Contract - Freightliner of Austin - 12/6/2018 . . ? ?DISCO'
. FREIGHTLINER OF AUSTIN
3701 Smith Rd.(Hwy.293 So.) Bus.512.389.0000
}/JAustin.To4s�.7.8�721 FAX:512.389-2853 INV.
f�LI CY(^•P �•l�()tt�r.t ! 1 r.: T\�L� ��f.�lf F.! VIOLS:i:800.395.2005 Dnl1-8-1E
PITY OF ROUND ROCK -� 512-218-5571
Im CITY STATE ZIP CODE
,21 E.MAIN ST ROUND ROCK 1X 178664
/Ve Hereby Purctiese from You,under the Terme ano Conditions Speclitea,the Fd=ng:
y r
2020 I FREIGHTLINER M2106 ORDER
A documentary fee Is not an official fee,a documentary fee miLuze
(s not required by law but may be charged to buyers for
handling documents and performing services relating to the
the closing of a sale.Buyers may avoid payment of the fee
to the seller by handling the documents and perbrming the
services relating to the closing of the sale.A dacumentary RICE
to may not exceed$50,00.This notice is requl red by law. 15'OX 14 YD DUMPY VATH ELETRIC TAIM17, .00
El cobra documental no es un cobra orldel. El cot m (2)STORBE LIGHTS RECESSED IN THE CAB PROTECTOR
documental no es un requlslto Wc)la ley,Peru se le puede
cobrar.Al compradorpar el rendlmlento de los serviclos ( )
relacJonados con la completaclon de Is vents y pw
compleiarias documentos.E7 compmdor puede evitarel
pago al vendedor de este costo sl el comprador mismo se
enearga de mande)ar las documenzos y de los serviclos
nemsados para fa completacion de la venta.Ef cobro
documental no puede sabrepasar los$50.00(U.S.) Este
avlso es requerldo Wo is ley.
tsc a mer ot werrainigs
Any warranties on the products sold hereby are those made by
the factory.The Seller,Frelghtgner of Austin, hereby
expressly dlsctalms all warranties,either expressed or implied
Including any Implied warranty of march antabllltyorfitness
=qt Ca particular purpose,and FralghUlner of Austin,neither
Issumes not authorizes any other person to assume for It any
;lability in connection with the sale of this vehicle.
CUSTOMER SIGNATURE
SALESMAN SIGNATURE KEVIN KRIEG
COSTAACTUAL COCLOSU11 E VIAM ENT FOA USED VEHICLE ONLY.-nee InfermmuM Pau see on the*l 0ory folm Ida tbb vehft b port of 11th tanlraM Infamelhe on ITu pdrl00rr farts 91 1"1106
and contrary Oroveben le the oorareet Of 11111.
VEM WME MODEVOODY Vifl LICENSE
TEM d1AFlE hIDDEL/eoDT VIN LICENSE PLATE
TOTAL 104,902.00
PAYOFF TO: Trade Allowance N/A
ADDRESS: Trading Difference N/A
TELEPHONE: /FAX Sales Tex N/A
GOOD UNTIL* Vehicle Inventory Tax N/A
QUOTED BY:
License Fes fV/q
SHOW LIEN TO: Body Type: Documentary Fee N/A
ADDRESS: License WG Federal Excise Tex N/A
Stats Insp.: TOTAL SALE PRICE 104,902,00
DATED: LIEN AMOUNT$ Ucan30: Payoff on Trade
DRAFT FOR$ T11.1o: Ext.service Agreement
DRAFT THRU; Transfer: Leas Deposit
IR Total Balance Due 104,9
02.00
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12-2v� ,- ���-
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
I Name of business entity filing form,and the city,state and country of the business entity's place lCertificate Number:
Of business. 2018-426534
Freightliner of Austin
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 11/16/2018
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.
BuyBoard 521-16
Dump Truck
4 Nature of interest
Name of Interested Party City,State,Country(place of business) (check applicable)
Controlling intermediary
Hempel,Carlton Austin,TX United States X
5 Check only if there is NO Interested Party. ❑
6 UNSWORN DECLARATION
My name is
and my date of birth is
/7c, '7 ot
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 /7-e—Z4--S on the�day of 20
(month) (year)
Signature of autba�friz�ed agent of contr fling business entity
(Declarant)
Forms provided by Texas Ethics Commission www.ethics.state.tx,us Version V1.0.6711
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. 2018-426534
Freightliner of Austin
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 11/16/2018
being filed.
City of Round Rock Date Acknowledged:
11/21/2018
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.
BuyBoard 521-16
Dump Truck
4
Nature of interest
Name of Interested Party City,State,Country(place of business) (check applicable)
Controlling Intermediary
Hempel, Carlton Austin,TX United States X
5 Check only if there is NO Interested Party. ❑
6 UNSWORN DECLARATION
My name is and my date of birth is
My address is
(street) (city) (state) (zip code) (country)
1 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 V1.0.6711