2010-10-19
I
Special October Meeting Held October 19, 2010
THE STATE OF TEXAS ~
~
COUNTY OF CALHOUN ~
BE IT REMEMBERED, that on this 19th day of October, A.D., 2010 there was begun and holden
in the Commissioners' Courtroom in the County Courthouse in the City of Port Lavaca, said
County and State, at present on this date the following members of the Court, to-wit:
Michael J. Pfeifer
Roger C. Galvan
Vern Lyssy
Kenneth W. Finster
Wendy Marvin
County Judge
Commissioner, Precinct # 1
Commissioner, Precinct #2
Commissioner, Precinct #4
Deputy County Clerk
Commissioner Neil Fritsch was absent from the meeting.
Thereupon the following proceedings were had:
APPROVE PAYMENT ON A 2005, 672D JOHN DEERE MOTOR GRADER IN THE AMOUNT
OF $26,114.91:
A Motion was made by Commissioner Galvan and seconded by Commissioner Lyssy to approve
the payment on a 2005, 672D Jo~n Deere Motor Grader in the amount of $26,114.91.
Commissioners Galvan, Lyssy, Finster and Judge Pfeifer all voted in favor.
Court was adjourned at 10:02 am
't..
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VENDOR DEPARTMENT
ACCOUNT
NUMBER
-&4Q-
John Deere Credit .
AUn: Acel. Cept. - ALP Processing
PO Box 6600
Johnston, IA 50131-6600
540 Road & Bridge
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TOTAL
PRICE
. $2€, 111.91-
V# 0A \~
D C-c..
TOTAL
$26,114.91
COUNTY AUDI1iOR THE ITEMS OR SERVICES SHOWN ABOVE ARE NEEDED IN THE DISCHARGE OF MY OFFICIAL
APPROVAL ONLY DUTIES AND I CERTIFY THAi' FUNDS ARE AVAILABLE TO PAY THIS OBLIGATION.
..... /.""\ .--4? "J
"i./~p-~.<<~ ,,-..e~
10/14/2010
DATE
DEPARTMENT HEAD
APPROVED
OCT 1 8 2010
COUNTY AUDITO BY:
I CERTIFY THAT THE ABOVE ITEMS OR SERVICES WERE RECEIVED BY ME IN GOOD
CONDITION AND REQUEST THE COUNTY TREASURER TO PAY THE ABOVE OBLIGATION.
DATE
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D JOHN DEERE
Lease Settlement & Bill of Sale
CREDIT Lease Schedule No. 030-0061291-000
Master Lease Agreement No. 0061291
Lessee: CALHOUN COUNTY
(Name & Address) CR 101" PORT LAVACA, TX 77979
Supplier: DOGGETT MACHINERY SERVICES, GP Dealer No: 117-7166
705 E NOLANA LOOP, PHARR, TX 78577 ,
Lessor: DEERE CREDIT, INC.
6400 NW 86th ST, PO BOX 6600, JOHNSTON, IA 50131-6600
" Please review the following information carefully.' This information reflects the credit to your dealership."
1. Selling Price ~,r "~ ; $121,314.60
2. Trade - In - $0.00
3. Up-front Sales Tax - Financed + $0.00
4. Preventative Maintenance - Financed + $0.00
5. Secure/Power Guard - Financed + $0.00
,6. Insurance Premium - Financed + $0.00
7. Processing/Origination Fee - Financed ..."........ + $0.00
8. Official/UCC Fees Financed . :. + $10.00
.. :, '.
9: Amount Financed {Purchase Price} $121,324.60
10. Less: Up-Front Sales Tax Remitted by JDC - $0.00
11. Less: Insurance Premium Submitted by JDC - $0.00
12. Less: Processing/Origination Fees for JDC . - $0.00
13. Less: Official/UCC Fees for JDC - $10.00
14. Less: Dealer Reserve (Ag only) ._....'.:. - $0.00
15. Less Dealer Subsidy (mandatory proqram charqe) - $0.00
16. Less: Dealer Buy Down (optional) - $0.00
17. Add: Dealer Participation + $0.00
18. Credit to Dealer for Lease .,,, $121,314.60
'. Subject to acceptance of the above referenced Schedule by Oeef9..Credit, Inc. ("Deere Credit"), Dealer hereby sells, transfers and assigns to
Deere Credit all of Dealer's right, title and interest in and to the .Schedule and the equipment described in the Schedule (the "Equipment") for
the Purchase Price shown on Line 9. Dealer represents and warrants that (1) the Equipment is free from all security interests, liens, and
encumbrances (except those held by Deere & Company or subsidiaries), and (2) the safe operation and proper servicing of the Equipment and
the importance of following the instructions in the Operator's Manual were explained to Lessee. All risk of loss to the Equipment shall remain
with Dealer until the Equipment Is delivered to and accepted by Lessee under the terms of the Schedule. Dealer acknowledges and agrees that
(1) Deere Credit's rights, as described in the John Deere Agricultural Dealer Leasing Agreement or the John Deere Construction Dealer Leasing
Agreement, to purchase the Equipment may be assigned to John Deere Exchange, Inc. or such other parties as Deere Credit may identify from
time to time, and (2) regardless of whether Deere Credit assigns these .rights, Dealer acknowledges and agrees that the provisions of Section
1.4 of the John Deere Agricultural Dealer Leasing Agreement or the John Deere Construction Dealer Leasing Agreement shall govern Deere
Credit's payment ofthe Purchase Price to Dealer. : . .' ,."...;
By signing below I agree that the proceeds from this lease trilllsaction".
are accurate and reflect the appropriate credit to my dealership. .......:."
DOGGETT MACHINERY SERVICES, GP
. . - 705 E NOLANA LOOP,
PHARR, TX 78577
By: ..
AUTHORIZED SIGNERffITLE
Date: ..
,.
3ettkmwnt [1 Sin of S!~l~:~ 11f2004
Pa~JC' '1 <)f .2
App 10997482
". I
Lease ett ement I 0 ae- :Quipment 1st
Year Make Model Equipment Description .... Serial Number Invoice Datel Retail Value
Invoice Number
,,'
2005 JD 672D MOTOR GRADER " DW672DX601167 $121,314.60
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App 10997482
o JOHN DEERE
CREDIT
, Advance Lease Payment Invoice
,Due Date:
10/14/2010
Billing Address:
Total Due: $26,114.91
Updated Billing Information:
CALHOUN COUNTY
202 S ANN
PORT LA V ACA, TX 77979
Please Note: All future invoices will be sent to the billlllg'ad\:l.ressshown unless you update your billing information above.
App#
Mfg.
Model # Serial Number
Due Date
RentallTax
,Amount
Security
Deposit
Processing
Fees
Total Due
Correspondence Only:
John Deere Credit
Attn: Lease Administration
PO Box 6600
Johnston, IA 50131-6600
Phone: (800) 771-0681 - select "lease" prompt"
Fax: 800 254-0020 Lease issues onl
John Deere Credit
Attn: Acct. Dept. - ALP Processing
PO Box 6600
Johnston, IA 50131-6600
TO ENSURE PROPER CREDIT, STAPLE CHECK AND RETURN THIS INVOICE WITH THE LEAS!: DOCUMENTS.
rr;
,
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STAPLE ADVANCE LEA~,E PAYMENT CHECK HERE
, i "',
Every Dishonored Check will result in a fee of $20.00 or an\~inount not to exceed the highest amount permitted by law.
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LfNSE PAYMUH INV()ICC'1112004
of1
App
10997482
JOHN DEERE
CREDIT
Physical Damage/Liability Insurance
Lease Schedule No.
030-0061291-000
0061291
Master Lease Agreement No.
Lessor:
CALHOUN COUNTY
CR 101.. PORT LAVACA. TX 77979
DEERE CREDIT, INC. . .
6400 NW 861h ST, PO BOX 6600. JOHNSTON, IA 50131~6eoO
Lessee:
(Nam. & Addr.ss)
LIABILITY INSURANCE on the above referenced Lease Schedule (the "Schedule") to the above referenced Master Lease
Agreement will be provided by the following insurance agency:
'G-~~~n~~~~~:---- ?CV(",\ ~:v~~~;,:---.
Mailing Address of Agency . \} - --.-
. D';;L'E.~, S-k-- -. RXd2. ~-r)\ ''l't~~ '""'
.P.honeNumber.(jfAgency:.--.._._.....----
30\--'( 'd--q ~-- 5414
Fax Number of Agency -------.--
3<01 -- ~l d. C,\_ ~ 'C t ....7
PHY. SICAL DA, NJ!.GE INSU, RA,:,!CE on the Schedule will be pr,OV;ded by the follow;n9 jency;
Name of Agency: I Phone Number of Agency:
1J~"I.].".. 0....0 a.A_)-tr\..)-~- ' .
-Marling-Address of Agency--------------- ,------- "Fax Number-of Agency----------
'''If an insurance certificate is available, it should be provided in place of the above information
ADDITIONAL INSURED and LOSS PAYEE:
Deere Credit. lnc_
II's Successors &/or Assigns
22408 Network Place
Chicago. IL 60673-1224
Contact Date(s):
Office Use Onl
Contact Nllme:
-UabilltY Insurance Company Policy #:
Liability Insurance Expiration Date
Liability Limits:
, Notes:
Physical Damage Insurance Company and Policy #
Physical Damage Insurance Expiration Date
Insured Value:
Notes:
Loss Payee Deere Credit, Inc.?
DYes DWiII Be Added
. yerified By:
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App 10997482
9ALHOUN COUNTY
CR 101, ; PORT LAVACA, TX 77979
D,EERE CREDIT, INC.
6400 NW 86TH ST, PO BOX 6600, JOHNSTON, IA 50131-6600
This Master Lease:Purchase Agreement {"Master Agreemenn is entered Into between Deere Credit, Inc.. as Lessor ("we", "us" or "our"), and the lessee
identified above ("you" or "your"). "Schedule" shall mean any Lease Schedule signed by you and us, which Incorporates the terms of this Master Agreement.
~Le;lse" shall mean this Masterp'greement and any Schedule.
JOHN DEERE
CREDIT
Lessee:
Lessor:
1. 'LeaseTerm;Pavments:Vou agree to lease from uS the property
("Equipment") described in each Schedule for the Lease Term. The Lease
Term will begin on the Lease Tenn Start Date and end on the Lease Term
End Date. All attachments and accessories itemized on the Schedule and
all replacements, parts and repairs to the Equipment shall form part of the
Equipment. A Schedule is not accepted by us until we sign it, even if you
have made a payment to us. You agree to remit to us the Lease Payments
indicated in the Schedule and all other amounts when due and payable
each Billing Period, even if we do not send you a bill or an invoice. Except
as otherwise provided in Section 2 of this Master Agreement. YOUR
PAYMENT OBLIGATIONS ARE ABSOLUTE AND UNCONDITIONAL,
AND ARE NOT SUBJECT TO CANCELLATION, REDUCTION OR
SETOFF FOR ANY REASON WHATSOEVER. For any payment which is '
not received by its due date, you agree to pay'a late charge equal to 5% of
the past due amount (not to exceed the maximum amount permitted by law)
as reasonable collection costs, plus interest from the due date until paid at
a rate of 1.5% per month, but in no event more than the maximum lawful
rate.
2. Non-Appropriation of Funds. You intend to remit to us all Lease
Payments and other payments for the full Lease Term if funds are legally
available. In the event you are not granted an appropriation of funds at any
time during the Lease Term for the Equipment or for equipment which is
functionally similar to the Equipment and operating funds are not otherwise
available to you to remit Lease Payments and other payments due and to
become due under the Lease. and there is no other legal procedure or
available funds by or with which payment can be made to us, and the non-
appropriation did not result from an act or omission by you, you shall have
the right to return the Equipment in accordance with Section 8, of this
Master Agreement and terminate the Lease on the last day of the fiscal
period for which appropriations were received without penalty or expensetQ
you, except as to the portion of the Lease Payments for which funds shall '
have been appropriated and budgeted. At least thirty (30) days prior to the
end of your fiscal period, your chief executive officer (or legal counsel) shall
certi1y in writing that (a) funds have not been appropriated for the fiscal
period, (b) such non-appropriation did not result from any act or failure 'to
act by you, and (c) you have exhausted all funds legally available to pay
lease Payments. If you terminate the Lease because of a non-
appropriation of funds. you may not. to the extent permitted by applicable
law. purchase. lease, or rent, during the subsequent fiscal period.
equipment performing the same functions as, or functions taking Ihe place
of, those performed by the Equipment. This Section 2 shall not permit you
to terminate the Lease in order to acquire any other equipment or to
allocate funds directly or indirectly to perform essentially the application for
which the Equipment is intended. , "
3. Taxes. Allhough you may be exempt from the payment of ceriain
taxes, you agree to pay us when invoiced (a) all sales, use, rental; gross
receipts and all other taxes which may be imposed on the Equipment or its
use, and (b) all taxes and governmental charges associated with the
ownership, use or possession of the Equipment including, but not limited to,
personal property and ad valorem taxes ("Taxes"). Taxes do not include
those measured by our net income. If applicable law requires tax returns or
reports to be filed by you, you agree to promptly file such tax returns and
reports and deliver copies to us. You agree to keep and make available t6
us all tax returns and reports for Taxes paid by you. " .' ,
4. Security Interest; Missinq Information. You shall have title to 'the
Equipment immediately upon delivery and shall be the owner of the
Equipment. You (a) grant us a security interest in the Equipment (and all
proceeds) to secure all of your obligations under the Lease, and (b) authorize
us to file financing statements naming you as debtor. You agree to keep the
Equipment free and clear of all liens and encumbrances, except those in our
favor, and promptly notify us if a lien or encumbrance is placed or threatened
against the Equipment. You irrevocably authorize us, at any time, to '(1)
insert or correct information on Schedules, including your correct legal name.
serial numbers and Equipment descriptions; (2) submit notices and proofs of
loss for any required insurance; and (3) endorse your name on remittances
for insurance and Equipment sale or lease proceeds.
5. Equipment Maintenance. Operation and Use. You agree to '(a) not
move the Equipment to another county or state without notifying us within
30 da s; (b) operate and maintain the Equi ment in accordance with all (1)'
;.:'>:r:~;:;c;":' ~,,\!.(,;:./, 1.-:\1'\.)!'-1:') rl_.~.i.?i)(;;;'
\~'~ge ~ Of ~.:
Master Lease-Purchase A
reement
Agreement No.
0061291
laws, ordinances and regulations, (2) manuals and other instructions issued by
the manufacturer(s) and supplier(s), and (3) insurance policy terms and
requirements; (c) perform (at your expense) all maintenance and repairs
necessary to keep the Equipment in as good a condition as when delivered to
you, reasonable wear excepted; (d) not install any accessory or device on the
Equipment which affects the value, useful life or the originally intended
function or use of the Equipment in any way, unless it can be removed without
damaging the Equipment; (e) allow us and our agent{s) to inspect the
Equipment and all of your records related to its use, maintenance and repair,
at any reasonable time; (I) keep any metering device installed on the
Equipment connected and in good working condition at all times; (g) affix and
maintain, in a prominent place on the Equipment, any labels, plates or other
markings we may provide to you; and (h) not permit the Equipment to be used
by, or to be in the possession of, anyone other than you or your employees.
6. Insurance. You agree. at your cost, to (a) keep the Equipment insured
against all risks of physical damage for no less than the Principal Balance (as
indicated in the Amortization Schedule attached to and made a part of the
Schedule), naming us as sole loss payee; and (b) maintain public liability
insurance, covering personal injury and property damage for not less than
$1,000,000 per occurrence, naming us as additional insured. All insurance must
be with companies and policies acceptable to us. Your obligation to insure the
Equipment continues until you return the Equipment to us and we accept it.
Each insurance policy must provide that (A) our interest in the policy will not be
invalidated by any act, omission, breach or neglect of anyone other than us;
and (8) the insurer will give us at least 30 days' prior written notice before any
cancellation of, or materiai change to, the policy,
Unless you provide us with evidence of the required insurance coverages,
we may purchase insurance, at your expense, to protect our interests in the
Equipment. This insurance may not (1) protect your interests; or (2) pay any
'''claim that you make or any claim that is made against you in connection with
th~'Equipment. You may later cancel any insurance purchased by us, but only
after providing us with evidence that you have obtained the insurance required
by the Lease. The cost of the insurance may be more than the cost of
insurance you may be able to obtain on your own,
7. Loss or Damaqe. Until the Equipment is returned to us in satisfactory
condition," you are responsible for all risk of loss and damage, 1055, theft,
destruction or seizure of the Equipment (an "Event of loss"). You must
promptly notify us of any Event of Loss. If the Equipment can be repaired or
replaced, you agree to promptly repair or replace the Equipment, at your cost,
and the terms of the Lease will continue to apply. If the Equipment cannot be
repaired or replaced, you agree to immediately pay us the pro rata portion of the
Prindpal Balance, as detennined by us as of the day before such Event of loss
occurred. Upon receipt of the pro rata portion of the Principal Balance, we will
transfer to you (or the insurance company) all of our right, title and interest in
such item(s) of Equipment (each, an "Item") AS-IS. WHERE-IS, WITHOUT ANY
WARRANTY AS TO CONDITION OR VALUE. All insurance proceeds must be
paid directly to us, and we may apply any excess insurance proceeds to any
other amounts you owe us.
8. Return of Equipment. If a Schedule is terminated for any reason
including, but not limited to, a non-appropriation of funds pursuant to Section 2
of this Master Agreement, you agree to return all Equipment to the place
designated by us, at your expense and ,in satisfactory condition, along with all
use, maintenance and repair records, Equipment is in satisfactory condition if
it is .in as good a condition as when the Equipment was delivered to you,
reasonable wear excepted, ,and conforms to the standards of any Maintenance
Addendum incorporated into the Lease.
9. Default. You will be in default if: (a) you fail to remit to us any lease
Payment or other payment when due; (b) you breach any other provision of
the lease and such default continues for 10 days; (c) a default occurs under
any other agreement between you and us (or any of our affiliates); or (d) you
fail to maintain the insurance required by Section 6. Time is of the essence
under the Lease.
'10. Remedies, If a default occurs, we may do one or more of the following:
(\l).,recaver from you, AS LIQUIDATED DAMAGES FOR LOSS OF BARGAIN
,AND NOT AS A PENALTY, the Principal Balance as of the date of such
ct:efault: (b) declare any other agreements between you and us in default; (c)
terminate any of your rights (but none of your obligations) under any
tease and any other agreement between you and us; (d) require you to return
,the Equipment in the manner outlined in Section B, or take possession of the
E' ui ment; e lease or sell the E ui ment or an ortion thereof at a ublic or
App10997482
ADDITIONAL TERMS AND CONDITIONS OF AGREEMENT
private sale; (f) apply the net proceeds we receive from any sale., lease or',::.13. Indemnltv. You are responsible for all losses. damage. claims,
other disposition of the Equipment (after deducting all of our costs .and. . infringement claims, injuries to or the death of an individual, and attorneys'
expenses) to your obligations under the Lease, with you remaining liable for fees and costs ("Claims"), incurred or asserted by any person, in any
any deficiency; (g) charge you for expenses incurred in connection with the manner related to the Equipment or the lease thereof, including its use.
enforcement of our remedies including, without limitation, repossession, repair' condition or possession. To the extent permitted under applicable law, you
and collection costs, attorneys' fees and court costs; (h) exercise any other agree to defend and indemnify us, and hold us harmless. against all Claims.
remedy available at law or in equity; and (i) take on your behalf (at your although we reserve the right to control the defense and to select or
expense) any action required by the Lease which you fail to take. These approve defense counsel. You agree to not bring any action for Claims
remedies are cumulative, are in addition to any other remedies provided for by against us. You will prompUy notify us of all Claims made. Your liability
law, and may be exercised concurrently or separately. Any failure or delay by under this Section is not limited to the amounts of insurance required under
us to exercise any right shall not operate as a waiver of any other right or the Lease. This indemnity continues beyond the termination of a Schedule.
future right. for acts or omissions, which occurred during the Lease Term.
11. Asslqnment. You will not assign, pledge or otherwise transfer any of 14. Time PrIce. You'understand that the Equipment may be purchased
your rights or interests in the Lease or any Equipment without our prior written for cash or it may be purchased pursuant to the terms of the Lease for a
.consent. Any assignment without our consent will be void. We may assign Time Price equal to the sum of (1) all Lease Payments due and to become
the Lease or our interest in the Equipment at any time without notice to you due thereunder, and (2) the Documentation Fees. By executing the Lease,
and without your consent. We may provide information about you to any you have' chosen to purchase the Equipment for that Time Price. You and
prospective assignee or participant. You agree riot to assert against our we intend to comply with all applicable laws. In no event will we charge or
assignee any claims, offsets or defenses which you may have against us. collect any amounts in excess of those allowed by applicable law. In the
12. Representations and Warranties. You represent and warrant to us, as event any amount in excess of that allowed by law is charged or recovered,
of the date of this Master Agreement and of each Schedule, and covenant to any such charge will be deemed limited by the amount legally allowed and
us so long as the Lease is in effect, that: (a) you are a State, or a political any amount received by us in excess of that legally allowed will be applied
subdivision thereof, for purposes of Section 103 of the Intemal Revenue C:;ode by us to the payment of amounts legally allowed under the Lease. or
of 1986. as amended (the .Code"); (b) any documents required to be delivered refunded to you. .
in connection with the Lease (collectively, the "Documents") have been duly 15. Miscellaneous. WE HAVE NOT MADE, AND DO NOT MAKE, ANY
authorized by you in accordance with all applicable laws, 'rules, ordinances, REPRESENTATION OR WARRANTY, EXPRESS OR IMPLIED, AS TO
and regulations; (c) the Documents are valid, legal, binding agreements, THE EQUIPMENT'S MERCHANTABILITY, FITNESS FOR A
enforceable in accordance with Iheir terms and the person(s) signing the PARTICULAR PURPOSE, SUITABILITY, OR OTHERWISE. WE ARE
Documents have the authority to do so. are acting with the full authorization of NOT LIABLE FOR CONSEQUENTIAL OR SPECIAL DAMAGES. You
your governing body. and hold the offices indicated below their signatures; (d) acknowledge that no supplier or dealer of the Equipment is an agent of ours,
the Equipment is essential to the immediate performance of a governmental or or authorized to act for or bind us. You agree not to withhold any amount
proprietary function by you within the scope of your authority and shall be' you owe us if you believe you have a claim against us. or any Equipment
used during the Lease Term only by you and only to perform such function; (e)....:supplier(s) or manufacturer(s), but to pursue that claim independently. Any
you intend to use the Equipment for the entire Lease Term andshilll.take'ljll:" claim .you have against us must be made within two years after the event
necessary action to include in your annual budget any funds requiredJo. fiJlfiI(- 'that caused it All notices must be in writing and will be deemed given 5 days
your obligations each fiscal period during the Lease Term; (f) you have' after mailing to the intended reapient at its address indicated above, unlesS
complied fully with all applicable law governing open meetings, public bidding changed by a notice given in accordance with this Section. Each Lease
and appropriations, required in connection with the Lease and the debt'undei s'upersedes and replaces all prior understandings and communications (oral
applicable slate law; (g) your obligations to remit Lease Payments alld 6'ther or written) concerning the subject matter thereof. No part of any Lease can
amounts due and to become due under the Lease constitute a current be amended, waived or terminated except by a writing signed by both you
expense and not a debt under applicable state law; (h) all financial information and us. Any part of this Master Agreement may be signed in separate
you have provided is true and a reasonable representation of your financial counterparts that, together, will constitute one document. If a court finds any
condition; (i) you shall not do or cause to be done any act which shall cause. part of this Master Agreement to be invalid or unenforceable, the remainder of
or by omission of any act allow the interest portion of any Lease Payment to this Master Agreement wiD remain in effect. You permit us to monitor and
become includible in our gross income for Federal income taxation purposes record telephone conversations between you and us. All of our rights under
under the Code; U) you shall maintain a complete and accurate account of all each Lease shall remain in effect after the expiration of the Lease Term or
assignments of the Lease in the form sufficient to comply with book entrY termination of the Schedule.
requirements of Section 149(a) of the Code and the regulations prescribed .
thereunder from time to time; and (k) you shall comply with the informaiion
reporting requirements of Section 149(13) of the Code. Such compliance 'shalf
include, but not be limited to, the execution of 8038-G or 8038-GC Information
Returns,
THE TERMS OF THIS,.MAS ER AGREEMENT SHOULD BE READ CAREFULl.Y BEFORE SIGNING BECAUSE ONLY THESE WRITTEN TERMS ARE
ENFORCEABLE NO ctrHER ERMS OR ORAL PROMISES MAY BE LEGALLY ENFORCED. BY SIGNING THIS MASTER AGREEMENT, YOU AGREE
TO THE TERMS ON OTH AGES 1 AND 2. THIS MASTER AGREEMENT IS THE COMPLETE AND EXCLUSIVE STATEMENT OF THE AGREEMENT
BETVVEE:'" you A US!" XCEPT AS MAY LATER AGREE IN WRITING Tp.!'JI()[)IFY IT.
.C UN COUN DEERE CREDIT, INC.
t 6400 NW 86"' ST, PO BOX 6600
JOHNSTON, IA 50131-6600
Date:
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By:
,"J" Y;\ 7.. F:Y Eh/,PT MU:1,!:' a,,1~.;r'i!: CHr:(;{y~
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App10997482
JOHN DEERE
CREDIT
Lease Schedule
Lease Schedule No. 030-0061291-000
Master Lease Agreement No.
0061291
Lessee:
(Name & Address)
CALHOUN COUNTY
CR 101, ,PORT LAVACA, TX 77979
DEERE CREDIT, INC.
ll400 NV\i8P" ST. PC) .BOXpp~q, JOHNSTON, IA 50131-PPOO
. . .
Serial Number
Hour Meter
Cash Price .
2005
JD
ll72D
MOTOR GRADER
DWp72DXp011p7
4125
$121,314.pO
Equipment
L!>cation
CR 101. PORT LAVACA. TX, 77.979.
OUTSIDE city limits: .0
CALHOUN COUNTY
. Leas~Tllrin
Start Date
Advil.nl:e Lease
. Pa ment
"Advance Lease Payment includes the first
1 and last 0 Lease Payment(s)
.' .
"Master Agreement" shall mean the above referenced Master Lease-Purchase Agreement. "Schedule" shall mean this Lease Schedule. "Lease" shall mean
this Schedule and the Master Agreement. All of the terms and conditions set forth in the Master Agreement and any amendment, addendum, schedule or
attachment thereto or hereto including, but not limited to, the Maintenance Addenduni are hereby incorporated into and made a part of this Schedule.
Lease Pavments. You agree to reniit the Lease Payments (and you; (4) you received the written warranty applicable to the Equipment and
applicable sales, use and property taxes) on the dates noted above and understand that your tights under the written warranty may be limited; (5) the
all other amounts when due to: DEERE CREDIT, INC.. P.O. Box 4450, Equipment is unconditionally and irrevocably accepted by you as being suitable
Carol Stream, IL P0197-4450. for its intended use; (p) the Equipment is in good condition and repair
Purchase Option. You may purchase the Equipment at Ihe end of the (operating and otherwise); (7) the Equipment shall be used only for the purpose
Lease Term for $1, provided (1) you are not in default, and (2) we receive indicated herein; (8) all information provided to us by you is true and correct.
all amounts you owe us on or before the Lease Term End Date (the . ;"Vou acknowledge and agree that: (1) we did not select, manufacture or
"Purchase Option"). Upon exerCise of the Purchase Option, we will (a) supply any of the Equipment; (2) we acquired the Equipment at your direction;
transfer to you all of our right, title and interest in such Item(s) of Equipment (3) you selected the supplier of the Equipment; (4) you are entitled to all
AS-IS. WHERE-IS. WITHOUT ANY WARRANTY AS TO CONDITION OR manufacturer warranties ("Warranty Rights") and we assign all Warranty Rights
VALUE, and (b) release our security interest in Ihe Equipment. to you. to the extent assignable; (5) you may request an accurate and complete
Representations and Warranties, You represent and warrant to us.. as. .; statement of the Warranty Rights, including any disclaimers and limitations,
of the date you signed this Schedule, that (1) the Equipment was selected directly from the manufacturer; and (p) you assign to us all your rights (but none
by you; (2) the Equipme 'ncluding all manufacturer manuals and of your obligations) under all purchase orders, purchase agreements or similar
instructions) has been de.livere to. and examined by, you: (3) the safe document.s relating to the Equip.ment. You waive all rights ~nd remedies
o eration and the ro ef' servic n of the E ui ment were ex lained to conferred upon a lessee under Article 2A of the Uniform Commercial Code.
.BYl;'c;fljlfljc; THIS ~CHED.YiE, YOU AGRI:E T,o..ALL OF THE TERMS AND CPNDITIQNS OF THIS SCHEDULE AND THE MASTER AGREEMENT.
/C HOUN COUNTY'/ i DEERE CREDIT, INC.
fiR 101 ~ ,/ p400 NW 8p" ST, PO BOX PPOO
PORT LAVACA, TX 7)~iT9 JOHNSTON,IA 50131-PPOO
,;". .<
, .f",,!' , / , '.f /
1,' ' I.},.... ,!" {,'''. /!
ROGE C GALV1, NTY /; fI)/
COM ISSIONERI . ( I
I ~ . J ,.{. - \. I
· /() i 't ",~-;"t~1 /} 'j
14
10/14/2010
o Monthly 0 Quarterly: 0 Semi-Annual 0 Annual
By:
By:
Date:
Title;
Date:
,~.h,,:>'::~{;, ,~~(.~h:'J.hn.':~ {Ii:.. t(1
P"ii;:.;e j uf;?
App 10997482
. ",.,.\,
.,<:....
II JOHN DEERE
CREDIT
Amortization Schedule
Lease Schedule No.
030-0061291-000
Master Lease-Purchase Agreement No. 0061291
Lessee:
(Name & Address)
CALHOUN COUNTY
CR 101, PORT LAVACA, TX 77979
DEERE CREDIT, INC. .
6400 NW 86"' ST, PO BOX 6600, JOHNSTON.IA 50131.6600
3.75%
.
Lessor:
Nominal Annual
Rate:
Remaining
Balance:
________._..___.__}.::eas.~___ 10/1412010 121.324.60
_.__________.______~ 10/14/2010 _ 26,114.91 0.00 26,114.91 95,2Q~
2 11114/2010 0.00 297.53 297.53- 95,507.22
~=~:~-~~===~~-=T~~~-=~~lm:~m~r=.--.--_iF=.-- ~~~:H ~~tit H:!~H~
=~~~-:t=-=~!;mf:$::::--n_::: ~::----i:tlr- n--:;t-----2~:=
=~=_____--2..I__-..-- 06/14/2011 .~.,-_____lQ4.10 _.__ 304.10- 97,616.13
_____________19_..__ 07114/2011 0.00 . 305.05 _. 305.05- _____.?.7,92J.1~-
__....._.._._...______JJ... ___ 08/14/2011 0.00. 306.00 306.00- 98,227~~
___._______ 12 09/14/2011 0.00 306.96 306.96- 98,534.14
________..__.__....!2... _____ 10114/2011 26,114.91 307.92 25,806.99 72,727.15
14 IIil4/2011 0.001 227.27 227.27- 72,954.42
15 12/14/2011 0.0ll'l 227.98 227.98- 73,182.40
~.""--: -'-===-'16 __ 01/14/2012 0.00 228.70 228.70- 73,411.10
17 02114/2012 _ 0.00 229.41 229.41- 73,640.51
18 03/1412012 0.00 230.13 230.13- 73,870.64
--
19 04/14/2012 0.00 230.85 230.85- 74,101.49
~- --==____-2~ 05/14/2012 0.00 -- 231.57 231.57- 74,333.06
_n'___" 21 06114/2012 0.0.0. F: '. 232.29 n._ 232.29- 74,565.35
22 __ 07/14/2012 0.00 I 233.02 233.02- 74,798.37
23 08/14/2012 O.OO! '. 233.74 233.74- 75,032.11
. .-
-----~ ---.- 09114/2012 0.00 L_ 234.48 234.48- 75,266.59
25 -, 10/14/2012 26..114.91 I 235.21 25,879:70 49~386~89
---------..26 - 11/14/2()12'-=~.. 0.00 I 154.33 _ 154.33- 49,541.22-
-.-. 27 - 12/14/2012- -. 0.0~=--'-r54.82 154.82- -49;696.Ci'4'
:-=:::~:-:=l! =--~!;;:!+~-==----!F-::-~-:~ll=-~ :mt --l!:ii
..__._______.__._....__.____ ...______.._._____. ___...____._._____--+__.____.....__.. _ _n __
_____..JJ_ _______..__m2~~/2(~!l.. __0.00 L_______ 156.76 156.76- ._50,320.16
___.__._.____.B.. _______Q.~.!.~{~11_L--- 0.00 L-.--- 157.25 157.25- '_ 50,477.41
~-==--=-~===--~ir----- ~~~::~;~:;-J-----~===-~~~~J=--- ~;~:~; :;~:~;~ ;~:~~;:~~
35 OR/1412013 ' 0.00 I .. 158.73 158.73- 50,952.11
----.------...----..--I.-------Tt---------nT-~..---.---.----.---"- ---
.====--=-~_~~~=--~~-r=~~ ~~~::~~~m=ff+-------u:II~:~...~. I-~-~ . ---. :;~:~~ 25~g~5~li.' ~~::~~:~~
____._.______.__~1. 11/14/201~_ ~. 78.61 78.61-___. 25,234.76
_.._________.________3~--r___~4/2013_ _.________0.004_. 78.86 78.86- 25,313.62
_.___._.._.___._..___~ ____._~!.'!!20..!i ______.._______ 0.00'.1 79.1 I 79.11- 25,392.73
41 02114/2014 0.00 I 79.35 79.35- 25,472.08
__......____.__________._.__ _______ _________,.._u.___-j-__ .'
_____..__.._.___.__~2 03/14/2014 __ ~_____.___._79.60 __ 79.60- 25,551.68
___...__........___.__~~___._ 04/1412014 q,~ _.. 79.85.__.. 79.85- 25,631.53
44 05/14/2014 0.00 80.10 80.10- 25,711.63
45 061l4/2014 0.00 80.35 80.35- 25,791.98
46 07114/20 14 0.00 80.60 80.60- 25,872.58
Payment Number:
Date:
Lease Payment:
Interest:
Principal:
i.)(! i\l''(>(i;1:ii:,:)t,()f". ":h:.h;~{hlh~' f,,,;::,;:(!:?i}e
;:J..t~~i 1 :)-:: i
App 10997482
: ~ '~:,'
0.00
0.00
26,114.91
1.00
130,575.55
-~:=~~=-~~~= / ~. _=~__ - _- _1~- ____ _
,
,
Payment Number:
Lease Payment:
Date:
47
48
....,-....-..---..-...-.---.----
49
..----..-.--.-..------ -------
50
------------C'rand -;-rotills ---------
08/14/2014
09/14/2014
10114/2014
11/14/2014
By:
Dale:
C'C~ ~'.:\!1cr~":'iz.ArlOH :~~CH~-:t;;ULE:. r)'1_i;::.;n~)
Interest:
Principal:
80.85-
8 1.1 0-
26,033.55
0.98
121,324.60
80.85
81.10
81.36
0.02
9,250.95
_DEERE CREDIT, INC.
6400 NW.86th STREET, PO BOX 6600
JOHNSTON, IA 50131-6600
By:
Title:
," ~
1"-'....~~'j:.:~ :.
Remaining
Balance:
25,953.43
26,034_53
0.98
0.00
Date:
App 10997482
(LETTERHEAD OF LESSEE'S COUNSEL)
(Date)
/{1-/f~ Uilo
f --
Deere Credit, Inc.
PO Box 6600
Johnston, IA 50131-6600
RE: Master Lease-Purchase Agreement No, 0061291 dated 10/14/2010 (the "Master Lease") and Lease Schedule
No. 030-0061291-000 dated 10/14/2010 (the "Lease Schedule"), and entered into between CALHOUN COUNTY
("Lessee") and Deere Credit, Inc., its successors and assigns ("Lessor") (The Master Lease and the Lease Schedule are
hereinafter collectively referred to as the "Lease").
Gentlemen and Ladies:
I have acted as counsel to Lessee in connection with the execution and delivery of the Lease by Lessee and, in this
capacity, I have reviewed a duplicate original or certified copy of the Lease and such other documents and instruments as
I have deemed necessary or appropriate. As counsel for lessee, I have made such factual inquiries, and have examined
or caused to be examined such questions of law as I have considered necessary or appropriate for the purposes of this
opinion. Based upon such inquiries, examination and review, I am of the opinion that:
(a) Lessee is the entity indicated on the face of the Lease and is a political subdivision of the state in which it
is located. Lessee is duly organized and existing under the Constitution and laws of said state, and is authorized to enter
into and to carry out its obligations under the Lease.
(b) Lessee has complied fully with all applicable law governing open meetings, public bidding and
appropriations required in connection with the Lease and the acquisition of the Equipment.
(c) The Lease has been duly authorized, executed and delivered by Lessee in accordance with all applicable
laws, rules and regulations. The Lease is a valid, legal, binding agreement, enforceable in accordance with its terms,
except as limited by laws of general application affecting the enforcement of creditors' rights.
(d) The person signing the Lease (1) has the authority to do so, (2) is acting with the full authorization of
Lessee's governing body, and (3) holds the office indicate? below their signature. The signature of the person signing the
Lease is genuine. .; ",'" .
(e) The execution of the Lease and the appropriation of funds to meet its obligations thereunder do not result
in the violation of any constitutional, statutory or other limitation relating to the manner, form or amount of indebtedness
which may be incurred by Lessee.
(f) The Lease does not constitute a debt Of Lessee U?a~PliCable state law or a pledge of the tax or
general revenues of Lessee. 'I' ,', ,"" ~/
,':: . I
'lLESSEE,t UNSELl
, ! t
I'
By:
.-.:..':.<....i'i ':;r: ,..~..':-t: ,"'.; .-:'~! :;'1'..,:;." :);::;;<;::;_~.'
,',>..'.
App
10997482
.
Federal and State Agency
Claim for Exemption of
State and Local Sales/Use Tax
Purchaser
Name: CALHOUN COUNTY
Address: 202 S ANN, PORT LA V ACA, TX 77979
10 Number (If Applicable): ___.
Seller
Name: DEERE CREDIT, INC.
Address: 6400 NW 86TH ST JOHNSTON IA 50131
Description otItem Being Purchased:
U JD 672D GRDR SN: DW672DX601167
.
':,:,:~~I:-;~:nr .;.... !~,;~i .....~ ~~:<~?,.: '~"'~\;::i~
P':ni;- ~.l o"! ~:
App 10997482
::1615534444
08:03:35 a.m. 09-03-2010
1 /3
::1615534444
.
08:03:35 a.m. 09-03-2010
1 /3
NOTICE OF MEETING
The Commissioners' Court of Calhoun County, Texas will meet on Seftember 9, 2010 at
10:00 a.m. in the Commissioners' Courtroom in the County Courthouse at 211 S. Ann
Street, Port Lavaca, Calhoun Count)r, Texas.
AGENDA
The subject matter of such meeting is as follows:
.//
\/ 1. Call meeting to order.
~.~ Invocation.
,// \ \., ,-,;-v\,J";;,
/,.,' . '1\'-'<"'..""")
/ 3.. Pledge of AllegIance. ," \1 .1oJ'.!).1......\l/'.j\
'" ,/ \ ~.j '....
vI~. Approve Minutes of August 12,2010, and August 2~:2~'10 meetings.
5. Hear Report From Memorial Medical Center.
, ~)consider and take necessary action to Transfer the proc"'iJ!s !,rp~ the ~ale of fj~e QLM"" ,uJto""y
V' ~) l{ealth to Memonal MedIcal Center. (MMC CEO) 'J- \. \}...... LL':u~ ~\1) f ':~~'jj ,- '
/\f'::<"'- ~i~(o_Lh\;J:t'*';:;-->h ~~\.o.*e.e-,~~ /QC,tf\,i.C""'-'l;) tP/\.- C\ \{~G.~ 'f f\.~ I,
~. Consider and take necessary action to accept Loan Payback from Memorial Medical
Center. (MMC CEO) '50 l<.
/'
\,//8. Hear and take ne~essary. action on b..Qnd re!undi.n~ ~a:ket presentation by F~rs~S'Tout?,west ~ , . \
Com~~z,.finan,cIal ~vlser. (CMt~~"'~::Y~" ~d.,:.':~( l:c"-;r"-- \\'lc;Z:)l"V~','-jl)",ck '::,) \:7l\ \\~0\.:l.j:;.JJ0)lc\_.
q..j ...~ .-\......, C'C' ,\~. <".:;;' r.. 1- ~~ .1\ \jcv '
.... "...~::> ~ .\1.......... '\ ~"". .." ,,;' (,,, \..'\.A........ l.. ::J ,_,,) .....J ~~, 'J'
V~ Consider and take necessary action to award bids for Fuel to be Delivered and Fuel on
, Automated Card System for the p~riod beginning September 16,2010 and ending
/October 15,2010. (CM) Q..Q.U,J l~0tl::. C.A,,('~c._Q.{J..~{j:L,,,
~ ~,onsider and take necessary action to declare Texas WindstoITn.lnsurance Association a
si,,!!gle source.JCM)
'K ,~~~nsi-der and take necessary action to approve specifications and authorize the County
Auditor to advertise for bids for various property, casualty and professional liability
insurance coverage for the period beginning 01/01/ II. Bids will be opened at 10:00 a.m.
/ on December 13,2010 and considered for action on December 20,2010. (CM)
')2. Consider and take necessary action to award bid for used motor grader for Pet. #1. (RG)
13. Consider and take necessary action on Ordinance E~tablishing a Justice Court Juvenil.e () ,
, Man~ger Fu?d. (JP#3) A*c1.J~\- kCVv\.o, t~) l/VV''''fJ.e..,,~JiI,J-' \..M-l 8-Q ld.., Vv'{.\...I.Lc'\.-6-~
~>+v~~ ~t&~/\iL ~/~tl{i-t1[)-'~Q/ 8JJ CQ~~ (t~/.
'\\ . a ,.
=- ~~\^^-. \1\l\JtM-J ~~7 Page 1 of3
\~; .f.U1..."J-,0-e.flJ
3615534444
Ul:l~:jb p.m. Ull-lU-lUlU
1/4
3615534444
",
02:25:36 p.m. 08-10-2010
1/4
".
NOTICE OF MEETING
The Commissioners' Court of Calhoun County, Texas will meet on August 12,2010 at
10:00 3.m. in the Commissioners' Courtroom in the County Courthouse at 21.1 S. Ann
Street, Port Lavaca, Calhoun County, Texas.
AGENDA
The subject matter of such meeting is as follows:
1. Call meeting to order.
2. Invocation.
~\ l\.,
\~\i"
\\CL. .
\~\ U...:
,'\ .l~'j..."~,;
\\((\J.,;\ ;)3
.;:. . ~~~~:;MinUles ofJuly 8, 2010, July 14, 2010, July 22, 2010, and July 27, 201 0 ",t;;.~ ~ <~
/' ..... ').I:;()C\ t. ')-.()l (> "oJ "~ 11 O:1~
',; 5. Hear Report From Memori~ Medical Cente~ \, \:)(\ ('" \ ~.\ (,).. M..~ jc'-- ~I'\ i:LC~\:tG\t\.L . .t:~.J.,,1~. rJ._\{~.pQ..~X OJRCi ,,'::~
40~ \l-J\5-...'V~1r C),Is;vv'.Q->J ~\:L"",-I.?.k Q.Q,l:,.,;e; LWi.xt ,M''..i..~QcL b-t.. c'^~ \rtc~.c.~z., ItLtJUil..Q.J)-Vl..cl cb U(1..1
A Consider and take necessary action on matter of Memorial Medical Center seeking
Interim Funding for hospital Operations.
3. .Pledge of Allegiance.
\//f~ Award bids for Fuel to be Delivered and Fuel on Automated Card System for the period
August 16,2010 through September 15,2010. (CM)JLtJ..>:s' l'J'-,&tL:A_.!'.J
vi" Consider and take necessary action on Malathion and Oil Soluble ~ynthetic Py,rethroid
bids that were awarded on Thursday, July 8, 2010. (CM) fLf.iN...,\} l,)'(LiAv+r'-C~.j~~l:QJ~_,Z).p..e_(<)~/
/" ~ ~
-fr~. Consider and take necessary action to approve specifications and authorize co~~ ~
Auditor to Advertise for Bids for a used Motor Grader for Precinct One. (RG) ~'tLOcd...i, :.J....~ "\
/ ~__ ~U> )
00. Pub~ic ~earing on the matter of the USD~ Rural Dev~lopmf~t G;~: Ap~!~a!i;>n fo~ ----~........../
furmshmgs for the Calhoun County Seadnft Branch Llbrary~(..q \ "6L~ ( <>f"'G::..>O/<.. 1(;c\.!2.Q..."'-./-
L/' \J ~:,lYA
V~Cons~de~ and take n~ce~sary action on the matter of the U~DA Rural I?evelopnient Grar:t {(f.....(j_~ ,
. ApplicatIOn, f~r .~urn~shm~s for ~e,Calhoun County Seadnft Branch Library. (KF) [Lo-y\C ' (. \.:,. )-7..~\
~..'\.j"'-J~~x.- \J~^J<s \::0Lr...../ ~..' \C r fu!.v'-X' lc'
~~onsid~r and take ne'~essary action on the renewal of the Builder's Risk insurance pol~cy U 6 -qc.rL')1.-11~r
:~r the New Seadrift Library building. (eM) CJt0t-c CLL-()~uj" (l..()-j{'l:"ChJ'(4tj~' 'f6. l\J?~l..l:~{e.}u
.1-J~~ct, 13. Consider and take necessary ac~ion _on Ordin~ce Es,tablish~g a Justice Co~ Juvenile . p.,C~~tCA..O
'1:\ . \ Manager Fund. (JP#3) l.AM'.A..QJi..1..<LP-1;-,/Vt..Q.C\ Ll-vy$5 :CLQJf\..-oIL'+i!...tt;~ VJcL.L~u\-Iv..<-.1tj
L ~~ @\\\ fSL ().J x.. !.J-CL" r 0 L' CA....
/1,)
Page I of4
i
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doggetlrnachinery.com
Doggett Heavy Machinery Services LLC
[] ORIGINAL
433 Flato Road
Corpus Christi, TX 78405
Phone: 361-289-0727
Fax: 361-289-7229
INVOICE TO:
[:':'1 DELIVER TO:
CALHOUN COUNTY PRCT 1
201 W AUSTIN STHEET
PORT LAVACA TX 77979
Pharr, TX
Brownsville, TX
Victoria, TX
956-787-0001
956-831~9377
361-570-6666
Sales Invoice
CALHOUN COUNTY PRCT 1
CR 101
PORT LAVACA TX 77979
175531
10/14/2010
1 of 2
540101310-1
STOCK UNIT DETAILS
STOCK No. TYPE CLASS ATTCH-TO MAKE MODEL
_.._-~-----_._--~------------~----_._------_._------
2957 Used Base JD 672D
TRADE INS
STOCK No. MAKE
MODEl.
PIN
ADDITIONAL CHARGES
DESCRIPTION
VEHICLE INVENTORY TAX
Total Selling Price
$121,000.00
$0.00
$0.00
$0.00
$0.00
$0.00
$314.60
$0.00
$121,314.60
PlUS Freight and Hancllin~r
-----_._..__...._-~._-~_....._-_.~.-
PlUG Insurance:
Less Discount:
Pius Stamp Duly:
-----_.........._-~-_.._--..-
Plus Registration Fee:
~~~ Additional ~~~~ges: ____
Pius Sales Tax:
Total Invoice:
Invoice No.:
Date:
Page:
Cust. PO No.:
Tax Exempt No,:
Payment Type:
Account
REG No.
PIN
DW672DX60 1177
SALE PRICE
$121000.00
$121,000.00
NET EQUITY
$0.00
VALUE
$314.60
$314.60
VALUE
PAYOUT
Invoice Notes
I
Less Net Equity from Trade In(s):
Plus Refund:
Less Deposit/Pre-Trade:
Less From Finance Contract:
$0.00
$0.00
$0.00
$0.00
$121,314.60
Amount To Settle COD:
Salesperson: DHEW SCHUELKE
TERMS OF SALE OR l.EASE
Payment terms are Net 30 days. All past due accounts are subject to 1.5% finance charge per month. Acceptance of delivel)' ollhe equipment described hereon sllall constitute
acceptance by the buyer or lessee of the following tel1115 and conditions upon which said equij>ment is sold. DISCLAIMER OF WARRANTIES. The buyer agrees and
acknowledges tlwt 009gell Heavy Machinery Services, L TO andlor The Doggell Group LLC (collectively referred to as "OHMS") MAKES NO WARRANTIES, EXPRESSED OR
IMPUED. wilh respecllo the equipment or pari sold or leased except such warranty as may have been given to the buyer or lessee inwrillng by OHMS and OHMS EXPRESSLY
DISCLAIMS ANY WARRANTY OR MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE with respect to such equipment or part.
DISCLAIMER OF LIABILITY, Thft buyer agrees anrl acknowledges thai OHMS DISCLAIMS AND SHALL HAVE No LIABILITY whatsoever FOR ANY DAMAGE, LOSS OR
INJURY to person or plOpMy, INCLUDING ANY DAMAGE, LOSS OR INJURY ATTRIBUTABLE TO OHMS NEOllOENCY OR FAULT resulting from or arising out of the
manufacture. sale or IMse. c1(~liveIY. inslallalion. reparr, operation, failure, or use of such equipment or part, In the event that this document pertains to the lease of said equipment.
the above tel msand conditions shall apply 10 Ihe lessee thereof the following additionallerms shall prevail: (e) lesseeinsurence thereon: (b) the equipment shall alalltimes
remain the properly of OHMS and shall be relurned to il upon expiration of the rental period in the same condition as the date of delivery, ordinary wear excepted.
ADDITIONAL TERMS OF SALE FOR USED EQUIPMENT
THIS BEING USED EQUIPMENT IN THE MANUFACTURE OR PRODUCTION OF WHICH WE WERE NOT INVOLVED (THIS SALE IS ON AN "AS-IS" BASIS) AND ALL
WARRANTIES EXPRESSED OR IMPLIED AS TO THE MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE ARE EXPRESSLY NEGATED. ALL CLAIMS FOR
DEFICIENCtES MUST BE MADE WITHIN 24 H()UI~S AFTER RECEIPT OF GOODS.
:;l..
~t~.'"t^
:, Cll~tofi\fer'ff'urchaseOtderforJOhn Deere Construction and ,Forestry Produc:ts~'USA
~"~".,' ,
'\
; f~.. '
i' ~
PURCHASE~ NAME ANDAPORE~~!irst Signer)
NAME (Firs!. Middle. Last)
Calhoun County Pret 111
u._______._.___.___~___.._____
STf~EET or RR
201 W Austin St
;;'~!~~f;_-~~~f~~!::~:E..
PURCHASER .~~.~.~..~.~~_~.E_~_~~SS (S~()n(0!J'Jer) ____.
NAME (First. Middle,. Las!)
;," SELLER NAME AND ADDRESS'
DEALER NAME
Doggett HeavyMachinery Sevices, Ltd
STREET or RR
433 Flato Rd
CITY
Corpl,lsChristi
Dealer Account No.:
PURCHASER TYPE:
4 County
AddclJstomoilo'MallingUst (CheCl<OneoiKnoi'e('
[gJC?n~tr~ctlon o Utility 0 Forestry 0
CUSTOMER"IS;.... "4'-:~;' purch~seT"Acct:;
.f;'
12] Business 0 Individual'
",. .,' '-, ., ..
-.------....---
9TREETOr RR
Government
~-r!:NDf:DWARI~ANTYIS:-.--:-.-..--. . . LOCATION OF F.IRST WORKING USE:
[~_Accep~.__ q_~~~~ecl~~~_.___-::.:::.::=::~.'~lliaIS) County Calgary City Port Lavaca
STATE
TX
"--....:;.;.,;----_._-;....;..........__...'''---~..._.-._--'"'.
D SOCIAk SECURITy
NO.:
o IRS TAX ID NO
CITY
STATE
PHONE-NUMBER
OTY- NEW DEMO "RE'Nl: uS"E'o EQUIPM
l--rr r':r T:r.J21 672D Mo
-..-- "'Cr 1J--" T] 0 -----
....---- -tr -rr -c:r -cr ---..----.-
. [T 'T:J ..tr -[J'- .---.--
o Cr- 0 ""-er .----
[J [J [J- cr
[J r:r- "TJ [J - .....
o - [] [] -tJ- ----.----
.' ~,D ~EJ- ~J:f t'j~ -.--
--- LJ 1:1....- Cl_:t:r _'__'__'
ENT (Model, Size, Description) Hours of Use PIN or Serial Number Doliverod Cash Price
tor Grader 4160 DW672DX601177 $121.000.00
- V '\
---. / i" /l "
/ )/1 fJ
.-. JU /
r~ /./
..- ~
... .,- '-., I.
-
.
(1) TOTAL CASH PRICE $121,000.00
T~t,?E'"1 N ~~~~'!:!?.:~~~:.'_~_r:~cri~tio~)
;;HQurs..of,Use~ "PIN OR SERIAL NUMBER .
'AMOUNT:
t f;', ..", _ . ~":
. ....;...(2)TOTALT.~ADE.IN,ALLOWANCE..
ACKNOW.LEOGMF..NTS:F'urch"se' .911.,"s to. soli, Jransfc,. and C9nvey.the,it~in(s).li"sted as'Trade'Il)~ lit.\he
Oeoler.at 9r:p,i9fo'1othelhn<:lGfrdehvoly:of Ihe above Equipment. as a "I,ade-in" to be applied against the cash (3rBA[ANCE(1~2)
p'ice Pu,chaserrGPros(,nis Ihal c'a("h "trade.in" item shalllJe lree and clear 0' all security interests. liens. and
e1icumbrances 'at..tholimco/ transfc, 10 the Op'l'Ile, exceptio the exlent shown below. The price 10 be allowed
.Ior'each.'"lrade:j,;" Item is listc(l.onlllis doc.umen!. The Purchaser promises topay .thebalance due (line 8)
Sl:lowp. here?n. In cash. or. to Gxec\.te ;~ Time. Sale Agrecrneni(Rela'tliisliJllmenl~qontr~~t):,pr .~.Li)an"; ($).ADcil.TION~Ii'FE'S:S';.
}\g'e!1menlforJh\j'P("i:ha~e pricebrthel:qu,pment. plus additional chi!rg!1s. shown lhe1eoll.6f1o"execulea::' ./'..h , ........ " .'1....,
Lease Alir~el1)e,lt,OI) Of belo,l' <1elivriry 0/ Ihe eqilipmenrordered hereii).'D~spitif deliv.~ry:()tlhegq\!ipinei\ft~'" .... ' . iC .': .;,. '. .. ..,-
the ~urC/iasor,tille'llhrlll'emainwjth the Seller unlU.olie .oftlleJ6regolng .is. 'accomplished: T.1ie"Pu~chaseranll (6)SUBT01'AL (3\'81111:.&,51 .
Hie Oeale'agree that this Pu,chase O,de, is Mia secll,ityagleemenl andihal deliveiy of-lIie'E'quipm'ent'tO'lhe':' \..:,: ;;t,,:,..:. .;.., ....
Purfhase, pursuant to this P.urfhaso Olde, will not conslilutepossession 0,' 11"\9 EqulPl1lenlbythe Purch'!ser. ., ~6)REN.TAL .Af>PLIED.
.,. as.'a debl~r! ~()r. thl':pulpose!\.of.lhe p(lIchase .1110nllY securltypr<;l\lisiolis IIl'any slatlrles r~tating 10p~rs?l'1al). ,'.: . ...... .... " N;!' ..... ,
. ';. ~,~~",11y.se7.11'~t.yori.I(f'e~J(liVa\",iltPurchas~" unde,sllli'd.sthalils' ,jghts inconn~ctioi\ with~th!~purChase'a~e'" tt)tASlfWrtH 'ORDER';
. hnNed'as seUorlh'in'1hi.s Pl1fcha~(l'Order, . '''.!,'' "ii,."""'" .,..
. :.{ .~:~'"..' '<':~.
$0.00
$O.~()()
,.1..,
JD'S17-01i. EFFECTIVE (03FEB091 U;S)~'ONlY .1,i.~~'s:~if~f~~4lr .... < ~,;g;gt\rrt~9t?V.::~~\
$121;000.00
$0.00
;"~31'4.60
" :. l;.i -~,
.: <
:"p~g~ 1.9' 4
pllrchasc'i:;) WlC'PlIrchas"r,lIereby ,,'ders the equipment (the 'EqUlpmen!') desC(ibedabove ffO/ll Ihe Dealer, The Dealer shall not be liable ror failure to provide the Equipme,\t or tOr any delay In
.ilure or delay IS due In m":~t','I(JI",'II"I.'hIY In obtai" sucll,Equipmentfrom thef"anofaclwer o(s\lPpllef'or'olher,ca\l~.lJeyo~d.lh. Daale(~}:Qf)lroL.Tt'a~I;P'l'c'HhoW'):'1~va is,'UbJ~t, 1,0 Ihe
.the E'lwpmr.ml frorn trIP." InnnllfacuJror ()'( supplier-prior to 'anv'('.hange :in prico by Ule manufatlurer "of'supplier and is 'al~o~o'bject to any new'b/tlncreast:Jd taxes tleinglmposed'Upon Iho' salo (If 1he
EqLJlp[!)ont"afte,r,the dale or 1111$ PIJrr.haSl1 Qrdw
OISCLOS,lIRE'OF,'IlEG,lIlATIONAPPtlCA'B1LllY:' \'\ihoh'operaled'ih'Cahlornia:any'Off;r03l:1' dl&s&1 vehicle maY'''1'''suQJa~no:the'CaUfomia,:Al( ~asourl?,ls'~o.rd Ilfills!! ',off.RoadOiesel Vehlele R!!(lulaIiOll:" It
tiierofore c",ndbe-sUbjoct lo'ro!ftjlil"or'a'cI;eleraICdllJn\over ro~ulrcments to reduce emissions 01 air pollUlanls.'Moreinfoimalionis avallalllen\nlho:Cat.foinlll'Air.iResollroos Board websile al
IitiJ12b.~!;~ni;t~,tiQY71JiSl!!illiLQfQifi$i1I1Q(di(lfM)111tOl ..' . .. , . ....'. .' .... ...
"::~Hr ..:
IMPORTANT WARRANTUiqTICE: 'I,," SI:tndard Warranly for flew John Deere C<lnslructlon and foreslry prodllcl~ i~ $(It. fqrth i~..s~par~!e. dOCllT?~lpr~vide~by l!lo,doolar. Plaase read the Standard Warranty
carerlllly,beloro.srgnlng, '146 f\)(pross w",mnly is made unlllssspeclfied in tho Warranly Slalemon!. PURCHASER'S',RIGHTS',ANDREMEDIES PERTAIi'!INGTOTHIS PURCHASE ARE lIMI1 ED AS INDICATED IN
.THE S'fANDARD WARRANl'VANO PURGHASLORI.lEf<: W1.IEHE,PERMIHED,BY LAW, NO IMPlIEIlWARRANlY'9F,MERPHANTABllITY ORFITNESS IS MADE, USED;I0HN'OEERE'PRODUCTS'ONlY:
John:Oeere willlraflsfer remainlllfj Siandafd Warranty ilfld/or StluclU(ALl. Warranty (0 the purChaser of a used John (}&6ra,canstfuction.an<1 forestry product that has been used for less than Ihe full warranty period
pf.ovlde~.al,~heprodtJc.rs I'JTlgH1al (clail pUrchs'5l;), Tliis lransfer Is nol f~UeCtivauflless and until John DQere~s WrHb:)J)'fXlnJirnla~jOn'Of transfer, indjcaling when the transferred warranty will expire, is received bY'lhe
CUStomer. ALL TiiETERMS, INlCUDING L1MI rAlION~ AND EXCLUSIONS, OF THE JOHN DEERE SMNDAROWARRANTY AND/,oR SlRUCTURAll WAHRAN1Y ,oRIGINALLY PROViDED FOR lHE
PfWOt:JCrHEMtiIN IN'EFFECT'AN01\PPLlCi\OLG,
I"
Pu'chaser~$:si9naturo below acknowlodgi,\s; the Purchaserhll$ received a copy,bHhe.StimdardWarranty, Ve,sl~n--.
'understands.its torms,andcondltions"l' .
, Purch3s.er'(EirS,('Signer) _5alhOlJl) COlJ~: Prc!.!!J.___._._______ Signature X . . 'I
Signllture,
_,;?, Date"'!
PU(Chaser.($econd:,Sigl1r.ir)...-:'f_'_""L_.;.._.-,-,._;.,_c..~."
:'.i',;
Defiler Hepresehlatlve ___..__..__....___...".,___..
Signature
...~alesperson".;......_..._,_..:..____,_.._._"_,______ _
PEll\jERY ACI<~OWlED-;;-EME~~~ive;ed wilhOperator's Manual On:
Signature: '.
Date,.
~ ':."~-
'C'
:q
JO-S;17 .O'1EEFECIIVE:(03FEB09) V,SA ONLY
pagll2 of4
:.
.- - . , f "'. ,.,'.. ". .1l, "1'" ,-,
,STANDARD WARRANTY FOR NEW JOHN,I)EERE'""
CONSTRUCTION, UTILITY, AND FORESTRY PRODUCTS - U.S.A.
. It
(;,~f'ls~rm;~I<>llerpducts,~.QOJiP,aniIAbove and Pull-Type Scrapers: 6 months Full MachineSta~d~;d Warranty
Pr~ductsunder100HP: 12 months FullMachine Standard Warranly ..' '.. '.' .' '. ..... . . . . .., ........... .' .... .> ....'
F orwardor~, DHSP' for(l.strj'Excava~ors.Harvosters..[ig.t.tad<irs;:S.ltld4orll:TtMked a."d;Wli~eloaf'eitofaJli(;her~;;(lf$trdni~il!>r.spfll';&h. '9,taftllr
i5,sopt~nibiH2QQ2', .12'Monlhsorr2000 1-10urs (whiche'ler'occurs iirst)1P.iiil.MachineSta'nctard:Wa'rran ty .' , ..., . .
~~(apor T~actors'(24 Months 012000 'Hours (Whiche\jefocCUrsfirSt)Flill'Math.iheStan~ardWarfllnty
~oroitry .AUaCIlI~ellt!l:+2:M61'thsdr2000. HoJrS(Whiclleveroci;ur$first)Fiill.Ma.chl~~$tahd~i-d;\ivaii'~riiy '.
· '.Frontie,,,Equlllment:.90 days Full Machine Slandard Warranty
.'
:r1\e"Sfal1dardWilrrahly'~:is 'part (if thl~warranty proteclion p'ackageavailabie tromJllhri DElere'Const(u~iIOti' &f:oreStry'Companyr("John Oeere,:),.topurchasers
'of new JohilD€)ere products:
. .' :,: :,:' .. ~, ~ >.." ' . . -,' -- , '. "... . : 0" :::, i
STANDARD'Warranty 'is';)<l!1trDeero'S'sliuldardnew 'eqliij:l.tfehfWarrahty " describedoi'ftlilspage.' providedaritO additionalthatgEflo the purclfasei. ..
", ~
EXTENDED Wllrrantyis a separate rOpair cOI\tracl made available by John Deere forpurchasefs who wishlocornplementlhelr SlandardWarraniy
coyeragc"Coll1plete Extended Warranty delails. including coverage opti(ms.l!I)d,lill1itatlo'~~. ar~ set f(lrthi~) th~,A.pp~sa.tio"for EXlendlj'd,WlI!ranty".which Is.
availahle from authorized John Deere dealers.
,slructti;J,LL:Warranty'applies'locertoirl'stru(:tural' cpmppncnts as listed' below and as describe~,Pn'thjs'page;.;. ".'
. '. ..,..: . oJ ,.- ':'-',. '-. "':'," ...."t,
ie STANDARD WARRANTY . GENERALPRC)VISIONS ...... ......... . '. .. .... ... . ......... .... ..... .. ....... ...
jotin Deme willlepair or replace. at its' option. any parts (except Ihose specified below) of anew John Deere producllhat as delivered to the original
retail purchasllf, are t1cfeclive in material or workmanship. Performance of this warranty will be Iree of charge for paris and labor, except as oU)erwise
slated helow. Standllfd Warranly applies only 10 purchases from John Deere and authorized John Deere dealers and, except as otherwise provided in
the next senlence. is extended only to the original retail purChaser ofthe product. Remaining Standard Warranty applicable to a used John Deere
product is translerred to a suhsequenl purchaser of Ihe prOduct only if the subsequent purchaser requests a transfer from an authorized .John Deere
dealer hefore the producl's Standard Warranty expires, Coverage begins on the date of delivery of the product to Ihe original retail purchaser. For
purposes of Ihis warranty, a product Ihat has heen renled. used for demonstration purposes for 150 or more hours, or otherwise used prior to its
original retail purChase has been "used' for Ihe total duration of such use, Warranty statements required by law covering engine emissions-related
parIs and components are found on a separate written warranty certificate provided to the cuslomer at the time of purchase.
8, WHAT IS COVERED BY STANDARD WARRANTY -
All parts of a new Jolln Deere product (excepl those noted in Sections D and E below) are covered during the Slandard Warranty period set out above.
C. EXCLUSIVE REMEDY -
The repair 01 r~!placernenl of coveled parts or components Ihat are defective, as provided In Section A, e, and 0.2 herein, shall be the purchaser's
exclusive remedy for any defect in the product. However, if after repeated allempts such repair or replacement fails 10 correct lhe performance problem
Caused by the defect. the purchaser's sole remedy shall be a refund of Ihe amount paid for the product (in exchange for a return of the product),
excluding any IranspOr1t1lion charges, license fees. taxes and insurance premiums, and less a reasonable allowance for use of the product prior to its
return, In no event will tho dealer, John Deere or any company affiliated with John Deere be liable for any incidental or consequential damages,
including but not limlled to loss of prolils. rental of substitute equipmenl or other commercialloss, Correction ot defects In the manner provided above
shall constituto fulfillment of allliabililies of the Dealer. John Deere. or any company afOliated with John Deere to the purchaser or any olher person.
whether based upon contract, tort, strict liability, or otherwlso. This limitation does not apply to claims for personal injury.
D. ITEMS COVERED SEPARA TEt Y -
1. Stimdar<l Warranty does not apply to balleries. radios. tires. or to Cummins Engines installed in John Deere producls. which are covered by
separate wrillen warranties,
2. Factory. Installed Undercarriage Warranty covers all non-rubberized factory-installed undercarriage wear components for 3 years or 4.000
hours, whichever occurs first. Factory-Installed Undercarriage Warranty does not cover: tailures due to wear. machine application. maintenance
praclices, or improper machine configuration; removal and installation labor: transportation or hauling costs: unapproved parts: non-wear items;
and rubberized undercarriage components such as rubber tracks, Warranty claims will be pro-rated based upon wear of the failed componenl
and whether track shoe width is approved by John Deere. Factory-Installed Undercarriage Warranty does not apply to ScraperTraclors.
3, StruclurALL Wan anty for new John Deer& Products (Compact Excavators &Loaders, Skid-Steer loaders. Scraper Tractors, Pull-Type
Scmpers. and Forestry Allachments are not eligible for StructurAll Warranty) begins al the end of Ihe Equipmenl's Standard Warranty and any
Extended Warranty purchased for the Equipment and applicable to StructurAll components, and ends (unless terminated earlier under
Section F, betow) three (3) years, or10.000 hours (whichever occurs first) after the Equipment's original retail purChase or first rental prior to the
first retail purchase. StructurAlL Warranty applies only to the follOWing structural components listed bolow as Installed on tile product
at the time of original manufacture. Ifa particular component is not listed below it is not covered by StructurAll Warranty.
Arm. Articulation Joint (inc!. pins and bushings), Bin Frame. Boom. Car body, C-Frame'.CirCle Frame. Coupler (John Deere buill ONLY), Dipper stick,
Drall Frame, Engine Frame. Equipmenl Frame, Grapple Arch, Grapple Boom, loader Arm, loader Frame. Mainframe, Moldboard Lift Arms.
NeverGrease TM Pin Joints. Rollover Protection Structure (ROPS),Side Frame. Swing Frame,Track Frame, Undercarriage Frame. X-Frame, Z-bar.
Specially booms and arms marketed as "heavy-duly" by John Deere. StruelurAll Warranty does not apply to equipment used primarily in extreme duty
or severe duty applications such as but not limited to: demolillon and wrecking, chemical plant (Including fertilizer plants). salt mines. sleet mill, land fill
and transfer stalions. scrap handling. scarifying and other applications thaI are similarly destructive or similariy heavy duty except specialty booms and
arms as staled in Section 0.2. above. 'StructurAll warranty does not appty to C-Frames on H.Series & J-Series Crawlers equipped with root rakes or
used in forestry applicalions unless equipped with an "extreme duty" reinforcement package.
JD-S 17-01 Attachmonl A Version 1.0
EFFECTIVE (OjFEB09) U_S.A. ONt Y
Page 3 of 4
',.
E. ITEMS NOT COVERED -
John Deere is NOT responsible for the following:
1. Freigtlt
2. Diagnostic Timo
3. Addilionallabor Jime - Above SPG/labor Rate
4. Additional Cleaning - Above SPG/labor Rate
5. Rental r-ees
6. DepreCiation or damage caused by normal wear or application. lack of reasonable and proper maintenance. failure to follow operating
instructions. misuse. collision or other accidents.
7. Premiums charged for Overtirne labor
8. Transportalion to and from the dealership.
9. Travel time. mileage or service calls by the dealer.
10. Non-.lohn Deere components or modifications. Rotobecgrapples. referral aUachments.
11. Shop supplies and maintenance ilems such as. but not limited to: fillers. fuels. oil. hydraulic fluid. lubricants, coolants, conditioners. shop
lowels. cleaners and degreasers. Note: Reimbursement for refills of Oils/coolants lost due to a warrantable fallure Is covered when a system
failure occursllulside Ihe boundaries of a normal oil change (within 25% of specified change interval).
12. Wear ilems, such as. but not limited to: body liner, belts. blades. bulbs, lubricated joints (Including pins and bushings), dry brakes. brake
linings. dry c1ulch linings. saw blades, chains. skidder grapple shocks, color marking nozzles, articulation bumpers, and undercarriage
components.
13. Items such as cutting edge parts. bucket teelh and rubber track are not warranted for depreciation or damage caused by normal wear. lack of
proper maintenance. misuse, failure 10 follow operating instructions. the elements or accIdent.
14. Any defect in a non-covered component, or damage to or failure 'of a covered component caused bya defect in a non-covered component.
15. Used Products (except as otherwise provided in section A above).
F.UNAPPROVED SERVICE OR MODIFICATION.
John Deere' is relieved of its ohligatlons under Standard Warranty and/or StructurAlL Warranty If:
1 Service (othelthan normal maintenance and replacement of service Items) is performed by someoneotherthan an authorized John Deere
dealer; or
2. The product is modified or altered in ways not approved by John Deere; or
3. Any unapproved or improperly sized allachmentis installed on Ihe product.
G. PARTS REPLACED UNDER STANDARD WARRANTY AND/OR STRUCTURAllWARRANTY .
Only new or remanufactured parts or components, furnished or approved by John Deere, will be used If John Deere elects to repair the product. If any
SUcll pari or component is defectivo in material or workmanship when installed in the product; John Deere will repair or replace, as it elects, such
defective pari or component. provided Ihe defect is reported to an authorized John Deere dealer wilhln 90 days (12 months or 1500 hours. whichever
occurs first, for remanufactured components) after installation or before expiration of the applicable Standard Warranty or SlructurAll Warranty
whichevp.r is laler.
H. OBTAINING WARRANTY SERVICE .
To obtain warranty service. the purchaser must request warranty service from a John Deere dealer aulhorized to sell the product to be serviced. When
making such a request. the purchaser must present evidence of the product's delivery date. make the product available althe dealer's place of
business. and inform the dealer in what way the purchaser believes the producI to be defective. Standard Warranty or StructurAll Warranty repairs
may be made in the field if Ihe purchaser and servicing dealer so desire. However, John Deere will not be responsible for any charges (such as dealer
travel time. mileage or extra labor) that would not have been incurred had the product been repaired at the dealer's place of business.
I. NO IMPLIED WARRANTY OR OTHER REPRESENTATION _
Where permitted by law. neither John Deere nor any company affiliated with it makes any warranties. representations or promises. express or implied,
as to Ihe quality. performances. or freedom from defect of Its products. other than those sel forth on this page, and NO IMPLIED WARRANTY OF
MERCHANTIBllITY OR FITNESS IS MADE.
J. NO DEALER WARRANTY -
The selling dealer makes no warranty of his own on any item covered by this warranty, and makes no warr.anty on other Items unless he delivers 10 the
purchaser a separate wrillen warranty certificate specifically warranllng the Item. The dealer has no authority to make any representation or
promlso on bohalf of John Oooro, or to modify the torms or limitations of this warranty In any way.
JO-S 17.01 Attachmont A Version 1.0
EFFECTIVI= tn~!:t:RnQllllt 4 ny. v
n___ ~ _. ~
"
Federal and State Agency
Claim for Exemption of
State and Local SaleslUse Tax
Purchaser
Name: CALHOUN COUNTY
Address: 202 S ANN, PORT LA V ACA, TX 77979
10 Number (If Applicable): 74.- ftpe::o - 19 d- ~
Seller
Name: DEERE CREDIT, INC.
Address: 6400 NW 86TH ST JOHNSTON IA 50131
(c
,-,:!)
::'"!l
Description of Item Being Purchased:
U 10 6720 GRDR SN: DW672DX601167
J; .
By signing below, purchaser certifies that the items being purchased are exempt from state and local sales tax.
By: Cindy _Mueller, County Auditor, By:
Title: ~..Uh~_~c; . lSk O/.)<x:~t-. ())L.lc1~*a'\-l
. ~' .
Date: \ o\\tiJ.J';;)
Telephone Number:_~:3kL---5~~3 ~- _~L~J,.. _
L,.'YH-/ S~tik~"'if.~'."lt g h~n ::}~ Safr:~ 1.~tZO(}d,
P;)<J~:' ~}i
App 10997482