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RES 2011-0321 - Bid from Deffenbaugh Industries Inc OF QMAHA.IyE� Parks, Recreation & 's Public Property Department y.I U 'f RECEIVED Omaha/Douglas Civic Center l ^ I I > R I I PH 3 1819 Farnam Street,Suite 701 I; �..�� ro Omaha,Nebraska 68183-0701 o (402)444-5900 ^TED 1-0,0' CITY Y C L_R N FAX(402)444-4921 City of Omaha O M A H A, N E B R A S K A Melinda Pearson Jim Suttle,Mayor Director Honorable President and Members of the City Council, Transmitted herewith is a BID TABULATION and a RESOLUTION authorizin*the Purchasing Agent to issue a Purchase Order to Deffenbaugh Industries, Inc., 5902 North 16t Street, Omaha, NE, to furnish portable chemical restroom service for Park Maintenance for the 2011 park season for the Parks, Recreation and Public Property Department. The following bids were received on February 9, 2011: VENDOR BID DEFFENBAUGH INDUSTRIES, INC. $26,141.00 (LOWEST BID) Eagle $26,736.00 The contractor has on file a current Annual Contract Compliance Report Form (CC-1). As is City policy, the Human Rights & Relations Director will review the contractor to ensure compliance. The Parks, Recreation and Public Property Department recommends the acceptance of the bid from Deffenbaugh Industries, Inc., in the total amount of$26,141.00, for the portable chemical restroom service as being the lowest bid received, and requests your consideration and approval of this Resolution. The Finance Department is authorized to pay for the portable chemical restroom service from the General Fund No. 11111 and Organization No. 115024, Parks and Community Centers. Respectfully submitted, Approved: r - ic. .31..7 I ,41,4K , 11101 Melinda Pearson, Director Date Human Rights and Relations Date Parks, Recreation and Public Property Department TION SHEET f language usage. Two copies of literature showing analysis and details of offering to accompany the bid. Also a sample of product. Deliver to Levi Carter Lake Butler Building, 1008 Grand Avenue. 40 bags per pallet. It is the bidder's responsibility to make sure his carrier has the material at the City storage area before 9:00 a.m. on the delivery date if help is needed for unloading. Notice of delivery is mandatory. Please contact Bill Anderson at(402)699-1704, 48 hours prior to any anticipated deliveries. NOTE: All bagged material must be delivered palletized and shrink wrapped, 40 bags per pallet. SIGN ALL COPIES Firm By Title CONTINUATION SHEET ed sulfur coated urea. BID/bag: $ $ SIGN ALL COPIES Firm By Title CONTINUATION SHEET ond(negotiable)are acceptable substitutes for bond requirements. All bidders awarded a contract in the amount of$5,000 or more must comply with the Contract Compliance Ordinance and have on file with the Human Rights& Relations Department the Contract Compliance Report(Form CC-1). This report shall be in effect for 24 months from the date received by the Human Rights& Relations Department. Any questions regarding the Contract Compliance Ordinance should be directed to the Human Rights&Relations Department at(402)444- 5055. (PLEASE PRINT LEGIBLY OR TYPE) Payment Terms % Firm: Incorporated In: Delivery(or completion) Name: Signature: calendar days following award Title: Phone: Fax: Address: Street/P.O.Box City State Zip Email Address: .. 1,::' G`"`i"� .a'd%:r'.irry11.1i,:. s161 y w'^aa..e.y1 s-�•�r.a"�. . �r t {,�c, a ,.i 'f,+',.S:w^rZrJ''.AsT ic.�''i,;F:15 Oas?-3.,rJq c'c{' t x -Y- as•• o t gi .. cy ,n�... T;a ¢ . � .•t<u^s'�:4r'T"�, ':a'€`` t�" r�e�S4'f"rs '':',�f3s;•''::�'�5�`".,� 2�'`•� ..k�..r�' • Dark Blue Pearl Metallic DX • 'jt•y.-.:a� Y-y r�-,'.Y.-nl:: :f F:-'c.41:•Y" v,.�,, -L� ,C�'Z. ..3•,:;'S`;-w�-� v'F>5,.+;G _ .:�"., L:^:>hc..c`f...(.i ._v ,d1,. rE '.t:�- o-.,t,r':s::-tt F : n. _'BE 'jr :.:;'t r�,�.S., r ✓f y .( s.: �s;'Y1 • �. ..LLY .�'��.•. 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Nn 1 • • • • • • • • • • • • • • • • • • • • **New for this model year • • •=Available • • -16- - Ford Division . . • . .. . . - . n reviewed with me by the selling dealer and will be given to me upon delivery of the product. • YES/NO The correct operator's manual has been given to me.YES/NO • The selling dealer explained safety precautions to me.YES/NO The selling dealer explained safety features of the product to me.YES/NO The selling dealer explained the warranty terms and coverage to me.YES/NO . The answers circled above are correct.I acknowledge that I have read and I accept thls.warranty policy statement Model- Product identification number Operator's manual form number- Customer name(Please Print)- Purchaser Address Dealer Name City,Slate,Zip City,State,Zip • Purchaser . . Signature Date Dealer' . Signature • Date• • Mail original signed cony to 360 Services Inc.12623 Newburgh Road.Livonia.MI 48150.USA Page -2- Honorable President And Members of the City Council Approved as to Funding: Referred to City Council for Consideration: • /1 l ,2ol Pam Spaccarotella, Director Date Ma is ffice/Title Date Finance Department �o1 �/ 3' p:1395tmb r ,__, g R. r p rj9 g. 4 a. �- 'Oro a: CD A) CD 1. f l t .y ..#.' .e. Ai •(• • A .t.t.\ k,, . v., . , . , . . _. __ , ..\, , ' l ruck Page 16 of 16 ,. 26(11) - 22- Control No. 22325 "Q" Street Bridge, 26th—27th Streets Preliminary Engineering, NEPA Documentation and Final Design Services lerk Approved... OF,.. Mayor • PRPP/Parks MEMO TO: There s FROM: tch Park Maintenance Manager DATE: February 14, 2011 SUBJECT: Council Documents for Deffenbaugh Industries, Inc Attached please find one copy of the requisition, and one copy of the bid sheet and bid tabs, for the portable restroom service for Park Maintenance for 2011. Deffenbaugh Industries, Inc. was the lowest bidder for this contract. Please prepare the necessary documents for signing and submittal to the City Council. Bidder: Deffenbaugh Industries, Inc. Contact: Cynthia Bryant 5902 N 16th Street Omaha, NE 68110 (402) 731-3333 Contract Amount approximately: $26,141.00 This contract will be paid from the general fund. Funding: Fund: 11111, General Fund Organization: 115024, Parks and Community Centers ,�,�J 4,1 Expense: 42239, Professional fees - other �`'`1 !U Description: Portable Restroom Service for Park Maintenance. 1my loi (, 5:\COMMON\D005\deffenbaugh02.14.2011.doc e $26,736.00 The contractor has on file a current Annual Contract Compliance Report Form (CC-1). As is City policy, the Human Rights & Relations Director will review the contractor to ensure compliance. The Parks, Recreation and Public Property Department recommends the acceptance of the bid from Deffenbaugh Industries, Inc., in the total amount of$26,141.00, for the portable chemical restroom service as being the lowest bid received, and requests your consideration and approval of this Resolution. The Finance Department is authorized to pay for the portable chemical restroom service from the General Fund No. 11111 and Organization No. 115024, Parks and Community Centers. Respectfully submitted, Approved: r - ic. .31..7 I ,41,4K , 11101 Melinda Pearson, Director Date Human Rights and Relations Date Parks, Recreation and Public Property Department TION SHEET f language usage. Two copies of literature showing analysis and details of offering to accompany the bid. Also a sample of product. Deliver to Levi Carter Lake Butler Building, 1008 Grand Avenue. 40 bags per pallet. It is the bidder's responsibility to make sure his carrier has the material at the City storage area before 9:00 a.m. on the delivery date if help is needed for unloading. Notice of delivery is mandatory. Please contact Bill Anderson at(402)699-1704, 48 hours prior to any anticipated deliveries. NOTE: All bagged material must be delivered palletized and shrink wrapped, 40 bags per pallet. SIGN ALL COPIES Firm By Title CONTINUATION SHEET ed sulfur coated urea. BID/bag: $ $ SIGN ALL COPIES Firm By Title CONTINUATION SHEET ond(negotiable)are acceptable substitutes for bond requirements. All bidders awarded a contract in the amount of$5,000 or more must comply with the Contract Compliance Ordinance and have on file with the Human Rights& Relations Department the Contract Compliance Report(Form CC-1). This report shall be in effect for 24 months from the date received by the Human Rights& Relations Department. Any questions regarding the Contract Compliance Ordinance should be directed to the Human Rights&Relations Department at(402)444- 5055. (PLEASE PRINT LEGIBLY OR TYPE) Payment Terms % Firm: Incorporated In: Delivery(or completion) Name: Signature: calendar days following award Title: Phone: Fax: Address: Street/P.O.Box City State Zip Email Address: .. 