Loading...
2015 Police Schedule 24 pay request 8 052115 Lease 2®l5 — Sch # 24 (Police Dept.) Payment Request # 8 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: L3 Communications Amount: $2,045.00 Description of Equipment Item Cost: 17 Stud mount antennas Dated: 05/20/2015 LESSEE: City of Carmel One Civic Square Carmel,IN 46032 - r ;1 .• By j _ : , - Name: Liana Cordray Title: Clerk Treasurer (Attached duplicate original of Payee's statement) Wire transfer information included on separate sheet. PAGE 1 ID Invoice communications Mobile-Vision, Inc. Invoice Number: 0225371-IN 90 Fanny Road Invoice Date: 5/15/2015 Boonton, NJ 07005 Phone: (800) 336-8475 Order Number: 0139329 Fax: (973) 257-3024 Order Date 5/14/2015 Salesperson: ZLMB Tracking Number: 1zx5x9890366399217; Customer Number: INCARME Sold To: Ship To: Carmel Police Department Carmel Police Department 3 Civic Square 3 Civic Square Attn:Pat Young Attn:Brian Smith Carmel,IN 46032 Carmel,IN 46032 Confirm To: Brian Smith Page: 1 Customer P.O. Ship VIA F.O.B. Terms 32878 UPS GROUND BOONTON,NJ Net 30 Days Item Number Unit Ordered Shipped Back Order Price Amount MVD-DM2-24/55BK EACH 17.00 17.00 0.00 119.00 2,023.00 Stud mount antenna 18'cables(RF-195&RG-174)with SMA/SMA bolt configuration(not m Whse: 000 PLEASE REMIT PAYMENT TO L-3 COM MOBILE VISION, INC Subtotal: 2,023.00 PO BOX 5580 NEW YORK NY 10087-5580 Ship/Handling: 22.00 Sales Tax: 0.00 Invoice Total: 2,045.00 These commodities are controlled under the Export Administration Regulations(EAR)and may not be exported without proper authorization by the US Dept of Commerce. 1 communications Mobile-Vision,Inc. 90 Fanny Road Boonton,NJ 07005 Tel: (800)336-8475 (973)263-1090 Fax: (973)316-9509 www.L-3com.corr'imr Electronic Funds Transfer Information Account Name: L-3 Communications Mobile-Vision,Inc. Account Number: 777140773 ABA Number: 071000013 Bank Name: JPMorgan Chase Bank,N.A. Bank Address: One Bank One Plaza 2 S Dearborn Chicago,IL 60670-0002 Commercial Banking Officer JPMorganChase Treasury Client Services Tel. 866-696-4217 Fax 313-256-3300 L- 3 A/R Contact: Joann P. Laporte Sr.Accounts Receivable Clerk Phone:973/263-1090 ext 125 Fax: 973-316-9509 Email:joann.laporte0)l-3 corn.com AccoRcit CERTIFICATE OF LIABILITY INSURANCE 1/13/2015 TE(MMI D/YYYY) 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 301 Pennsylvania Parkway,#201 PHONE.EXu:317 817 5136 FAX No):31 7 817-51 51 Indianapolis IN 46280 ADDREss:marianne.uban @hylant.com — INSURER(1)AFFORDING COVERAGE NAIL fl INSURER A Charter Oakfire 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. INSR ADDL.TYPE OF INSURANCE INSR W POLICY EFF POLICY EXP VD POLICY NUMBER (MMIODlYYVY) (MMlDDIYYYY) LIMITS A GENERAL LIABILITY Y ZLP14T62033 1/1/2015 1/1/2016 EACH OCCURRENCE $2,000,000 X DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY 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 7 POLICY PRO- JECT LOC $ A AUTOMOBILE LIABILITY H8103036P64ACOF15 1/1/2015 1/1/2016 COMBINED SINGLE LIMIT (Ea accident) $2,000,000 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 YIN TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE N!A 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 $ DESCRIPTION OF OPERATIONS I 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 EquipmentNehicles 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 fi ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD