Contract - Magnum Custom Trailers - 10/14/2021JWA4GJV11A9'
0 410
SALES PARTS
QUOTE
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[] Austin - 10806 Hwy 620 N
512-258-4101 FAX 512-258-2701
Cj San Antonio -11210 IH35 N
210-599.2325 FAX 210-599-1220
0 Georgetown -1209 IH35 N
512-868-9900 FAX 512-869-7277
❑ San Marcos - 2601 IH35 S
512-392-6246 FAX 512-392-6247
SERVICE BuySoard #599-19
Quote # Salesman: Steve Date' 7122/2021
Customers Name: City of Round Rock Customer Email. r
Adress: City: Round Rock State: Texas Zip:
Phone: 512-218-3298 Celt 512-844-1248 Fax -
Year: 2021 Model; 20+5 Pintle Make: Magnum Serial #
Model or Part #
Descrii tlon
---
Q .
Price
Amount
20+5 Pintle
20+5x102 PinUe
4
$ 29,995.00
5 119 980.00
6 dovetail wtfli ver ramps
Pintle
2 1 OK axles with air brakes/
Hutch, 215175R 17.5 LR-H,
ABS on 1, Hub Meter
•'Trailer noted FOB our Austin Location"
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Sub Total $ 119,980.04
Less Trade
Trade ,Serial #
In IlAake:
Year: _
Color.
AttanVon By low the vehide may reWre brakes and/or other safety devices.
Wa assume no responsiWty it purchased without.
Quote Good for 5
Other Options Not Included:
Pricing subject to change due to surcharges
GVINR: . 25000 Nei Ca Em WT:
auo 1014111
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Tax
Days License
Tide Fee
Road & Bridge
Documentation
$ 320.00
Temp Tag Fee
$ 20.00
Freight
State Inspection
$ 58.00
Clean Air Fee
Service Parts Ticket
Mail Plate
Build Time 16 to 20 weeks estimated Total $ 120.378.00
Less [down Payment
Approved B
PMT CASH CHECK CC Balance Due $ 120,378.00
Any change order Mier the order has been placed will have a $75.00 fee applied.
DOWN PAYMENTS ON SPECIAL ORDERS ARE NON-REFUNDABLE
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-- CERTIFICATE OF INTERESTED PARTIES FORM 1295
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Complete Nos., 1- 4 and 6 if there are interested parties. OFFICE USE ONLY
Complete Nos.. 1, 2s 31 5, and 6 if there are no -interested parties,. CERTIFICATION OF FILING
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1 Name of business entity filing form, and the city, state and country of the business entity's place Certificate Number,
of business,. 2021-794465
Magnum Custom Trailer Mfg Co, Inc,.
Austin, TX United Stales Date Filed:
2 Name- of governmental entity or state agency that is a party to the contract for which the form is p8/24/2021
being filed.
City of Round Rock Date Acknowledged:
---------------- - ------------ ------ --- --- - ------- ----------- ---
- ----- - g 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.
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420+5 Pintle Magnum Trailers
N Nature of interest
4 Name of Interested Party City, State, Country (place of business) (check applicable)
MW Controlling,--- Intermediary
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5 Check only if there is NO Interested Party. ❑
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NOW ------------- --
6 UNSWORN DECLARATION
My name is v�.. „tiG �'1'�^1'iGC7�and my date of birth is
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4% yl )c ���'�Myaddress is10�0N,111111�1 --- - - - Real
(street) (city) (state) (zip code) (country)
I declare under penalty of perjury that the foregoing is true and correct.
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V 115 County, State ofon the ,*Aq day of Executed in
(month) (year)
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Signature of authorized agent of contracting business entity
(Declarant)
Forms provided by Texas - Ethics Commission --- --- - www.ethics.state.Uc.us s Version V1.1.191b5cdc
CERTIFICATE OF INTERESTED PARTIES FORM 1295
10fl
Complete Nos, 1 - 4 and s if there are interested parties. OFFICE USE ONLY
Complete Nos, 1, 2, 39 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. 2021=794465
Magnum Custom Trailer Mfg Co, Inc.
Austin, TX United States Date Filed:
2
Name of governmental entity or state agency that is a party to the contract for which the form is 08/24/2021
being filed.
City of Round Rock Date Acknowledged:
08/25/2021
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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.
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4m2O+5 Pintle Magnum Trailers
Nature of interest
4
Name of Interested PartyCity,State
Country of business)
a licable 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)
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 vl.l.lyluot;ac