1,::' G`"`i"� .a'd%:r'.irry11.1i,:. s161 y w'^aa..e.y1 s-�•�r.a"�. . �r t {,�c, a ,.i 'f,+',.S:w^rZrJ''.AsT ic.�''i,;F:15 Oas?-3.,rJq c'c{' t x -Y- as•• o t gi .. cy ,n�... T;a ¢ . � .•t<u^s'�:4r'T"�, ':a'€`` t�" r�e�S4'f"rs '':',�f3s;•''::�'�5�`".,� 2�'`•� ..k�..r�' • Dark Blue Pearl Metallic DX • 'jt•y.-.:a� Y-y r�-,'.Y.-nl:: :f F:-'c.41:•Y" v,.�,, -L� ,C�'Z. ..3•,:;'S`;-w�-� v'F>5,.+;G _ .:�"., L:^:>hc..c`f...(.i ._v ,d1,. rE '.t:�- o-.,t,r':s::-tt F : n. _'BE 'jr :.:;'t r�,�.S., r ✓f y .( s.: �s;'Y1 • �. ..LLY .�'��.•. 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Nn 1 • • • • • • • • • • • • • • • • • • • • **New for this model year • • •=Available • • -16- - Ford Division . . • . .. . . - . n reviewed with me by the selling dealer and will be given to me upon delivery of the product. • YES/NO The correct operator's manual has been given to me.YES/NO • The selling dealer explained safety precautions to me.YES/NO The selling dealer explained safety features of the product to me.YES/NO The selling dealer explained the warranty terms and coverage to me.YES/NO . The answers circled above are correct.I acknowledge that I have read and I accept thls.warranty policy statement Model- Product identification number Operator's manual form number- Customer name(Please Print)- Purchaser Address Dealer Name City,Slate,Zip City,State,Zip • Purchaser . . Signature Date Dealer' . Signature • Date• • Mail original signed cony to 360 Services Inc.12623 Newburgh Road.Livonia.MI 48150.USA 1- WI I 1 I I ! 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All bidders awarded a contract in the amount of$5,000 or more must comply with the Contract Compliance Ordinance and have on file with the Human Rights& Relations Department the Contract Compliance Report(Form CC-1). This report shall be in effect for 24 months from the date received by the Human Rights& Relations Department. Any questions regarding the Contract Compliance Ordinance should be directed to the Human Rights&Relations Department at(402)444- 5055. (PLEASE PRINT LEGIBLY OR TYPE) Payment Terms % Firm: Incorporated In: Delivery(or completion) Name: Signature: calendar days following award Title: Phone: Fax: Address: Street/P.O.Box City State Zip Email Address: .. 1,::' G`"`i"� .a'd%:r'.irry11.1i,:. s161 y w'^aa..e.y1 s-�•�r.a"�. . �r t {,�c, a ,.i 'f,+',.S:w^rZrJ''.AsT ic.�''i,;F:15 Oas?-3.,rJq c'c{' t x -Y- as•• o t gi .. cy ,n�... T;a ¢ . � .•t<u^s'�:4r'T"�, ':a'€`` t�" r�e�S4'f"rs '':',�f3s;•''::�'�5�`".,� 2�'`•� ..k�..r�' • Dark Blue Pearl Metallic DX • 'jt•y.-.:a� Y-y r�-,'.Y.-nl:: :f F:-'c.41:•Y" v,.�,, -L� ,C�'Z. ..3•,:;'S`;-w�-� v'F>5,.+;G _ .:�"., L:^:>hc..c`f...(.i ._v ,d1,. rE '.t:�- o-.,t,r':s::-tt F : n. _'BE 'jr :.:;'t r�,�.S., r ✓f y .( s.: �s;'Y1 • �. ..LLY .�'��.•. F,h.n•4t.�.-.r..,...:li'1?�'.;,.;,.,.,.�.....•..,,:v,iu;;sctiikl::.._.:V.•'t...,,.:.u.,..:tai:-:.,:.�..;::'rK�4:?�.wir?�^+.�<c5?r.,:ni:tT.w',;dtia-'a1'.'»:k�`>,^,:K,V-�.'r�.�.�t�ryre` •f`Fs�>r t'•'o`x�Jt:�:: •F• orest Green Metallic GG - ,.i.'-r�.""4.S y�'•r,.1N.'1 M1:f�', Tk^:.-:.`...'�'.:...�Y+n.. ..iG� <Cf:• y;S.::JJY rrr :c:'r� r :f' z'•�.4 .,(.:,. ,SI?'K -�s.' .t4'^'; ,i"+-:itE�i�;.. :.Q.. a�� 'UU6.7V1ete 1 G <7t=:: ..t.: ::s•. ,ci.; 'C�' -,k?•t3,: ..�a,^t": t.: .,. rC'L;��'Y... • *Tuxedo Black Metallic uti v`•= . ... .._ ._t...: . .... . :•Yj • • Royal Red Metallic UK •:. . ..: 1.L c+: a P•`i'�' t *Golden Bronze Metallic �. 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The answers circled above are correct.I acknowledge that I have read and I accept thls.warranty policy statement Model- Product identification number Operator's manual form number- Customer name(Please Print)- Purchaser Address Dealer Name City,Slate,Zip City,State,Zip • Purchaser . . Signature Date Dealer' . Signature • Date• • Mail original signed cony to 360 Services Inc.12623 Newburgh Road.Livonia.MI 48150.USA • I-- w • a I- w z Da I- III • a w a S O 8 I-Z U ,1 o 4 c..) C<1 N = a 0 CD y w a p O p • o H• V U o — CI_ I- S\ ? i a . V +L-' .L-. J t < O• .0 0 O O O I-- c O w O m E 3 O CO E N , E E 0 o N0 E -I cn > u) EJ to m ►5 I- E ,- Q co = E Q ui Q ca 0 — •s a Q r. v • a0 X ' Q- O x C = 0 0 Q3 !-' x NL = I_ CO , O +c CO ▪ Q Q 7 7 L ._ C E (O Q E N � CO Z c_ ,� 03 z � m L C t 1- - 0 a I0 O 115 -E Q. Cr) O O O. N LL O -.� C x 'C �- i j x L p 0 co d p p 0 cam 0 L ca . Q a _. • o <Y F, _ 0 m m a ra m c cn 5 m o a N u, w co 06IL J c E czy QQw E ZV IY, Q ct L Ls! 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All bidders awarded a contract in the amount of$5,000 or more must comply with the Contract Compliance Ordinance and have on file with the Human Rights& Relations Department the Contract Compliance Report(Form CC-1). This report shall be in effect for 24 months from the date received by the Human Rights& Relations Department. Any questions regarding the Contract Compliance Ordinance should be directed to the Human Rights&Relations Department at(402)444- 5055. (PLEASE PRINT LEGIBLY OR TYPE) Payment Terms % Firm: Incorporated In: Delivery(or completion) Name: Signature: calendar days following award Title: Phone: Fax: Address: Street/P.O.Box City State Zip Email Address: .. 1,::' G`"`i"� .a'd%:r'.irry11.1i,:. s161 y w'^aa..e.y1 s-�•�r.a"�. . �r t {,�c, a ,.i 'f,+',.S:w^rZrJ''.AsT ic.�''i,;F:15 Oas?-3.,rJq c'c{' t x -Y- as•• o t gi .. cy ,n�... T;a ¢ . � .•t<u^s'�:4r'T"�, ':a'€`` t�" r�e�S4'f"rs '':',�f3s;•''::�'�5�`".,� 2�'`•� ..k�..r�' • Dark Blue Pearl Metallic DX • 'jt•y.-.:a� Y-y r�-,'.Y.-nl:: :f F:-'c.41:•Y" v,.�,, -L� ,C�'Z. ..3•,:;'S`;-w�-� v'F>5,.+;G _ .:�"., L:^:>hc..c`f...(.i ._v ,d1,. rE '.t:�- o-.,t,r':s::-tt F : n. _'BE 'jr :.:;'t r�,�.S., r ✓f y .( s.: �s;'Y1 • �. ..LLY .�'��.•. F,h.n•4t.�.-.r..,...:li'1?�'.;,.;,.,.,.�.....•..,,:v,iu;;sctiikl::.._.:V.•'t...,,.:.u.,..:tai:-:.,:.�..;::'rK�4:?�.wir?�^+.�<c5?r.,:ni:tT.w',;dtia-'a1'.'»:k�`>,^,:K,V-�.'r�.�.�t�ryre` •f`Fs�>r t'•'o`x�Jt:�:: •F• orest Green Metallic GG - ,.i.'-r�.""4.S y�'•r,.1N.'1 M1:f�', Tk^:.-:.`...'�'.:...�Y+n.. ..iG� <Cf:• y;S.::JJY rrr :c:'r� r :f' z'•�.4 .,(.:,. ,SI?'K -�s.' .t4'^'; ,i"+-:itE�i�;.. :.Q.. a�� 'UU6.7V1ete 1 G <7t=:: ..t.: ::s•. ,ci.; 'C�' -,k?•t3,: ..�a,^t": t.: .,. rC'L;��'Y... • *Tuxedo Black Metallic uti v`•= . ... .._ ._t...: . .... . :•Yj • • Royal Red Metallic UK •:. . ..: 1.L c+: a P•`i'�' t *Golden Bronze Metallic �. 'A�� :+ .,. ...:...::-..f. Is:::is`:.,.k•.,:� i^4,-. .��u��.��.. ^:Pr'•'i'.R!•••. ..1�'•:t.v :-Tli. r'xI' K1i: ate::,' s'; .,;: .yYf�._ v _.u•'.'. t'F...r..,._:._,.rti�.f'ri+r,:r..1:x!_._...r�. .,.,..,_-,',i� %i<z,..r..,mc, x-.,.r'1gat• ° r• :�J.�s-<,.-+.:..}•=��` • • • • �G .� W�arS. Nn 1 • • • • • • • • • • • • • • • • • • • • **New for this model year • • •=Available • • -16- - Ford Division . . • . .. . . - . n reviewed with me by the selling dealer and will be given to me upon delivery of the product. • YES/NO The correct operator's manual has been given to me.YES/NO • The selling dealer explained safety precautions to me.YES/NO The selling dealer explained safety features of the product to me.YES/NO The selling dealer explained the warranty terms and coverage to me.YES/NO . The answers circled above are correct.I acknowledge that I have read and I accept thls.warranty policy statement Model- Product identification number Operator's manual form number- Customer name(Please Print)- Purchaser Address Dealer Name City,Slate,Zip City,State,Zip • Purchaser . . Signature Date Dealer' . Signature • Date• • Mail original signed cony to 360 Services Inc.12623 Newburgh Road.Livonia.MI 48150.USA w � r • � CL Z V D a 1- w z , ma w B v g 8 8 z �' 6 _A r f v...- y a 0 4:,\ I- Z V r' = P g Da Z m IT l.lx- tp v .'6 u p v p n « 00 m t o mom om E r) coE N E -� r- E -I N E J co ..ECr) F- a a) I- x a) i- , O a) I- xQ ro oa a0 ... QO •E a LLi a0 O c CO X _ F- •j cF- :to = H C Q .2 vv a) c +. — c m OU; = N a) > O 3 N O a) m x a) w a) x 3 t� p c > w _a O. (n n c r �. L O E aas a o Z'Y p N 0 E Q Y C) c N a O o ° - m m E . w m m E a N _ w E w `m cn a) v) .� a) a. .�' V Q N Y N c a O co Q c Q 0 :.= re c C �a p Q o a op c ' o w o c ' o o Z .0 a N U `O 7 •r- L Y V % 3 O O Y Z c`a a) '� n. is cu a) m a Utns m ccO ,g, aQ -o a a) a � v W p U Z d s v ... a .. m v t -� 00 ca0o a) O o3 ( m m °03 ,_ m , i= 5 O a) w ac) E a) (1) E c O Z o C_ o cn u) CO CC CC al Ct Ct ❑ O a- G N Y co j 0 ' C C C si •... Q _J FQ.. li m 0 a N N co m co H 0 ca) 0 C� a M N . O Z o c .- (1) u) -, co w < I3Oa 'GN „ � o cr) co C N t _ C vs ? ' 7 C C = 7 a 3 CO w a J = N CO N ' 1- I- OS CI ti G 0 U' , e area before 9:00 a.m. on the delivery date if help is needed for unloading. Notice of delivery is mandatory. Please contact Bill Anderson at(402)699-1704, 48 hours prior to any anticipated deliveries. NOTE: All bagged material must be delivered palletized and shrink wrapped, 40 bags per pallet. SIGN ALL COPIES Firm By Title CONTINUATION SHEET ed sulfur coated urea. BID/bag: $ $ SIGN ALL COPIES Firm By Title CONTINUATION SHEET ond(negotiable)are acceptable substitutes for bond requirements. All bidders awarded a contract in the amount of$5,000 or more must comply with the Contract Compliance Ordinance and have on file with the Human Rights& Relations Department the Contract Compliance Report(Form CC-1). This report shall be in effect for 24 months from the date received by the Human Rights& Relations Department. Any questions regarding the Contract Compliance Ordinance should be directed to the Human Rights&Relations Department at(402)444- 5055. (PLEASE PRINT LEGIBLY OR TYPE) Payment Terms % Firm: Incorporated In: Delivery(or completion) Name: Signature: calendar days following award Title: Phone: Fax: Address: Street/P.O.Box City State Zip Email Address: .. 1,::' G`"`i"� .a'd%:r'.irry11.1i,:. s161 y w'^aa..e.y1 s-�•�r.a"�. . �r t {,�c, a ,.i 'f,+',.S:w^rZrJ''.AsT ic.�''i,;F:15 Oas?-3.,rJq c'c{' t x -Y- as•• o t gi .. cy ,n�... T;a ¢ . � .•t<u^s'�:4r'T"�, ':a'€`` t�" r�e�S4'f"rs '':',�f3s;•''::�'�5�`".,� 2�'`•� ..k�..r�' • Dark Blue Pearl Metallic DX • 'jt•y.-.:a� Y-y r�-,'.Y.-nl:: :f F:-'c.41:•Y" v,.�,, -L� ,C�'Z. ..3•,:;'S`;-w�-� v'F>5,.+;G _ .:�"., L:^:>hc..c`f...(.i ._v ,d1,. rE '.t:�- o-.,t,r':s::-tt F : n. _'BE 'jr :.:;'t r�,�.S., r ✓f y .( s.: �s;'Y1 • �. ..LLY .�'��.•. F,h.n•4t.�.-.r..,...:li'1?�'.;,.;,.,.,.�.....•..,,:v,iu;;sctiikl::.._.:V.•'t...,,.:.u.,..:tai:-:.,:.�..;::'rK�4:?�.wir?�^+.�<c5?r.,:ni:tT.w',;dtia-'a1'.'»:k�`>,^,:K,V-�.'r�.�.�t�ryre` •f`Fs�>r t'•'o`x�Jt:�:: •F• orest Green Metallic GG - ,.i.'-r�.""4.S y�'•r,.1N.'1 M1:f�', Tk^:.-:.`...'�'.:...�Y+n.. ..iG� <Cf:• y;S.::JJY rrr :c:'r� r :f' z'•�.4 .,(.:,. ,SI?'K -�s.' .t4'^'; ,i"+-:itE�i�;.. :.Q.. a�� 'UU6.7V1ete 1 G <7t=:: ..t.: ::s•. ,ci.; 'C�' -,k?•t3,: ..�a,^t": t.: .,. rC'L;��'Y... • *Tuxedo Black Metallic uti v`•= . ... .._ ._t...: . .... . :•Yj • • Royal Red Metallic UK •:. . ..: 1.L c+: a P•`i'�' t *Golden Bronze Metallic �. 'A�� :+ .,. ...:...::-..f. Is:::is`:.,.k•.,:� i^4,-. .��u��.��.. ^:Pr'•'i'.R!•••. ..1�'•:t.v :-Tli. r'xI' K1i: ate::,' s'; .,;: .yYf�._ v _.u•'.'. t'F...r..,._:._,.rti�.f'ri+r,:r..1:x!_._...r�. .,.,..,_-,',i� %i<z,..r..,mc, x-.,.r'1gat• ° r• :�J.�s-<,.-+.:..}•=��` • • • • �G .� W�arS. Nn 1 • • • • • • • • • • • • • • • • • • • • **New for this model year • • •=Available • • -16- - Ford Division . . • . .. . . - . n reviewed with me by the selling dealer and will be given to me upon delivery of the product. • YES/NO The correct operator's manual has been given to me.YES/NO • The selling dealer explained safety precautions to me.YES/NO The selling dealer explained safety features of the product to me.YES/NO The selling dealer explained the warranty terms and coverage to me.YES/NO . The answers circled above are correct.I acknowledge that I have read and I accept thls.warranty policy statement Model- Product identification number Operator's manual form number- Customer name(Please Print)- Purchaser Address Dealer Name City,Slate,Zip City,State,Zip • Purchaser . . Signature Date Dealer' . Signature • Date• • Mail original signed cony to 360 Services Inc.12623 Newburgh Road.Livonia.MI 48150.USA 1_ W 0 a a I- ill 0 Et � III 0 a o v H W q A g J c--4ZU - - = d -� �- i� ejl cp Q c Q o L1 0 Et a cry P 1- V j - - .4 Ct d Q _C o o •E o o O o Y .c O 6 m c - c - c - W c •-' o W o CO E o m E o m E W 0 mE m E U E -I (\I E J co E Q co E a 10 Q Cl. 0 0 0 a) F- x a)- F- -a- r a6 1- W a Q m F- ch a. n o o a s` Q .N m 2 m aa)i vi -- N V) j o Z = 'v N x x as .0 �(13 O .- O o o C a x N _a. r p o- A -J .c oa x v O E0 nT I-' C o c a o p , o oc N rn.§ o C o w — C.) a. o m o m E m E o 3 m co a v) CL r. Eas L 1- Yt_ c U Q U 0 m = ' o Q •` a L. Cl) Q a u1 > a� O '= Q = d o o Tu `� a 0 z m a� a CZ C Z v 0 1L co -v U a) E a� .. c O O —) o > — 7 it Q a� f° Cl- ¢ a U Zp0 c) c ca mo p � m m o .cOU v LL - H C Q m 3 Q j ' m as W cn -t p pZ o cr- Yo u Q a s 0Q ct � 3n CC OaN O L.. E a. "rco c p ca t 0 c c C CO = 0.1° U- cf E 1Q- 0 U. 0 M CV `_ si •... Q _J FQ.. li m 0 a N N co m co H 0 ca) 0 C� a M N . O Z o c .- (1) u) -, co w < I3Oa 'GN „ � o cr) co C N t _ C vs ? ' 7 C C = 7 a 3 CO w a J = N CO N ' 1- I- OS CI ti G 0 U' , e area before 9:00 a.m. on the delivery date if help is needed for unloading. Notice of delivery is mandatory. Please contact Bill Anderson at(402)699-1704, 48 hours prior to any anticipated deliveries. NOTE: All bagged material must be delivered palletized and shrink wrapped, 40 bags per pallet. SIGN ALL COPIES Firm By Title CONTINUATION SHEET ed sulfur coated urea. BID/bag: $ $ SIGN ALL COPIES Firm By Title CONTINUATION SHEET ond(negotiable)are acceptable substitutes for bond requirements. All bidders awarded a contract in the amount of$5,000 or more must comply with the Contract Compliance Ordinance and have on file with the Human Rights& Relations Department the Contract Compliance Report(Form CC-1). This report shall be in effect for 24 months from the date received by the Human Rights& Relations Department. Any questions regarding the Contract Compliance Ordinance should be directed to the Human Rights&Relations Department at(402)444- 5055. (PLEASE PRINT LEGIBLY OR TYPE) Payment Terms % Firm: Incorporated In: Delivery(or completion) Name: Signature: calendar days following award Title: Phone: Fax: Address: Street/P.O.Box City State Zip Email Address: .. 1,::' G`"`i"� .a'd%:r'.irry11.1i,:. s161 y w'^aa..e.y1 s-�•�r.a"�. . �r t {,�c, a ,.i 'f,+',.S:w^rZrJ''.AsT ic.�''i,;F:15 Oas?-3.,rJq c'c{' t x -Y- as•• o t gi .. cy ,n�... T;a ¢ . � .•t<u^s'�:4r'T"�, ':a'€`` t�" r�e�S4'f"rs '':',�f3s;•''::�'�5�`".,� 2�'`•� ..k�..r�' • Dark Blue Pearl Metallic DX • 'jt•y.-.:a� Y-y r�-,'.Y.-nl:: :f F:-'c.41:•Y" v,.�,, -L� ,C�'Z. ..3•,:;'S`;-w�-� v'F>5,.+;G _ .:�"., L:^:>hc..c`f...(.i ._v ,d1,. rE '.t:�- o-.,t,r':s::-tt F : n. _'BE 'jr :.:;'t r�,�.S., r ✓f y .( s.: �s;'Y1 • �. ..LLY .�'��.•. F,h.n•4t.�.-.r..,...:li'1?�'.;,.;,.,.,.�.....•..,,:v,iu;;sctiikl::.._.:V.•'t...,,.:.u.,..:tai:-:.,:.�..;::'rK�4:?�.wir?�^+.�<c5?r.,:ni:tT.w',;dtia-'a1'.'»:k�`>,^,:K,V-�.'r�.�.�t�ryre` •f`Fs�>r t'•'o`x�Jt:�:: •F• orest Green Metallic GG - ,.i.'-r�.""4.S y�'•r,.1N.'1 M1:f�', Tk^:.-:.`...'�'.:...�Y+n.. ..iG� <Cf:• y;S.::JJY rrr :c:'r� r :f' z'•�.4 .,(.:,. ,SI?'K -�s.' .t4'^'; ,i"+-:itE�i�;.. :.Q.. a�� 'UU6.7V1ete 1 G <7t=:: ..t.: ::s•. ,ci.; 'C�' -,k?•t3,: ..�a,^t": t.: .,. rC'L;��'Y... • *Tuxedo Black Metallic uti v`•= . ... .._ ._t...: . .... . :•Yj • • Royal Red Metallic UK •:. . ..: 1.L c+: a P•`i'�' t *Golden Bronze Metallic �. 'A�� :+ .,. ...:...::-..f. Is:::is`:.,.k•.,:� i^4,-. .��u��.��.. ^:Pr'•'i'.R!•••. ..1�'•:t.v :-Tli. r'xI' K1i: ate::,' s'; .,;: .yYf�._ v _.u•'.'. t'F...r..,._:._,.rti�.f'ri+r,:r..1:x!_._...r�. .,.,..,_-,',i� %i<z,..r..,mc, x-.,.r'1gat• ° r• :�J.�s-<,.-+.:..}•=��` • • • • �G .� W�arS. Nn 1 • • • • • • • • • • • • • • • • • • • • **New for this model year • • •=Available • • -16- - Ford Division . . • . .. . . - . n reviewed with me by the selling dealer and will be given to me upon delivery of the product. • YES/NO The correct operator's manual has been given to me.YES/NO • The selling dealer explained safety precautions to me.YES/NO The selling dealer explained safety features of the product to me.YES/NO The selling dealer explained the warranty terms and coverage to me.YES/NO . The answers circled above are correct.I acknowledge that I have read and I accept thls.warranty policy statement Model- Product identification number Operator's manual form number- Customer name(Please Print)- Purchaser Address Dealer Name City,Slate,Zip City,State,Zip • Purchaser . . Signature Date Dealer' . Signature • Date• • Mail original signed cony to 360 Services Inc.12623 Newburgh Road.Livonia.MI 48150.USA , • w � I a }.. w Le I- w Z � - a o • I- w ,� r = a Ce v 0 Q o Z - r r' rr lIPP E- w `` ,, Z U lX = a a' Y ❑ vi in ❑ vi ❑ vi ."... w C " 0 I C `5 O 40 C m O ko w O CO 0 _, Q O m E Q O E N N , a 0.L1 E < 10 :-E .w EQu) Q a o c 0Q `a) O c>i < O aiH ui = QU ai <- V> p) _ c) U w ca- O x cn Z Q- O x t Z n-O x C Q U 7' fc O L U L. .� p '= H = o O 5 1- N O C C co G C C C • m d ❑ Z 7 E a) •C O = C �. M O anOin c ZZ c 45 O= L. " 3 a5 > 3 a) is 0c s a x = = n- x al a x 1.. O E 0 cc I-- O D•3 ❑ w 0 ? O_ .- n m w O tY n' O O C m CO 8 a) m CO ,- 0 c a. (� N Q V f/) M O E -0 E O� a ZI Ce N ` C 1 a) O a) N N C w Q c13 W co a 0 a a a a ❑ Z ❑ O. d ,c ,r OO E , a`) aria z o a s = N ❑ U Z o .j w o. cc N 0- = cNN, a m a) O .0 O C U m •E � c- as V iii• ` N C E Y 5 7 CD E O • 5 m Q. O • 3 m Ca (0 m r V f0 0 m W p) �' • -c Q v ca -c Q m v W a 0 w a) 3 -- a) v .c a a) 0 p E. Y v> ❑ � 3u) cnwcn CK Uwcn CL n - Q v m O H 0 tL ❑ 0 . C� a M N . O Z o c .- (1) u) -, co w < I3Oa 'GN „ � o cr) co C N t _ C vs ? ' 7 C C = 7 a 3 CO w a J = N CO N ' 1- I- OS CI ti G 0 U' , e area before 9:00 a.m. on the delivery date if help is needed for unloading. Notice of delivery is mandatory. Please contact Bill Anderson at(402)699-1704, 48 hours prior to any anticipated deliveries. NOTE: All bagged material must be delivered palletized and shrink wrapped, 40 bags per pallet. SIGN ALL COPIES Firm By Title CONTINUATION SHEET ed sulfur coated urea. BID/bag: $ $ SIGN ALL COPIES Firm By Title CONTINUATION SHEET ond(negotiable)are acceptable substitutes for bond requirements. All bidders awarded a contract in the amount of$5,000 or more must comply with the Contract Compliance Ordinance and have on file with the Human Rights& Relations Department the Contract Compliance Report(Form CC-1). This report shall be in effect for 24 months from the date received by the Human Rights& Relations Department. Any questions regarding the Contract Compliance Ordinance should be directed to the Human Rights&Relations Department at(402)444- 5055. (PLEASE PRINT LEGIBLY OR TYPE) Payment Terms % Firm: Incorporated In: Delivery(or completion) Name: Signature: calendar days following award Title: Phone: Fax: Address: Street/P.O.Box City State Zip Email Address: .. 1,::' G`"`i"� .a'd%:r'.irry11.1i,:. s161 y w'^aa..e.y1 s-�•�r.a"�. . �r t {,�c, a ,.i 'f,+',.S:w^rZrJ''.AsT ic.�''i,;F:15 Oas?-3.,rJq c'c{' t x -Y- as•• o t gi .. cy ,n�... T;a ¢ . � .•t<u^s'�:4r'T"�, ':a'€`` t�" r�e�S4'f"rs '':',�f3s;•''::�'�5�`".,� 2�'`•� ..k�..r�' • Dark Blue Pearl Metallic DX • 'jt•y.-.:a� Y-y r�-,'.Y.-nl:: :f F:-'c.41:•Y" v,.�,, -L� ,C�'Z. ..3•,:;'S`;-w�-� v'F>5,.+;G _ .:�"., L:^:>hc..c`f...(.i ._v ,d1,. rE '.t:�- o-.,t,r':s::-tt F : n. _'BE 'jr :.:;'t r�,�.S., r ✓f y .( s.: �s;'Y1 • �. ..LLY .�'��.•. F,h.n•4t.�.-.r..,...:li'1?�'.;,.;,.,.,.�.....•..,,:v,iu;;sctiikl::.._.:V.•'t...,,.:.u.,..:tai:-:.,:.�..;::'rK�4:?�.wir?�^+.�<c5?r.,:ni:tT.w',;dtia-'a1'.'»:k�`>,^,:K,V-�.'r�.�.�t�ryre` •f`Fs�>r t'•'o`x�Jt:�:: •F• orest Green Metallic GG - ,.i.'-r�.""4.S y�'•r,.1N.'1 M1:f�', Tk^:.-:.`...'�'.:...�Y+n.. ..iG� <Cf:• y;S.::JJY rrr :c:'r� r :f' z'•�.4 .,(.:,. ,SI?'K -�s.' .t4'^'; ,i"+-:itE�i�;.. :.Q.. a�� 'UU6.7V1ete 1 G <7t=:: ..t.: ::s•. ,ci.; 'C�' -,k?•t3,: ..�a,^t": t.: .,. rC'L;��'Y... • *Tuxedo Black Metallic uti v`•= . ... .._ ._t...: . .... . :•Yj • • Royal Red Metallic UK •:. . ..: 1.L c+: a P•`i'�' t *Golden Bronze Metallic �. 'A�� :+ .,. ...:...::-..f. Is:::is`:.,.k•.,:� i^4,-. .��u��.��.. ^:Pr'•'i'.R!•••. ..1�'•:t.v :-Tli. r'xI' K1i: ate::,' s'; .,;: .yYf�._ v _.u•'.'. t'F...r..,._:._,.rti�.f'ri+r,:r..1:x!_._...r�. .,.,..,_-,',i� %i<z,..r..,mc, x-.,.r'1gat• ° r• :�J.�s-<,.-+.:..}•=��` • • • • �G .� W�arS. Nn 1 • • • • • • • • • • • • • • • • • • • • **New for this model year • • •=Available • • -16- - Ford Division . . • . .. . . - . n reviewed with me by the selling dealer and will be given to me upon delivery of the product. • YES/NO The correct operator's manual has been given to me.YES/NO • The selling dealer explained safety precautions to me.YES/NO The selling dealer explained safety features of the product to me.YES/NO The selling dealer explained the warranty terms and coverage to me.YES/NO . The answers circled above are correct.I acknowledge that I have read and I accept thls.warranty policy statement Model- Product identification number Operator's manual form number- Customer name(Please Print)- Purchaser Address Dealer Name City,Slate,Zip City,State,Zip • Purchaser . . Signature Date Dealer' . Signature • Date• • Mail original signed cony to 360 Services Inc.12623 Newburgh Road.Livonia.MI 48150.USA H C I j C a Lu a M re I— w g P g Q. 3 Ce PS ''S '...._4 V g, a P U A- = ce • 0o 0oCnON u) , a) � co Nrm EomE a) - c E C) w C - J a) N N J O vOi 'J h a) - C3w a) H M .c ,, op i- x . NF- x CO Q v d o u_ a C � :,., = • o 0 c aa) 3 1- c 0 C c c a� a� 3 = N m a _ •L 0 uO caw o 15 ti as.OQ w � -' 0 a5 _ 'tca w x a, x 4) E cn m Z a) v rn z a x > E . - U .. v • s tp O cv0p o ix a_ o o mz o L L O. H :7, C O 83 C cA • 3 N 5� E 2 ui 0 3 O O cu a C !- O O •.. L t- Cu _ o y 0 -- T 'C a5 ci — a) 0 3 a E ., a = .. T Q w Y ca aa) a) a W o •" E o 'c 3 0 Z V0 _ Z L L a) a L p p E = "t Q 3 Q 0 0 L CI cLimco Cll ir m omega. _. F F- c lL in o 0 7 CD E O • 5 m Q. O • 3 m Ca (0 m r V f0 0 m W p) �' • -c Q v ca -c Q m v W a 0 w a) 3 -- a) v .c a a) 0 p E. Y v> ❑ � 3u) cnwcn CK Uwcn CL n - Q v m O H 0 tL ❑ 0 . C� a M N . O Z o c .- (1) u) -, co w < I3Oa 'GN „ � o cr) co C N t _ C vs ? ' 7 C C = 7 a 3 CO w a J = N CO N ' 1- I- OS CI ti G 0 U' , e area before 9:00 a.m. on the delivery date if help is needed for unloading. Notice of delivery is mandatory. Please contact Bill Anderson at(402)699-1704, 48 hours prior to any anticipated deliveries. NOTE: All bagged material must be delivered palletized and shrink wrapped, 40 bags per pallet. SIGN ALL COPIES Firm By Title CONTINUATION SHEET ed sulfur coated urea. BID/bag: $ $ SIGN ALL COPIES Firm By Title CONTINUATION SHEET ond(negotiable)are acceptable substitutes for bond requirements. All bidders awarded a contract in the amount of$5,000 or more must comply with the Contract Compliance Ordinance and have on file with the Human Rights& Relations Department the Contract Compliance Report(Form CC-1). This report shall be in effect for 24 months from the date received by the Human Rights& Relations Department. Any questions regarding the Contract Compliance Ordinance should be directed to the Human Rights&Relations Department at(402)444- 5055. (PLEASE PRINT LEGIBLY OR TYPE) Payment Terms % Firm: Incorporated In: Delivery(or completion) Name: Signature: calendar days following award Title: Phone: Fax: Address: Street/P.O.Box City State Zip Email Address: .. 1,::' G`"`i"� .a'd%:r'.irry11.1i,:. s161 y w'^aa..e.y1 s-�•�r.a"�. . �r t {,�c, a ,.i 'f,+',.S:w^rZrJ''.AsT ic.�''i,;F:15 Oas?-3.,rJq c'c{' t x -Y- as•• o t gi .. cy ,n�... T;a ¢ . � .•t<u^s'�:4r'T"�, ':a'€`` t�" r�e�S4'f"rs '':',�f3s;•''::�'�5�`".,� 2�'`•� ..k�..r�' • Dark Blue Pearl Metallic DX • 'jt•y.-.:a� Y-y r�-,'.Y.-nl:: :f F:-'c.41:•Y" v,.�,, -L� ,C�'Z. ..3•,:;'S`;-w�-� v'F>5,.+;G _ .:�"., L:^:>hc..c`f...(.i ._v ,d1,. rE '.t:�- o-.,t,r':s::-tt F : n. _'BE 'jr :.:;'t r�,�.S., r ✓f y .( s.: �s;'Y1 • �. ..LLY .�'��.•. F,h.n•4t.�.-.r..,...:li'1?�'.;,.;,.,.,.�.....•..,,:v,iu;;sctiikl::.._.:V.•'t...,,.:.u.,..:tai:-:.,:.�..;::'rK�4:?�.wir?�^+.�<c5?r.,:ni:tT.w',;dtia-'a1'.'»:k�`>,^,:K,V-�.'r�.�.�t�ryre` •f`Fs�>r t'•'o`x�Jt:�:: •F• orest Green Metallic GG - ,.i.'-r�.""4.S y�'•r,.1N.'1 M1:f�', Tk^:.-:.`...'�'.:...�Y+n.. ..iG� <Cf:• y;S.::JJY rrr :c:'r� r :f' z'•�.4 .,(.:,. ,SI?'K -�s.' .t4'^'; ,i"+-:itE�i�;.. :.Q.. a�� 'UU6.7V1ete 1 G <7t=:: ..t.: ::s•. ,ci.; 'C�' -,k?•t3,: ..�a,^t": t.: .,. rC'L;��'Y... • *Tuxedo Black Metallic uti v`•= . ... .._ ._t...: . .... . :•Yj • • Royal Red Metallic UK •:. . ..: 1.L c+: a P•`i'�' t *Golden Bronze Metallic �. 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The answers circled above are correct.I acknowledge that I have read and I accept thls.warranty policy statement Model- Product identification number Operator's manual form number- Customer name(Please Print)- Purchaser Address Dealer Name City,Slate,Zip City,State,Zip • Purchaser . . Signature Date Dealer' . Signature • Date• • Mail original signed cony to 360 Services Inc.12623 Newburgh Road.Livonia.MI 48150.USA I— w M a ILI I- w Z U n Ce CL 111 u S vJ v` 4 Z U - 6 v 6 N = a 4, O 43 40.. U a U r H V Q 0 d Z V 1 i (NI a� EdE r w a; Urx o m ° m E aD N —Ito o co Jel. ti Is."0 } (NI N }" x (NI03 1" x .0 ill }� LLI N }- x .>c. a) �y H .C ch 3 F. C 3 1— = - H 0) a) a. E 0 , O n co (NU - G C '5 > C p _ co v" N r- C 3 E p W' .�/} _ U o o f x E x o _Q x cL W _Q x O2w m O m w C = Z C0 „Sco 0 r -OW ° >< 0 E c cc E m > E _c o m oo � u1 m E L. 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SIGN ALL COPIES Firm By Title CONTINUATION SHEET ed sulfur coated urea. BID/bag: $ $ SIGN ALL COPIES Firm By Title CONTINUATION SHEET ond(negotiable)are acceptable substitutes for bond requirements. All bidders awarded a contract in the amount of$5,000 or more must comply with the Contract Compliance Ordinance and have on file with the Human Rights& Relations Department the Contract Compliance Report(Form CC-1). This report shall be in effect for 24 months from the date received by the Human Rights& Relations Department. Any questions regarding the Contract Compliance Ordinance should be directed to the Human Rights&Relations Department at(402)444- 5055. (PLEASE PRINT LEGIBLY OR TYPE) Payment Terms % Firm: Incorporated In: Delivery(or completion) Name: Signature: calendar days following award Title: Phone: Fax: Address: Street/P.O.Box City State Zip Email Address: .. 1,::' G`"`i"� .a'd%:r'.irry11.1i,:. s161 y w'^aa..e.y1 s-�•�r.a"�. . �r t {,�c, a ,.i 'f,+',.S:w^rZrJ''.AsT ic.�''i,;F:15 Oas?-3.,rJq c'c{' t x -Y- as•• o t gi .. cy ,n�... T;a ¢ . � .•t<u^s'�:4r'T"�, ':a'€`` t�" r�e�S4'f"rs '':',�f3s;•''::�'�5�`".,� 2�'`•� ..k�..r�' • Dark Blue Pearl Metallic DX • 'jt•y.-.:a� Y-y r�-,'.Y.-nl:: :f F:-'c.41:•Y" v,.�,, -L� ,C�'Z. ..3•,:;'S`;-w�-� v'F>5,.+;G _ .:�"., L:^:>hc..c`f...(.i ._v ,d1,. rE '.t:�- o-.,t,r':s::-tt F : n. _'BE 'jr :.:;'t r�,�.S., r ✓f y .( s.: �s;'Y1 • �. ..LLY .�'��.•. 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Nn 1 • • • • • • • • • • • • • • • • • • • • **New for this model year • • •=Available • • -16- - Ford Division . . • . .. . . - . n reviewed with me by the selling dealer and will be given to me upon delivery of the product. • YES/NO The correct operator's manual has been given to me.YES/NO • The selling dealer explained safety precautions to me.YES/NO The selling dealer explained safety features of the product to me.YES/NO The selling dealer explained the warranty terms and coverage to me.YES/NO . The answers circled above are correct.I acknowledge that I have read and I accept thls.warranty policy statement Model- Product identification number Operator's manual form number- Customer name(Please Print)- Purchaser Address Dealer Name City,Slate,Zip City,State,Zip • Purchaser . . Signature Date Dealer' . Signature • Date• • Mail original signed cony to 360 Services Inc.12623 Newburgh Road.Livonia.MI 48150.USA I- w I - - a 1- w z2 Da �_ Li.] a 8 CD *8' a . 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' 7 C C = 7 a 3 CO w a J = N CO N ' 1- I- OS CI ti G 0 U' , e area before 9:00 a.m. on the delivery date if help is needed for unloading. Notice of delivery is mandatory. Please contact Bill Anderson at(402)699-1704, 48 hours prior to any anticipated deliveries. NOTE: All bagged material must be delivered palletized and shrink wrapped, 40 bags per pallet. SIGN ALL COPIES Firm By Title CONTINUATION SHEET ed sulfur coated urea. BID/bag: $ $ SIGN ALL COPIES Firm By Title CONTINUATION SHEET ond(negotiable)are acceptable substitutes for bond requirements. All bidders awarded a contract in the amount of$5,000 or more must comply with the Contract Compliance Ordinance and have on file with the Human Rights& Relations Department the Contract Compliance Report(Form CC-1). This report shall be in effect for 24 months from the date received by the Human Rights& Relations Department. Any questions regarding the Contract Compliance Ordinance should be directed to the Human Rights&Relations Department at(402)444- 5055. (PLEASE PRINT LEGIBLY OR TYPE) Payment Terms % Firm: Incorporated In: Delivery(or completion) Name: Signature: calendar days following award Title: Phone: Fax: Address: Street/P.O.Box City State Zip Email Address: .. 1,::' G`"`i"� .a'd%:r'.irry11.1i,:. s161 y w'^aa..e.y1 s-�•�r.a"�. . �r t {,�c, a ,.i 'f,+',.S:w^rZrJ''.AsT ic.�''i,;F:15 Oas?-3.,rJq c'c{' t x -Y- as•• o t gi .. cy ,n�... T;a ¢ . � .•t<u^s'�:4r'T"�, ':a'€`` t�" r�e�S4'f"rs '':',�f3s;•''::�'�5�`".,� 2�'`•� ..k�..r�' • Dark Blue Pearl Metallic DX • 'jt•y.-.:a� Y-y r�-,'.Y.-nl:: :f F:-'c.41:•Y" v,.�,, -L� ,C�'Z. ..3•,:;'S`;-w�-� v'F>5,.+;G _ .:�"., L:^:>hc..c`f...(.i ._v ,d1,. rE '.t:�- o-.,t,r':s::-tt F : n. _'BE 'jr :.:;'t r�,�.S., r ✓f y .( s.: �s;'Y1 • �. ..LLY .�'��.•. F,h.n•4t.�.-.r..,...:li'1?�'.;,.;,.,.,.�.....•..,,:v,iu;;sctiikl::.._.:V.•'t...,,.:.u.,..:tai:-:.,:.�..;::'rK�4:?�.wir?�^+.�<c5?r.,:ni:tT.w',;dtia-'a1'.'»:k�`>,^,:K,V-�.'r�.�.�t�ryre` •f`Fs�>r t'•'o`x�Jt:�:: •F• orest Green Metallic GG - ,.i.'-r�.""4.S y�'•r,.1N.'1 M1:f�', Tk^:.-:.`...'�'.:...�Y+n.. ..iG� <Cf:• y;S.::JJY rrr :c:'r� r :f' z'•�.4 .,(.:,. ,SI?'K -�s.' .t4'^'; ,i"+-:itE�i�;.. :.Q.. a�� 'UU6.7V1ete 1 G <7t=:: ..t.: ::s•. ,ci.; 'C�' -,k?•t3,: ..�a,^t": t.: .,. rC'L;��'Y... • *Tuxedo Black Metallic uti v`•= . ... .._ ._t...: . .... . :•Yj • • Royal Red Metallic UK •:. . ..: 1.L c+: a P•`i'�' t *Golden Bronze Metallic �. 'A�� :+ .,. ...:...::-..f. Is:::is`:.,.k•.,:� i^4,-. .��u��.��.. ^:Pr'•'i'.R!•••. ..1�'•:t.v :-Tli. r'xI' K1i: ate::,' s'; .,;: .yYf�._ v _.u•'.'. t'F...r..,._:._,.rti�.f'ri+r,:r..1:x!_._...r�. .,.,..,_-,',i� %i<z,..r..,mc, x-.,.r'1gat• ° r• :�J.�s-<,.-+.:..}•=��` • • • • �G .� W�arS. Nn 1 • • • • • • • • • • • • • • • • • • • • **New for this model year • • •=Available • • -16- - Ford Division . . • . .. . . - . n reviewed with me by the selling dealer and will be given to me upon delivery of the product. • YES/NO The correct operator's manual has been given to me.YES/NO • The selling dealer explained safety precautions to me.YES/NO The selling dealer explained safety features of the product to me.YES/NO The selling dealer explained the warranty terms and coverage to me.YES/NO . The answers circled above are correct.I acknowledge that I have read and I accept thls.warranty policy statement Model- Product identification number Operator's manual form number- Customer name(Please Print)- Purchaser Address Dealer Name City,Slate,Zip City,State,Zip • Purchaser . . Signature Date Dealer' . Signature • Date• • Mail original signed cony to 360 Services Inc.12623 Newburgh Road.Livonia.MI 48150.USA • M.W. DOUGLAS COUNTY • REQUEST FOR BID AND BID SHEET ON: CITY OF OMAHA PORTABLE CHEMICAL RESTROOM SERVICE FROM: P.M.Burke Published: January 26,2011 Page 1 Asst.Douglas County Purchasing Agent 902 Omaha-Douglas Civic Center BID BOND OR CERTIFIED CHECK REQUIRED IN THE AMOUNT 5% 1819 Famam Street IF THE TOTAL AMOUNT FOR THE ITEM OFFERED IS$20,000 OR MORE. Omaha,Nebraska 68183-0902 BID BOND OR CERTIFIED CHECK SHALL BE MADE PAYABLE TO "CITY OF OMAHA" • NOT AN ORDER Bid Closing Time&Date: 11:00 A.M.on Wednesday,February 09,2011 IMPORTANT 1. Bid must be In the office of the CITY CLERK,IC-1,OMAHA-DOUGLAS CIVIC CENTER, 4. If Federal Excise Tax applies,show amount of same and deduct. 1819 Famam Street,Omaha,NE 68183-0011 by the closing date and time Indicated Exemption certificates wit be furnished. Do not include tax in bid. in a sealed envelope marked: BID ON:CITY OF OMAHA PORTABLE CHEMICAL RESTROOM SERVICE 5. BID MUST INCLUDE ANY DELIVERY OR SHIPPING CHARGES. 2. As evidence of good faith a bid bond or certified check must be submitted with bid. 6. When submitting bid on items fisted,bidder may on a separate sheet,make Bid bond or certified check shall be made payable to'City of Omaha' suggestions covering reduction in costs wherever this is possible through FAILURE TO DO SO IS CAUSE FOR REJECTION. redesign,change of material or utilization of standard hems or quantity change. 3. Right Is reserved to accept or reject any or all bids in their entirety and the bidders shall 7. If you do not bid,return sheets with reason for declining. Failure to do so will Indicate have the right to appeal any decision to the City Council. Right is also reserved to your desire to be removed from our mailing list.TABULATION SHEETS FOR THE BIDS accept or reject any part of your bid unless otherwise indicated by you. SUBMITTED ARE AVAILABLE ON THE DOUGLAS COUNTY WEBSITE AT www.douglascountvvurchasing.org. DO NOT CALL FOR THIS INFORMATION. Quote your lowest price,best delivery and terms.F.O.B.delivery point on the Item(s)listed below: QUANTITY DESCRIPTION UNIT PRICE EXTENSION It is the intent of the City of Omaha to enter into a Price Agreement for portable chemical restroom service for the 2011 season. Units to be removed when service is discontinued,and when removed,final payment. Units shall be in accordance with revised specifications(2 pages)of 12/21/93. The tank capacity shall be 50 gallons minimum, and the inside area shall be 13 square feet minimum. Unit shall be essentially equal to"Aquazyme." A location shall be considered to be a given park or recreation area, such as:Johnny Goodman, Benson, Elmwood, Fonterielle,Warren Swigart,Spring Lake, Westwood,etc. SECTION A. ALL OR NONE TOTAL BID (GOLF): $4.466.00 SECTION B. ALL OR NONE TOTAL BID (PARKS): $26.141.00 TOTAL BID(SECTION A&B): $30.607.00 (5%Bid Bond is to be based upon this total amount) All bidders awarded a contract in the amount of$5,000 or more must comply with the Contract Compliance Ordinance and have on file with the Human Rights& Relations Department the Contract Compliance Report(Form CC-1). This report shall be in effect for 24 months from the date received by the Human Rights& Relations Department. Any questions regarding the Contract Compliance Ordinance should be directed to the Human Rights&Relations Department at (402)444 5055. (PLEASE PRINT LEGIBLY OR TYPE) Payment Terms % Firm:Deffenbaugh Industries,Inc. lircorporated lI Delivery(or completion) Name:Cynthia Bryant Signature: /= calendar days following award Title:Sales and Marketing Manager Phone:402-731-3333 Fa402-451-7'230 Address: 5902 N 16'h Street Street/P.O.Box City Omaha State NE Zip 68110 Email Address: cbryant©deffenbaughinc.com gi .. cy ,n�... T;a ¢ . � .•t<u^s'�:4r'T"�, ':a'€`` t�" r�e�S4'f"rs '':',�f3s;•''::�'�5�`".,� 2�'`•� ..k�..r�' • Dark Blue Pearl Metallic DX • 'jt•y.-.:a� Y-y r�-,'.Y.-nl:: :f F:-'c.41:•Y" v,.�,, -L� ,C�'Z. ..3•,:;'S`;-w�-� v'F>5,.+;G _ .:�"., L:^:>hc..c`f...(.i ._v ,d1,. rE '.t:�- o-.,t,r':s::-tt F : n. _'BE 'jr :.:;'t r�,�.S., r ✓f y .( s.: �s;'Y1 • �. ..LLY .�'��.•. F,h.n•4t.�.-.r..,...:li'1?�'.;,.;,.,.,.�.....•..,,:v,iu;;sctiikl::.._.:V.•'t...,,.:.u.,..:tai:-:.,:.�..;::'rK�4:?�.wir?�^+.�<c5?r.,:ni:tT.w',;dtia-'a1'.'»:k�`>,^,:K,V-�.'r�.�.�t�ryre` •f`Fs�>r t'•'o`x�Jt:�:: •F• orest Green Metallic GG - ,.i.'-r�.""4.S y�'•r,.1N.'1 M1:f�', Tk^:.-:.`...'�'.:...�Y+n.. ..iG� <Cf:• y;S.::JJY rrr :c:'r� r :f' z'•�.4 .,(.:,. ,SI?'K -�s.' .t4'^'; ,i"+-:itE�i�;.. :.Q.. a�� 'UU6.7V1ete 1 G <7t=:: ..t.: ::s•. ,ci.; 'C�' -,k?•t3,: ..�a,^t": t.: .,. rC'L;��'Y... • *Tuxedo Black Metallic uti v`•= . ... .._ ._t...: . .... . :•Yj • • Royal Red Metallic UK •:. . ..: 1.L c+: a P•`i'�' t *Golden Bronze Metallic �. 'A�� :+ .,. ...:...::-..f. Is:::is`:.,.k•.,:� i^4,-. .��u��.��.. ^:Pr'•'i'.R!•••. ..1�'•:t.v :-Tli. r'xI' K1i: ate::,' s'; .,;: .yYf�._ v _.u•'.'. t'F...r..,._:._,.rti�.f'ri+r,:r..1:x!_._...r�. .,.,..,_-,',i� %i<z,..r..,mc, x-.,.r'1gat• ° r• :�J.�s-<,.-+.:..}•=��` • • • • �G .� W�arS. Nn 1 • • • • • • • • • • • • • • • • • • • • **New for this model year • • •=Available • • -16- - Ford Division . . • . .. . . - . n reviewed with me by the selling dealer and will be given to me upon delivery of the product. • YES/NO The correct operator's manual has been given to me.YES/NO • The selling dealer explained safety precautions to me.YES/NO The selling dealer explained safety features of the product to me.YES/NO The selling dealer explained the warranty terms and coverage to me.YES/NO . The answers circled above are correct.I acknowledge that I have read and I accept thls.warranty policy statement Model- Product identification number Operator's manual form number- Customer name(Please Print)- Purchaser Address Dealer Name City,Slate,Zip City,State,Zip • Purchaser . . Signature Date Dealer' . Signature • Date• • Mail original signed cony to 360 Services Inc.12623 Newburgh Road.Livonia.MI 48150.USA DOUGLAS COUNTY REQUEST FOR BID & BID SHEET ON: CITY OF OMAHA PORTABLE CHEMICAL RESTROOM SERVICE NOT AN ORDER Page 2 QUANTITY DESCRIPTION UNIT PRICE EXTENSION SECTION A- GOLF COURSES: Portable Chemical Restrooms to be set on Site by April 1, 2011 and removed after November 1, 2011. 2 units Johnny Goodman Golf Course, 6111 S. 99th Street BID/per unit per month $58.00 TOTAL SITE BID: $812.00 (BID/per unit per month x 2 units x 7 months) 3 units Benson Golf Course, 5333 N. 72nd St. BID/per unit per month $58.00 TOTAL SITE BID: $ 1218.00 (BID/per unit per month x 3 units x 7 months) 2 units Elmwood Golf Course, 6232 Pacific Street BID/per unit per month $58.00 TOTAL SITE BID: $812.00 (BID/per unit per month x 2 units x 7 months) 1 unit Fonteneile Golf Course, 4575 Ames Avenue BID/per unit per month $58.00 TOTAL SITE BID: $406.00 (BID/per unit per month x 1 units x 7 months) 1 unit Warren Swigart Golf Course, 3865 Parkview Dr. BID/per unit per month $ 58.00 TOTAL SITE BID: $406.00 (BID/per unit per month x 1 units x 7 months) 1 unit Spring Lake Golf Course, 4020 Hoctor Blvd. BID/per unit per month $ 58.00 TOTAL SITE BID: $406.00 (BID/per unit per month x 1 units x 7 months) SIGN ALL COPIES Firm T l _tma (.g /e< By �cr Title ? 4 /774_4-hG 't� 1gO.r CONTINUATION SHEET �/ or declining. Failure to do so will Indicate have the right to appeal any decision to the City Council. Right is also reserved to your desire to be removed from our mailing list.TABULATION SHEETS FOR THE BIDS accept or reject any part of your bid unless otherwise indicated by you. SUBMITTED ARE AVAILABLE ON THE DOUGLAS COUNTY WEBSITE AT www.douglascountvvurchasing.org. DO NOT CALL FOR THIS INFORMATION. Quote your lowest price,best delivery and terms.F.O.B.delivery point on the Item(s)listed below: QUANTITY DESCRIPTION UNIT PRICE EXTENSION It is the intent of the City of Omaha to enter into a Price Agreement for portable chemical restroom service for the 2011 season. Units to be removed when service is discontinued,and when removed,final payment. Units shall be in accordance with revised specifications(2 pages)of 12/21/93. The tank capacity shall be 50 gallons minimum, and the inside area shall be 13 square feet minimum. Unit shall be essentially equal to"Aquazyme." A location shall be considered to be a given park or recreation area, such as:Johnny Goodman, Benson, Elmwood, Fonterielle,Warren Swigart,Spring Lake, Westwood,etc. SECTION A. ALL OR NONE TOTAL BID (GOLF): $4.466.00 SECTION B. ALL OR NONE TOTAL BID (PARKS): $26.141.00 TOTAL BID(SECTION A&B): $30.607.00 (5%Bid Bond is to be based upon this total amount) All bidders awarded a contract in the amount of$5,000 or more must comply with the Contract Compliance Ordinance and have on file with the Human Rights& Relations Department the Contract Compliance Report(Form CC-1). This report shall be in effect for 24 months from the date received by the Human Rights& Relations Department. Any questions regarding the Contract Compliance Ordinance should be directed to the Human Rights&Relations Department at (402)444 5055. (PLEASE PRINT LEGIBLY OR TYPE) Payment Terms % Firm:Deffenbaugh Industries,Inc. lircorporated lI Delivery(or completion) Name:Cynthia Bryant Signature: /= calendar days following award Title:Sales and Marketing Manager Phone:402-731-3333 Fa402-451-7'230 Address: 5902 N 16'h Street Street/P.O.Box City Omaha State NE Zip 68110 Email Address: cbryant©deffenbaughinc.com gi .. cy ,n�... T;a ¢ . � .•t<u^s'�:4r'T"�, ':a'€`` t�" r�e�S4'f"rs '':',�f3s;•''::�'�5�`".,� 2�'`•� ..k�..r�' • Dark Blue Pearl Metallic DX • 'jt•y.-.:a� Y-y r�-,'.Y.-nl:: :f F:-'c.41:•Y" v,.�,, -L� ,C�'Z. ..3•,:;'S`;-w�-� v'F>5,.+;G _ .:�"., L:^:>hc..c`f...(.i ._v ,d1,. rE '.t:�- o-.,t,r':s::-tt F : n. _'BE 'jr :.:;'t r�,�.S., r ✓f y .( s.: �s;'Y1 • �. ..LLY .�'��.•. F,h.n•4t.�.-.r..,...:li'1?�'.;,.;,.,.,.�.....•..,,:v,iu;;sctiikl::.._.:V.•'t...,,.:.u.,..:tai:-:.,:.�..;::'rK�4:?�.wir?�^+.�<c5?r.,:ni:tT.w',;dtia-'a1'.'»:k�`>,^,:K,V-�.'r�.�.�t�ryre` •f`Fs�>r t'•'o`x�Jt:�:: •F• orest Green Metallic GG - ,.i.'-r�.""4.S y�'•r,.1N.'1 M1:f�', Tk^:.-:.`...'�'.:...�Y+n.. ..iG� <Cf:• y;S.::JJY rrr :c:'r� r :f' z'•�.4 .,(.:,. ,SI?'K -�s.' .t4'^'; ,i"+-:itE�i�;.. :.Q.. a�� 'UU6.7V1ete 1 G <7t=:: ..t.: ::s•. ,ci.; 'C�' -,k?•t3,: ..�a,^t": t.: .,. rC'L;��'Y... • *Tuxedo Black Metallic uti v`•= . ... .._ ._t...: . .... . :•Yj • • Royal Red Metallic UK •:. . ..: 1.L c+: a P•`i'�' t *Golden Bronze Metallic �. 'A�� :+ .,. ...:...::-..f. Is:::is`:.,.k•.,:� i^4,-. .��u��.��.. ^:Pr'•'i'.R!•••. ..1�'•:t.v :-Tli. r'xI' K1i: ate::,' s'; .,;: .yYf�._ v _.u•'.'. t'F...r..,._:._,.rti�.f'ri+r,:r..1:x!_._...r�. .,.,..,_-,',i� %i<z,..r..,mc, x-.,.r'1gat• ° r• :�J.�s-<,.-+.:..}•=��` • • • • �G .� W�arS. Nn 1 • • • • • • • • • • • • • • • • • • • • **New for this model year • • •=Available • • -16- - Ford Division . . • . .. . . - . n reviewed with me by the selling dealer and will be given to me upon delivery of the product. • YES/NO The correct operator's manual has been given to me.YES/NO • The selling dealer explained safety precautions to me.YES/NO The selling dealer explained safety features of the product to me.YES/NO The selling dealer explained the warranty terms and coverage to me.YES/NO . The answers circled above are correct.I acknowledge that I have read and I accept thls.warranty policy statement Model- Product identification number Operator's manual form number- Customer name(Please Print)- Purchaser Address Dealer Name City,Slate,Zip City,State,Zip • Purchaser . . Signature Date Dealer' . Signature • Date• • Mail original signed cony to 360 Services Inc.12623 Newburgh Road.Livonia.MI 48150.USA DOUGLAS COUNTY REQUEST FOR BID & BID SHEET ON: CITY OF OMAHA PORTABLE CHEMICAL RESTROOM SERVICE NOT AN ORDER Page 3 QUANTITY DESCRIPTION UNIT PRICE EXTENSION SECTION A-GOLF COURSES (continuedl; 1 unit Westwood Golf Course, 12929 W. Center Road $ BID/per unit per month $58.00 TOTAL SITE BID: $406.00 (BID/per unit per month x 1 units x 7 months SECTION A(Golf Courses) ALL OR NONE TOTAL BID: $4466.00 SIGN ALL COPIES Firm Q ,i la y*Th tUs51 Y ZL3/ C- By Title ,yta r K-- CONTINUATION SHEET __ , ..\, , ' l ruck Page 16 of 16 ,. 26(11) - 22- Control No. 22325 "Q" Street Bridge, 26th—27th Streets Preliminary Engineering, NEPA Documentation and Final Design Services lerk Approved... OF,.. Mayor DOUGLAS COUNTY REQUEST FOR BID & BID SHEET ON: CITY OF OMAHA PORTABLE CHEMICAL RESTROOM SERVICE NOT AN ORDER Page 4 QUANTITY DESCRIPTION UNIT PRICE EXTENSION SECTION A-GOLF COURSES (continuedl; The City reserves the right to reject any unit(without obligation)delivered and not considered in condition of appearance, etc. to be compatible with surroundings in which placed. Further, the right to award to the next low bidder is reserved in event of unsatisfactory service. A weekly service ticket must be signed by the golf manager for"services"when performed at a golf course, before payment can be made. Exact locations will be marked by management personnel on site. Questions regarding this portion of bid may be directed to: Bob Baber at(402)444-5963. All containers are to be maintained in a clean and neat appearing condition. The successful vendor(s)shall maintain a reasonable standard of quality and service during the term of this contract. Failure to perform to standards shall be cause for cancellation and the award given to the next lowest bidder. SIGN ALL COPIES Firm � !ba l" I �Yf Uft jt°,s By Title CONTINUATION SHEET 1 unit Spring Lake Golf Course, 4020 Hoctor Blvd. BID/per unit per month $ 58.00 TOTAL SITE BID: $406.00 (BID/per unit per month x 1 units x 7 months) SIGN ALL COPIES Firm T l _tma (.g /e< By �cr Title ? 4 /774_4-hG 't� 1gO.r CONTINUATION SHEET �/ or declining. Failure to do so will Indicate have the right to appeal any decision to the City Council. Right is also reserved to your desire to be removed from our mailing list.TABULATION SHEETS FOR THE BIDS accept or reject any part of your bid unless otherwise indicated by you. SUBMITTED ARE AVAILABLE ON THE DOUGLAS COUNTY WEBSITE AT www.douglascountvvurchasing.org. DO NOT CALL FOR THIS INFORMATION. Quote your lowest price,best delivery and terms.F.O.B.delivery point on the Item(s)listed below: QUANTITY DESCRIPTION UNIT PRICE EXTENSION It is the intent of the City of Omaha to enter into a Price Agreement for portable chemical restroom service for the 2011 season. Units to be removed when service is discontinued,and when removed,final payment. Units shall be in accordance with revised specifications(2 pages)of 12/21/93. The tank capacity shall be 50 gallons minimum, and the inside area shall be 13 square feet minimum. Unit shall be essentially equal to"Aquazyme." A location shall be considered to be a given park or recreation area, such as:Johnny Goodman, Benson, Elmwood, Fonterielle,Warren Swigart,Spring Lake, Westwood,etc. SECTION A. ALL OR NONE TOTAL BID (GOLF): $4.466.00 SECTION B. ALL OR NONE TOTAL BID (PARKS): $26.141.00 TOTAL BID(SECTION A&B): $30.607.00 (5%Bid Bond is to be based upon this total amount) All bidders awarded a contract in the amount of$5,000 or more must comply with the Contract Compliance Ordinance and have on file with the Human Rights& Relations Department the Contract Compliance Report(Form CC-1). This report shall be in effect for 24 months from the date received by the Human Rights& Relations Department. Any questions regarding the Contract Compliance Ordinance should be directed to the Human Rights&Relations Department at (402)444 5055. (PLEASE PRINT LEGIBLY OR TYPE) Payment Terms % Firm:Deffenbaugh Industries,Inc. lircorporated lI Delivery(or completion) Name:Cynthia Bryant Signature: /= calendar days following award Title:Sales and Marketing Manager Phone:402-731-3333 Fa402-451-7'230 Address: 5902 N 16'h Street Street/P.O.Box City Omaha State NE Zip 68110 Email Address: cbryant©deffenbaughinc.com gi .. cy ,n�... T;a ¢ . � .•t<u^s'�:4r'T"�, ':a'€`` t�" r�e�S4'f"rs '':',�f3s;•''::�'�5�`".,� 2�'`•� ..k�..r�' • Dark Blue Pearl Metallic DX • 'jt•y.-.:a� Y-y r�-,'.Y.-nl:: :f F:-'c.41:•Y" v,.�,, -L� ,C�'Z. ..3•,:;'S`;-w�-� v'F>5,.+;G _ .:�"., L:^:>hc..c`f...(.i ._v ,d1,. rE '.t:�- o-.,t,r':s::-tt F : n. _'BE 'jr :.:;'t r�,�.S., r ✓f y .( s.: �s;'Y1 • �. ..LLY .�'��.•. F,h.n•4t.�.-.r..,...:li'1?�'.;,.;,.,.,.�.....•..,,:v,iu;;sctiikl::.._.:V.•'t...,,.:.u.,..:tai:-:.,:.�..;::'rK�4:?�.wir?�^+.�<c5?r.,:ni:tT.w',;dtia-'a1'.'»:k�`>,^,:K,V-�.'r�.�.�t�ryre` •f`Fs�>r t'•'o`x�Jt:�:: •F• orest Green Metallic GG - ,.i.'-r�.""4.S y�'•r,.1N.'1 M1:f�', Tk^:.-:.`...'�'.:...�Y+n.. ..iG� <Cf:• y;S.::JJY rrr :c:'r� r :f' z'•�.4 .,(.:,. ,SI?'K -�s.' .t4'^'; ,i"+-:itE�i�;.. :.Q.. a�� 'UU6.7V1ete 1 G <7t=:: ..t.: ::s•. ,ci.; 'C�' -,k?•t3,: ..�a,^t": t.: .,. rC'L;��'Y... • *Tuxedo Black Metallic uti v`•= . ... .._ ._t...: . .... . :•Yj • • Royal Red Metallic UK •:. . ..: 1.L c+: a P•`i'�' t *Golden Bronze Metallic �. 'A�� :+ .,. ...:...::-..f. Is:::is`:.,.k•.,:� i^4,-. .��u��.��.. ^:Pr'•'i'.R!•••. ..1�'•:t.v :-Tli. r'xI' K1i: ate::,' s'; .,;: .yYf�._ v _.u•'.'. t'F...r..,._:._,.rti�.f'ri+r,:r..1:x!_._...r�. .,.,..,_-,',i� %i<z,..r..,mc, x-.,.r'1gat• ° r• :�J.�s-<,.-+.:..}•=��` • • • • �G .� W�arS. Nn 1 • • • • • • • • • • • • • • • • • • • • **New for this model year • • •=Available • • -16- - Ford Division . . • . .. . . - . n reviewed with me by the selling dealer and will be given to me upon delivery of the product. • YES/NO The correct operator's manual has been given to me.YES/NO • The selling dealer explained safety precautions to me.YES/NO The selling dealer explained safety features of the product to me.YES/NO The selling dealer explained the warranty terms and coverage to me.YES/NO . The answers circled above are correct.I acknowledge that I have read and I accept thls.warranty policy statement Model- Product identification number Operator's manual form number- Customer name(Please Print)- Purchaser Address Dealer Name City,Slate,Zip City,State,Zip • Purchaser . . Signature Date Dealer' . Signature • Date• • Mail original signed cony to 360 Services Inc.12623 Newburgh Road.Livonia.MI 48150.USA DOUGLAS COUNTY REQUEST FOR BID & BID SHEET • ON: CITY OF OMAHA PORTABLE CHEMICAL RESTROOM SERVICE NOT AN ORDER Page 5 QUANTITY DESCRIPTION UNIT PRICE EXTENSION SECTION B -PARKS: Mandan Park, 13th &Harrison,April 1 -October 31, 2011 Portable units with TWICE A WEEK SERVICE. To be placed in the enclosure off of the Harrison Street entrance across from the playground. Call 699-1702 or 444-4721 BEFORE DELIVERY. 1 unit Regular BID/per unit per month: $ 110.00 TOTAL BID: (BID/per unit per month x 1 unit x 7 months) $ 770.00 1 unit ADA Accessible BID/per unit per month: $ 125.00 TOTAL BID: (BID/per unit per month x 1 unit x 7 months) $875.00 Zorinsky Recreation Area, October 14, 2011 -April 30, 2012 Portable units with TWICE A WEEK SERVICE. Units to be staked in the ground. The City will call Vendor for placements. 