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Contract - Axon - 7/13/2017
Axon Enterprise, Inc. Protect Life. lgk� 17800 N 85th St. Scottsdale,Arizona 85255 United States AXON Phone:(800)978-2737 Tax:+14809910791 i Damaris Morales (512)671-2836 Quotation Quote: Q-122053-2 Date:6/22/2017 11:35 Alii Quote Expiration: 8/31/2017 Contract Start Date*:7/28/2017 Contract Term:5 years AX Account Number: 107982 Bill To: Ship To: Round Rock Police Dept.-TX Damaris Morales 221 E.Main Street Round Rock Police Dept.-TX ROUND ROCK,TX 78664 2701 N.MAYS ST. US ROUND ROCK,TX 78665 US SALESPERSON PHONE ENTAIL DELIVERY METHOD PAYMENT METHOD Elliott Kelly +l 5127123580 ekcllyQtaser.com Fedex-Ground Net 30 "Note this will vary based an the shipment date of the product. Year I Due Net 30 QTY ITEM# DESCRIPTION UNIT TOTAL BEFORE DISCOUNT(S) NET TOTAL PRICE DISCOUNT 1 22013 KIT,DATAPORT DOWNLOAD,USB,X2/ USD 176.49 USD 176.49 USD 0.00 USD 176.49 X26P 41 11002 HANDLE,BLACK,CLASS III,X26P USD 964.05 USD 39,526.05 USD 0.00 USD 39,526.05 41 85058 TASER ASSURANCE PLAN CEW,X26P USD 0.00 USD 0.00 USD 0.00 USD 0.00 41 85059 TASER ASSURANCE PLAN CEW USD 197.22 USD 8,086.02 USD 0.00 USD 8,086.02 ANNUAL PAYMENT,X26P 37 11501 HOLSTER,BLACKHAWK,RIGHT,X26P USD 57.04 USD 2,110.48 USD 0.00 USD 2,110.48 4 11504 HOLSTER,BLACKHAWK,LEFT,X26P USD 57.04 USD 228,16 USD 0.00 USD 228.16 41 22012 TPPM,BATTERY PACK,TACTICAL, USD 58.38 USD 2,393.58 USD 0.00 USD 2,393.58 PINKY EXTENDER,X2/X26P 10 85058 TASER ASSURANCE PLAN CEW,X26P USD 0.00 USD 0.00 USD 0.00 USD 0.00 10 85059 TASER ASSURANCE PLAN CEW USD 197.22 USD 1,972.20 USD 0.00 USD 1,972.20 ANNUAL PAYMENT,X26P Year 1 Total Before Discounts: USD 54,492.98 Year i Net Amount Due: USD 54,492.98 Page I of 3 Spares QTY ITEM# DESCRIPTION UNIT TOTAL BEFORE DISCOUNT(S) NET TOTAL PRICE DISCOUNT 1 11002 HANDLE,BLACK,CLASS III,X26P USD 964.05 USD 964.05 USD 964.05 USD 0.00 1 85058 TASER ASSURANCE PLAN CEW,X26P USD 0.00 USD 0.00 USD 0.00 USD 0.00 1 22012 IT M,BATTERY PACK,TACTICAL, USD 58.38 USD 58.38 USD 5838 USD 0.00 PINKY EXTENDER(,X2/X26P Spares Total Before Discounts: USD 1,022.43 Spares Discount; USD 1,022.43 Spares Net Amount Due: USD 0.00 ,I Yeer 2 4 ! QTY ITEM# DESCRIPTION UNIT TOTAL BEFORE DISCOUNT(S) NET TOTAL PRICE DISCOUNT 10 85059 TASER ASSURANCE PLAN CBW USD 197.22 USD 1,972.20 USD 0.00 USD 1,972.20 ANNUAL PAYMENT,X26P 3 41 $5059 TASER ASSURANCE PLAN CEW USD 197.22 USD 8,086.02 USD 0.00 USD 8,086.02 ANNUAL PAYMENT,X26P Year 2 Total Before Discounts: USD 10,058.22 i Year 2 Net Amount Due: USD 10,05822 Year 3 QTY ITEM# DESCRIPTION UNIT TOTAL BEFORE DISCOUNT(S) NET TOTAL PRICE DISCOUNT 10 85059 TASER ASSURANCE PLAN CEW USD 197.22 USD 1,972.20 USD 0.00 USD 1,972.20 ANNUAL PAYMENT,X26P 1 41 85059 TASER ASSURANCE PLAN CEW USD 197.22 USD 8,086.02 USD 0.00 USD 8,086.02 I ANNUAL PAYMENT,X26P i Year 3 Total Before Discounts: USD 10,058.22 Year 3 Net Amount Due: USD 10,058.22 Year 4 QTY ITEM# DESCRIPTION UNIT TOTAL BEFORE DISCOUNT(S) NET TOTAL PRICE DISCOUNT 10 85059 TASER ASSURANCE PLAN CEW USD 197.22 USD 1,972.20 USD 0.00 USD 1,972.20 ANNUAL PAYMENT,X26P 41 85059 TASER ASSURANCE PLAN CEW USD 197.22 USD 8,086.02 USD 0.00 USD 8,086.02 ANNUAL PAYMENT,X26P ( Year 4 Total Before Discounts: USD 10,058.22 Year 4 Net Amount Due: USD 10,058.22 Year 5 QTY ITEM# DESCRIPTION UNIT TOTAL BEFORE DISCOUNT(S) NET TOTAL PRICE DISCOUNT e F 10 85059 TASER ASSURANCE PLAN CBW USD 197.22 USD 1,972.20 USD 0.00 USD 1,972.20 ANNUAL PAYMENT,X26P 41 85059 TASER ASSURANCE PLAN CSW USD 197.22 USD 8,086.42 USD 0.00 USD 8,086.02 ANNUAL PAYMENT,X2611 4 1 Year 5 Total Before Discounts: USD 10,058.22 Year 5 Net Amount Due: USD 10,058.22 Page 2 of 3 Subtotal USD 94,725.86 Estimated Shipping&Handling Cost USD 533.22 Grand Total USD 95,259.08 This quote is for 41 new X26P CEWs covered under the Tascr Assurance Plan.This quote also includes 10 extra TAP payments to cover the CEWs purchased on quote Q-97772 in February 2017. Axon Enterprise,Inc.'s Sales Terms and Conditions for Direct Sales to End User Purchasers By signing this Quote,you are entering into a contract and you certify that you have read and agree to the provisions set forth in this Quote and Axon's Master Services and Purchasing Agreement posted atvw.exon.cotr►/!a al.You represent that you are lawfully able to enter into contracts and if you are entering into this agreement for an entity,such as the company,municipality,or government agency you work for,you represent to Axon that you have legal authority to bind that entity.If you do not have this authority,do not sign this Quote. Signature: Date: Name(Print): Title: PO#(if needed): Quote:Q-122053-2 Please sign and email to Elliott Kelly at ckcily@taser.com or fax to+14809910791 THANK YOU FOR YOUR BUSINESSI 'Protect LifeV and TASER®are registered trademarks of Axon Enterprise,Inc,registered in the U.S. ©2013 Axon Enterprise,Inc.All rights reserved. i Page 3 of3 CERTIFICATE OF INTERESTED PARTIES FORM 1295 10f 1 Complete Nos.1-4 and 6 if there are interested parties. OFFICE USE ONLY Complete Nos.1,2,3,5,and 6 if there are no interested parties. CERTIFICATION OF FILING 1 Name of business entity filing form,and the city,state and country of the business entity's place Certificate Number: of business. 2017-230953 Axon Enterprise, Inc. Scottsdale,AZ United States Date Filed: 2 Name of governmental entity or state agency that is a party to the contract for which the form Is 06/29/2017 being filed. City of Round Rock Date Acknowledged: 3 Provide the identification number used by the governmental entity or state agency to track or identify the contract,and provide a description of the services,goods,or other property to be provided under the contract. Q-122053-2 Taser and accessories a Nature of interest Name of Interested Party City,State,Country(place of business) (check applicable) Controlling Intermediary Taylor,Bret Scottsdale,AZ United States X Partovi,Hadi Scottsdale,AZ United States X Martz,Judy Scottsdale,AZ United States X Kroll, Mark Scottsdale,AZ United States X Carmona, Richard Scottsdale,AZ United States X McGrady,Matthew Scottsdale,AZ United States X Garnreiter,Michael Scottsdale,AZ United States X Smith, Patrick Scottsdale,AZ United States X 5 Check only if there is NO Interested Party. 6 AFFIDAVIT I swear,or affirm,under penalty of perjury,that the above disclosure is true and correct. CAITLIN M MORGAN Notary Pubilc,Stete of Arizona .i Marlcopa County - (J My Commission Expires September 19, 2020 0 04 'WI-11Signature of authorized agent of contracting business entity AFFIX NOTARY STAMP 1 SEAL ABOVE Sworn to and subscribed before me,by the said � �� Cj ,this the day of,�A1� 4 2Q in __,to certify which,witness my hand and seal of office. M tl Signature of officer aftinisteriAg oath Printed name of officer administers ath Title of officer administering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.883 CERTIFICATE OF INTERESTED PARTIES FORM 3.295 10f1 Complete Nos.1-4 and 6 if there are interested parties. OFFICE USE ONLY Complete Nos.1,2,3,5,and 6 if there are no interested parties. CERTIFICATION OF FILING 1 Name of business entity filing form,and the city,state and country of the business entity's place Certificate Number: of business. 2017-230953 Axon Enterprise, Inc. Scottsdale,AZ United States Date Filed: 2 Name of governmental entity or state agency that is a party to the contract for which the form is 06/29/2017 being filed. City of Round Rock Date Acknowledged: 06/30/2017 3 Provide the identification number used by the governmental entity or state agency to track or identify the contract,and provide a description of the services,goods,or other property to be provided under the contract. Q-122053-2 Taser and accessories 4 Nature of interest Name of Interested Party City,State,Country(place of business) (check applicable) Controlling Intermediary Taylor, Bret Scottsdale,AZ United States X Partovi, Hadi Scottsdale,AZ United States X Martz,Judy Scottsdale,AZ United States X Kroll, Mark Scottsdale,AZ United States X Carmona, Richard Scottsdale,AZ United States X McGrady, Matthew Scottsdale,AZ United States X Garnreiter, Michael Scottsdale,AZ United States X Smith, Patrick Scottsdale,AZ United States X 5 Check only if there is NO Interested Party. ❑ 6 AFFIDAVIT I swear,or affirm,under penalty of perjury,that the above disclosure is true and correct. Signature of authorized agent of contracting business entity AFFIX NOTARY STAMP/SEAL ABOVE Sworn to and subscribed before me,by the said this the day of 20 ,to certify which,witness my hand and seal of office. Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.883