Contract - Mity-Lite - 2/28/2019 QUOTE ACKNOWLEDGEMENT
MSales Quote Number: 63366
M TY Mityl-ite Customer Number: 670945
INVOICE TO SHIP TO
City of Round Rock Round Rock Express
221 E. Main Street 3400 E. Palm Valley BLVD
ROUND ROCK,TX 78664 ROUND ROCK,TX 78664
US US
Attn: Accounts Payable Attn:Scott Allen
QUOTE DATE SALESPERSON PAYMENTTERMS
6/1/2018 Jeremy Spencer NET30
ITEM NUMBER DESCRIPTION QTY UNIT PRICE TOTAL PRICE
6'x 8' Mobile Staging, 16" -24" height 6 $1,932.94 $11,597.64
16"-24"Stair for Staging 2 $397.00 $794.00
8'Stage Skirting 6 $130.00 $780.00
6'Stage Skirting 6 $99.00 $594.00
60"ABS Round Tables 35 $231.94 $8,117.90
Part Number CT60BGB1
MAG20X20STLSV2 MG2 25STL 58ER2 8ER3 4CR 2CA 1 $16,650.00 $16,650.00
Includes: 25 Panels 16 Edges 4 Corners 1 Transport
Carts
Encore Series 350 $115.26 $40,341.00
Square Open Flex Back Stack Bar Winslow Jet Fabric
Tungsten Sand Frame
CRTXPTR3810 ROUNDTABLE CART 38" WIDE, 10 CAPACITY 4 $614.19 $2,456.76
CRTXPCPI XPRESSLINK CHAIR CART 4 $508.43 $2,033.72
30"x CABS Table 30 $167.72 $5,031.60
Part Number RT3072BGB1
CRTXPTS58 XPRESSPORT SLANT TABLE CART, HOLDS ANY 3 $604.46 $1,813.38
RECTANGULAR FOLDING LEG TABLE, CAPACITY VARIES
W TABLE SIZE
SUBTOTAL $90,210.00.90,210.00
FREIGHT AMOUNT $4,363.66
SALES TAX $0.00
QUOTE TOTAL(USD) $94,573.66
Quote Notes: BuyBoard Contract#503-16 Tables,chairs&carts 53' Contract $3572.80 Orem Staging$790.86 MI
DELIVERY IS DOCK-TO-DOCK CONTACT ME IF DELIVERY ASSISTANCE IS REQUIRED PLEASE PROVIDE
TAX EXEMPT FORM THANK YOU FOR CHOOSING MITYLITE!
Page 1 of 2
Signature Date
*A 50%prepayment is required for all custom products.Lead time is measured from receipt of prepayment.
For internal use
Quote:QUO-63366-F7Y8V7 Mityl-ite,Inc. 1301 W 400 N,Orem, UT 84057, US
Manufacturer's Rep:None Phone 801-224-0589 Fax 801-224-6191
Page 2 of 2
CERTIFICATE OF INTERESTED PARTIES FORM 1295
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.
MityLite 2019-449123
Orem,UT United States Date Filed:
2 Name of governmental entity or state agency that is a party to the contract for which the form is 02/05/2019
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.
503-16
Meeting&Event Room Furniture
4 Nature of interest
Name of Interested Party City,State,Country(place of business) (check applicable)
Controlling Intermediary
5 Check only if there is NO Interested Party.
X
6 UNSWORN DECLARATION
My name is C/I'u.f G^I and my date of birth ist—
My address is,i L A) , (�y p ,L �• ..� �r D yf3 S
(street) (city) (state)
(zip code) (country)
I declare under penalty
/ofperjury that the foregoing is true and correct.
Executed in County, State ofy�'t ""k 0 - rr
,on the day of 20
/1i (month) (year)
`� sj
Signature of authorizegent of contracting business entity
( eclarant)
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.1.28ab6150
CERTIFICATE OF INTERESTED PARTIES
FORM 1295
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. 2019-449123
MityLite
Orem, UT United States Date Filed:
2 Name of governmental entity or state agency that is a party to the contract for which the form is 02/05/2019
being filed.
City of Round Rock Date Acknowledged:
02/28/2019
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.
503-16
Meeting&Event Room Furniture
4 Nature of interest
Name of Interested Party City,State,Country(place of business) (check applicable)
Controlling Intermediary
5 Check only if there is NO Interested Party. ❑
X
6 UNSWORN DECLARATION
My name is and my date of birth is
My address is
(street) (city) (state) (zip code) (country)
I declare under penalty of perjury that the foregoing is true and correct.
Executed in County, State of on the day of ,20
(month) (year)
Signature of authorized agent of contracting business entity
(Declarant)
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.1.28ab6150