Contract - Vermeer - PO Only - 1/12/2017 Texas- Louisiana
Ver eer
City of Round Rock
Emsud/Marshall
12-6-16
Buy Board Contract# 424-13
- - We are pleased to quote the following: - - - -
One New Vermeer HG4000 Tier IV
- PT Tech Wet Clutch
- T Wing Cutters
- 515 Fiat Engine Tier 4 Final
- 20ft In Feed
- Magnetic Feed Roller
- Abrasion Resistant Mill
- 2 Inch Screens
- Deluxe Silencer
- Cleated Viper Belt
- 1 Year or 1000 Hour Vermeer Limited Standard Warranty
Buy Board Price.............................................................$382,250.00
Freight and Prep...............................................................$15,500.00
Pintle Hitch Option............................................................$9,952.00
Mobark 1200 Tub Trade In value (in working condition)...............$24,000.00
Prices good for 45 days. The HG4000 is in stock at the factory and is subject to
availability.
Thank you for the chance to earn your business.
Brad Carrozza
Solution Specialist
Cell # 512-799-9070
Email bradc cr vermeertexas.com
An ESOP Company 100%
CERTIFICATE OF INTERESTED PARTIES FORM 1295
10f1
Complete Nos.l-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. 2016-144108
Vermeer Equipment of Texas, Inc
Round Rock,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 12/08/2016
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.
Vermeer HG4000
purchase of a new Vermeer HG4000 Tier IV with accessories
Nature of interest
4
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 AFFIDAVIT I swear,or affirm,under penalty of perjury,that the above disclosure is true and correct.
LLINDSEY
E.MORONYI9D k 12586O801October .27
Signatur6 of authorized agent of contracting business entity
AFFIX NOTARY STAMP/SEAL ABOVE '� TJ
Sworn to and subscribed before me,by the said `)Af t?.V� 1 W V1 this the _day of WVL
20-[,U,,to certify which,witness my hand and seal of office.
Sign ure of o er administering oath Printed name of officer administering oath I Title of officer administering oath
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277
CERTIFICATE OF INTERESTED PARTIES FORM 1295
1 of 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. 2016-144108
Vermeer Equipment of Texas, Inc
Round Rock,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 12/08/2016
being filed.
City of Round Rock Date Acknowledged:
12/28/2016
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.
Vermeer HG4000
purchase of a new Vermeer HG4000 Tier IV with accessories
Nature of interest
4
Name of Interested Party City,State,Country(place of business) (check applicable)
Controlling I Intermediary
5 Check only if there is NO Interested Party.
X
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 V1.02,