( TIRE TAX $ r -.:Payment(s)of Due GAP INSURANCE $ i /p rt It is understood and agreed that this contract cash delivered price includes money EXTENDED SERVICE PROTECTION E.S.P. $ it I A that is owed by Purchaser upon Purchaser's trade-in in excess of the Fair Market TITLE FEES $ Value of that_trade-in, This purchase and the financing of this purchase are TOTAL OF ABOVE ITEMS(Delivered Cash Price) $ g 27RA 00 conditioned upon adding that additional debt to this purchase by either increasing TOTAL CREDIT(Transferred from left column) $ • gE:nn nn the sale price and/or adjusting the value of the trade-in. BALANCE DUE $ 7 17,RQ nn ,"The amount owed upon the trade-in in excess of its Fair Market Value is FINANCE SOURCE: $ N/A which has been added to this contract." ADDRESS: WARRANTY INFORMATION 1- IF THIS ORDER IS FOR A NEW VEHICLE AND THE MANUFACTURER OF THE VEHICLE DOES NOT NEW OR DEMONSTRATOR:If the Vehicle is a new or demonstrator vehicle,the only written- DELIVER SAME TO DEALER,THIS ORDER IS VOID AND BUYERS DOWN PAYMENT SHALL BE warranty provided with respect to the Vehicle and factory installed accessories is the most recent REFUNDED. 44 applicable printed warranty which is made sole) by the Manufacturer of the Vehicle. G., PP� P� Y Y Y 2- IF BUYER FOR ANY REASON,REFUSES DELIVERY,THE DOWN PAYMENT OR DEPOSIT SHALL'Dealer installed Accessories are not included in the Manufacturer's warranty on the Vehicle NOT BE REFUNDED,BUT RETAINED BY DEALER,AS LIQUIDATED DAMAGES. and may or may not be included in seperate written warranties which are made solely by the Manufacturer of the Accessories. 3- CALCULATION of FIGURES ON THIS ORDER ARE SUBJECT TO CORRECTION IN THE EVENT OF USED:If the Vehicle is a used vehicle,the Vehicle is sold by Dealer AS IS-WITH ALL MATHEMATICAL ERROR OR OBVIOUS MISTAKE,AND BOTH BUYER AND SELLER AGREE TO FAULTS,The information you see on the window form for this vehicle is part of this contract, • COOPERATE IN EXECUTION OF ANY DOCUMENTS NECESSARY TO CORRECT SUCH ERROR y p • OR MISTAKE,AS WELL AS THE BUYER AGREES TO PAY TO THE SELLER ANY AMOUNT Information on the window form overrides any contrary provisions in the contract of sale. NECESSARY TO CORRECT SUCH MISTAKE,AND SELLER AGREES TO REFUND TO BUYER ANY ALL VEHICLES:WHETHER THE VEHICLE IS NEW,A DEMONSTRATOR,OR USED, FUNDS NECESSARY TO CORRECT SUCH MISTAKE. DEALER DISCLAIMS ALL WARRANTIES,WRITTEN,EXPRESS OR IMPLIED,INCLUDING ALL WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE AND 4- IN THE EVENT THE EQUITY OF ANY TRADE-IN IS INCORRECTLY STATED,DEALER,MAY VOID DEALER EXPRESSLY DISCLAIMS ANY LIABILITY TO.PURCHASER FOR ANY CONSEQUEN- THIS ORDER. TIAL DAMAGES,LOSS OF TIME OR INCONVENIENCE ARISING OUT OF THE PURCHASE OR OPERATION OF THE VEHICLE. • CONTRACTUAL DISCLOSURE STATEMENT FOR USED VEHICLE ONLY I HAVE READ FRONT AND BACK AND RECEIVED A .The information you see on the window form for this vehicle is part of this contract.Information on the window COPY OF BUY form ovem BUYER'S ORDER AND ACKNOWLEDGE des any contrary'provisions in the contract of this sale.' G ACCEPTANCE OF VEH CLE DESCRIBED. X X )2/2 6,-- - SALES MANAGER TITLE // • THIS ORDER IS NOT VALID UNLESS SIGNED AND ACCEPTED BY DEA!/LER OR HIS AUTHORIZED REPRESENTATIVE I . ACORD CERTIFICATE OF LIABILITY INSURANCE DarE(MMmorrrr) .2/24/201 s 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 NAME: Marianne Uban Hylant Group A/CO.NN,fixt1:317-817-5136 (ac.Ne1:317 1317 5151 - 301 Pennsylvania Parkway,#201 E-MAIL Indianapolis IN 46280 ADDRE$S:marianne.uban©hylantsom INSURER(S)AFFORDING COVERAGE NAIC k INSURER A:Charter_Oak Fire Insurance-Co 25E15 INSURED CARME80 INSURER B: City of Carmel INSURER C One Civic Square INSURER D: Carmel, IN 45032 INSURER E! INSURER F: COVERAGES CERTIFICATE NUMBER:2050719743 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- INSR ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER fMM/PINYYYY) IMM1DC4'YYYI A GENERAL LIABILITY ZLP14T82033 111!2015 111,2018 EACH OCCURRENCE $2000000 X DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES IEa occunencel 550,000 CLAIMS-MADE X OCCUR MED EXP(Any one person) $0 PERSONAL 8 ADV INJURY $2,000,000 GENERAL AGGREGATE 1$2 000,000 GEN'L AGGREGATE LIMrV APPLIES PER: • PRODUCTS-COMP/OP AGG $2,000,000 POLICY n PEI n LOC COMBINED SINGLE LIMIT 1$ A AUTOMOBILE LIABILITY H810303fiP64ACOF15 111!2015 111!2016 (Ea accident) 52,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Per accident) X Comp X Coll ComplColl Ded $2,500 UMBRELLA LIAD OCCUR EACH OCCURRENCE 3 EXCESS LIAB CLAIMS-MADE AGGREGATE $ _ DED I RETENTIONS $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'UABILITY YIN TORY LIMITS FR_ ANY PROpRIETORIPARTNERIEXEGUTIVE I NIA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E L.DISEASE-POLICY LIMIT S 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 named as Loss Payee Re:2015 Ford F250#40970 and 2015 Ford F250#40967, 2015 Ford F250#0969,2015 Ford F250#0968 (City of Carmel Street Dept.) See Attached... 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 ACCORDANCE WITH THE POLICY PROVISIONS. 105 East 4th Street(CNO1) Cincinnati OH 45202 AUTHORIZED REPRESENTATIVE Akit-t t{v` ©1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD • AGENCY CUSTOMER ID: CARME80 LOC#: AR D ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED Hylant Group City of Carmel One Civic Square POLICY NUMBER Carmel, IN 46032 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Re: 2015 Subaru Forester#4258, 2015 Subaru Forester#6408,2015 Subaru Forester#6484,2015 Subaru Forester#7856 (Community Services-Bldg Inspectors) Re: 2014 Ford F150#5094,2014 Ford F150#5093(DOC) ACORD 101(2008/01) • ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD