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2013 Police Schedule 15 pay request 26 Lease 2013 — Sch # 15 (Police Dept.) Payment Request # 2013-26 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 14, 2013 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 tinder a purchase order or contract with respect to the Equipment described below and has not !brined 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: Visual Pro 360, Inc. Amount: $26.525.42 Description of Equipment Item Cost: 10 laptops Dated: January 9, 2014 LESSEE: City of Carmel One Civic Square Carmel, IN 4 1 13y: Name: Diana Cordray Title: Clerk Treasurer (Attached duplicate original of Payee's statement) PLEASE MAIL CHECK TO: Visual Pro 360_ Inc. 1747 Holbrook Lane Tempe, AZ 85281 rncI; I A� CERTIFICATE OF LIABILITY INSURANCE 3/25/2013 THIS 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: Mariafne Uban Hylant Group Inc-Indianapolis PHONE I FAX 301 Pennsylvania Parkway,#201 JAMgno Eau'317-817-5136 w/c,No:317_817-5151 Indianapolis IN 46280 ADDRES S:maria_nne,uban@hylafLCOm INSURER(S)AFFORDING COVERAGE NAIC4 • INSURER A Charter Oak.Fire-Insurance_Co 25615 INSURED CAR ME80 INSURER e: I City of Carmel INSURER C: One Civic Square INSURER D: I Carmel, IN 46032 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 1271512319 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. NOTWTHSTANDING 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 I IN$R I WVD I(MMIDD/YYYY)I(MMIDDIYYYYI I LIMITS LTR TYPE OF INSURANCE INSR YJYD POLICY NUMBER A I GENERAL LIABILITY ZLP141'62033 1/1/2013 1/1/2014 EACH OCCURRENCE I $2,000,000 'DAM/Ze TO REITTED I7-1 COMMERCIAL GENERAL LIABILITY PREMISES_(Eaoccurrenco) 1 550.000 17CLAIMS.MADE X 1 OCCUR MED EXP(Any one person) SExcluded I PERSONAL B ADV INJURY 52.000.000 J GENERAL AGGREGATE $2.000.000 GENT.AGGREGATE LIMIT APPLIES PER: PRODUCTS.COMP/OP AGG I$2,000,000 POLICY I JFCT n LOC S A AUTOMOBILE LIABILITY H8103036P64ACOF13 '1/1/2013 111/2014 COMBINED SINGLE LIMIT _ (Ea accident) _52,000,000 X ANY AUTO BODILY INJURY Per persanl 5 ALL OWNED SCHEDULED BODILY INJURY(Per accident) 5 AUTOS AUTOS PROPERTY DAMAGE I _ HIRED AUTOS AUTOS _(Per accident) $ X Comp X Coll ComprColl Ded I$2,500 UMBRELLALIAB OCCUR EACH OCCURRENCE S EXCESS LIAR CLAIMS-MADE AGGREGATE S DED I RETENTIONS 5 ' WORKERS COMPENSATION I WC S TATUSI I0T AND EMPLOYERS'LIABILITY Y I N ER ANY PROPRIETOR/PARTNER/EXECUTIVE NIA E.L.EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE[$ II yes.desonee under I • DESCRIPTION OF OPERATIONS belrrx E.L.DISEASE-POLICY LIMIT I$ DESCRIPTION OF OPERATIONS I LOCATIONS I 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 Re: Various Police Equipment/Vehicles i 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& its assignors and ACCORDANCE WITH THE POLICY PROVISIONS. assignees do American Lease Insurance AUTHORIZED REPRESENTATIVE 654 Amherst Ste. 335 Su nderland MA 0 1375 "32J / jge-1e�� ' ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD i► llis�a 361 agPro x Invoice PROVIDING TOMORROW'S SOLUTIONS TODAY Visual Pro 360 Inc 1747 Holbrook Lane Date Invoice# "Tempe A%85281 480-621-3395 1/3/2014 31328 Bill To Ship to City of Cannel City of Carmel Todd Luckoski Communications Center/Todd Luckoski 31 1st Ave NW 31 1st Ave NW Cannel, IN 46032 Carmel. IN 46032 Sales Rep P.O. Number Terms Due Date EM 31390 Net 20 1/23/2014 Item Description Quantity Price Each Amount CF-31 W13NEHLM Win7(Wing WA), Intel Core i5-3340M 2.70GI-Ir.vPro. 10 3,979.12 39,791.20 13.1 in XGA Touch, 128GB SSD.4GB,Gael Wifi a/b/g/n. TI'M. liluetooth.Dual Pass (Upper:WWAN/Lower:Selectahle).4G I:fr Multi Carrier. CPS, Emissive Backlit Keyboard,No Drive.Toughhook ('referred CF-SVCI:INF5Y Protection Plus- Laptop(Years I.2.3.4 &5) In 0.00 0.00 Serial 4s 31:IYA77500.3LI'YA77542.31:1'YA77573. 3I:TYA77624,31.IYA77633.31;fYA77661.31,TYA77745. 3CIYA77764.31, YA78026,3LTYA79510 Fedex'('racking Hs 570360567751.570360567762, 570360567773,570360567784.570360567795 slipped on 01/03 In Exempt Goat Sales'lax 0.00% 0.00 \ti pc \3t zvS - . \ o si)O,0\ \o‘ 2b 5 2S . t-\2 Balance Due $39.791.20 Payments/Credits so.00 Total $39.791.20