3 units Regular: BID/per unit per month: $ 110.00 1 unit at Main picnic area entrance, 156th Street 1 unit at Boat dock entrance, 156th& F Street 1 unit at Southeast parking lot, 168th Street TOTAL BID: (BID/per unit per month x 3 unit x 6.5 months) $2145.00 Levi Carter Park, 4405 Carter Lake Drive, April 15-Sept. 30, 2011 Portable units with TWICE A WEEK SERVICE. Call 699-1701 or 444- 5029 when ready to set for placement. 2 units. Regular BID/per unit per month: $ 110.00 TOTAL BID: (BID/per unit per month x 2 units x 5.5 months) $ 1210.00 Benson Park, 7002 Military Avenue. Portable units with ONCE A WEEK SERVICE. Units to be staked in the ground. Call 699-1704 or 444-4724 for placement. 1 unit Regular(year round service) BID/per unit per month: $68.00 TOTAL BID: (BID/per unit per month x 1 unit x 12 months) $_816.00 2 units Regular(April 1 -Oct. 31, 2011 service) BID/per unit per month: $ 70.00 TOTAL BID: (BID/per unit per month x 2 units x 7 months) $ 980.00 SIGN ALL COPIES Firm vri D - AC By J Title c CONTINUATION SHEET SION It is the intent of the City of Omaha to enter into a Price Agreement for portable chemical restroom service for the 2011 season. Units to be removed when service is discontinued,and when removed,final payment. Units shall be in accordance with revised specifications(2 pages)of 12/21/93. The tank capacity shall be 50 gallons minimum, and the inside area shall be 13 square feet minimum. Unit shall be essentially equal to"Aquazyme." A location shall be considered to be a given park or recreation area, such as:Johnny Goodman, Benson, Elmwood, Fonterielle,Warren Swigart,Spring Lake, Westwood,etc. SECTION A. ALL OR NONE TOTAL BID (GOLF): $4.466.00 SECTION B. ALL OR NONE TOTAL BID (PARKS): $26.141.00 TOTAL BID(SECTION A&B): $30.607.00 (5%Bid Bond is to be based upon this total amount) All bidders awarded a contract in the amount of$5,000 or more must comply with the Contract Compliance Ordinance and have on file with the Human Rights& Relations Department the Contract Compliance Report(Form CC-1). This report shall be in effect for 24 months from the date received by the Human Rights& Relations Department. Any questions regarding the Contract Compliance Ordinance should be directed to the Human Rights&Relations Department at (402)444 5055. (PLEASE PRINT LEGIBLY OR TYPE) Payment Terms % Firm:Deffenbaugh Industries,Inc. lircorporated lI Delivery(or completion) Name:Cynthia Bryant Signature: /= calendar days following award Title:Sales and Marketing Manager Phone:402-731-3333 Fa402-451-7'230 Address: 5902 N 16'h Street Street/P.O.Box City Omaha State NE Zip 68110 Email Address: cbryant©deffenbaughinc.com gi .. cy ,n�... T;a ¢ . � .•t<u^s'�:4r'T"�, ':a'€`` t�" r�e�S4'f"rs '':',�f3s;•''::�'�5�`".,� 2�'`•� ..k�..r�' • Dark Blue Pearl Metallic DX • 'jt•y.-.:a� Y-y r�-,'.Y.-nl:: :f F:-'c.41:•Y" v,.�,, -L� ,C�'Z. ..3•,:;'S`;-w�-� v'F>5,.+;G _ .:�"., L:^:>hc..c`f...(.i ._v ,d1,. rE '.t:�- o-.,t,r':s::-tt F : n. _'BE 'jr :.:;'t r�,�.S., r ✓f y .( s.: �s;'Y1 • �. ..LLY .�'��.•. F,h.n•4t.�.-.r..,...:li'1?�'.;,.;,.,.,.�.....•..,,:v,iu;;sctiikl::.._.:V.•'t...,,.:.u.,..:tai:-:.,:.�..;::'rK�4:?�.wir?�^+.�<c5?r.,:ni:tT.w',;dtia-'a1'.'»:k�`>,^,:K,V-�.'r�.�.�t�ryre` •f`Fs�>r t'•'o`x�Jt:�:: •F• orest Green Metallic GG - ,.i.'-r�.""4.S y�'•r,.1N.'1 M1:f�', Tk^:.-:.`...'�'.:...�Y+n.. ..iG� <Cf:• y;S.::JJY rrr :c:'r� r :f' z'•�.4 .,(.:,. ,SI?'K -�s.' .t4'^'; ,i"+-:itE�i�;.. :.Q.. a�� 'UU6.7V1ete 1 G <7t=:: ..t.: ::s•. ,ci.; 'C�' -,k?•t3,: ..�a,^t": t.: .,. rC'L;��'Y... • *Tuxedo Black Metallic uti v`•= . ... .._ ._t...: . .... . :•Yj • • Royal Red Metallic UK •:. . ..: 1.L c+: a P•`i'�' t *Golden Bronze Metallic �. 'A�� :+ .,. ...:...::-..f. Is:::is`:.,.k•.,:� i^4,-. .��u��.��.. ^:Pr'•'i'.R!•••. ..1�'•:t.v :-Tli. r'xI' K1i: ate::,' s'; .,;: .yYf�._ v _.u•'.'. t'F...r..,._:._,.rti�.f'ri+r,:r..1:x!_._...r�. .,.,..,_-,',i� %i<z,..r..,mc, x-.,.r'1gat• ° r• :�J.�s-<,.-+.:..}•=��` • • • • �G .� W�arS. Nn 1 • • • • • • • • • • • • • • • • • • • • **New for this model year • • •=Available • • -16- - Ford Division . . • . .. . . - . n reviewed with me by the selling dealer and will be given to me upon delivery of the product. • YES/NO The correct operator's manual has been given to me.YES/NO • The selling dealer explained safety precautions to me.YES/NO The selling dealer explained safety features of the product to me.YES/NO The selling dealer explained the warranty terms and coverage to me.YES/NO . The answers circled above are correct.I acknowledge that I have read and I accept thls.warranty policy statement Model- Product identification number Operator's manual form number- Customer name(Please Print)- Purchaser Address Dealer Name City,Slate,Zip City,State,Zip • Purchaser . . Signature Date Dealer' . Signature • Date• • Mail original signed cony to 360 Services Inc.12623 Newburgh Road.Livonia.MI 48150.USA DOUGLAS COUNTY REQUEST FOR BID & BID SHEET • ON: CITY OF OMAHA PORTABLE CHEMICAL RESTROOM SERVICE NOT AN ORDER Page 6 QUANTITY DESCRIPTION UNIT PRICE EXTENSION SECTION B-PARKS (continuedl: Elmwood Park, 808 S. 60th Street Portable units with TWICE A WEEK SERVICE. Call 699-1702 or 444- 4721 for placement. 1 unit Regular(year round service) BID/per unit per month: $ 110.00 TOTAL BID: (BID/per unit per month x 1 unit x 12 months) $ 1320.00 2 units Regular(May 1 thru Oct. 31, 2011 service) BID/per unit per month: $70.00 TOTAL BID: (BID/per unit per month x 2 units x 6 months) $ 840.00 Cunningham Lake Campgrounds, 8305 Rainwood Road Portable units with ONCE A WEEK SERVICE. To be placed in shelters at entrances. 3 units ADA Accessible(year round service) BID/per unit per month: $ 70.00 TOTAL BID: (BID/per unit per month x 3 units x 12 months) $ 2520.00 Cunningham Lake Campgrounds, 8305 Rainwood Road, April 15-October 15, 2011 Portable units with ONCE A WEEK SERVICE. Call caretaker for placement at 657-9832. 2 units Regular BID/per unit per month: $70.00 TOTAL BID: (BID/per unit per month x 2 units x 6 months) $840.00 1 unit ADA Accessible BID/per unit per month: $95.00 TOTAL BID: (BID/per unit per month x 1 unit x 6 months) $ 570.00 Westwood Water Park, 12334 Seldin Dr. (Memorial weekend through Labor Day weekend) Portable unit with TWICE A WEEK SERVICE. Call 699-1703 or 444-4722 for placement. 1 unit Regular BID/per unit per month: $ 110.00 TOTAL BID: (BID/per unit per month x 1 unit x 3.5 months) $385.00 Upland Water Park, 3104 Jefferson Street (Memorial weekend through Labor Day weekend) Portable unit with ONCE A WEEK SERVICE. Call 699-1702 or 444-4721 for placement. 1 unit Regular BID/per unit per month: $ 70.00 TOTAL BID: (BID/per unit per month x 1 unit '7x�3.5 months) $245.00 SIGN ALL COPIES Firm Title ,r, N f2'2lor CONTINUATION SHEET ha to enter into a Price Agreement for portable chemical restroom service for the 2011 season. Units to be removed when service is discontinued,and when removed,final payment. Units shall be in accordance with revised specifications(2 pages)of 12/21/93. The tank capacity shall be 50 gallons minimum, and the inside area shall be 13 square feet minimum. Unit shall be essentially equal to"Aquazyme." A location shall be considered to be a given park or recreation area, such as:Johnny Goodman, Benson, Elmwood, Fonterielle,Warren Swigart,Spring Lake, Westwood,etc. SECTION A. ALL OR NONE TOTAL BID (GOLF): $4.466.00 SECTION B. ALL OR NONE TOTAL BID (PARKS): $26.141.00 TOTAL BID(SECTION A&B): $30.607.00 (5%Bid Bond is to be based upon this total amount) All bidders awarded a contract in the amount of$5,000 or more must comply with the Contract Compliance Ordinance and have on file with the Human Rights& Relations Department the Contract Compliance Report(Form CC-1). This report shall be in effect for 24 months from the date received by the Human Rights& Relations Department. Any questions regarding the Contract Compliance Ordinance should be directed to the Human Rights&Relations Department at (402)444 5055. (PLEASE PRINT LEGIBLY OR TYPE) Payment Terms % Firm:Deffenbaugh Industries,Inc. lircorporated lI Delivery(or completion) Name:Cynthia Bryant Signature: /= calendar days following award Title:Sales and Marketing Manager Phone:402-731-3333 Fa402-451-7'230 Address: 5902 N 16'h Street Street/P.O.Box City Omaha State NE Zip 68110 Email Address: cbryant©deffenbaughinc.com gi .. cy ,n�... T;a ¢ . � .•t<u^s'�:4r'T"�, ':a'€`` t�" r�e�S4'f"rs '':',�f3s;•''::�'�5�`".,� 2�'`•� ..k�..r�' • Dark Blue Pearl Metallic DX • 'jt•y.-.:a� Y-y r�-,'.Y.-nl:: :f F:-'c.41:•Y" v,.�,, -L� ,C�'Z. ..3•,:;'S`;-w�-� v'F>5,.+;G _ .:�"., L:^:>hc..c`f...(.i ._v ,d1,. rE '.t:�- o-.,t,r':s::-tt F : n. _'BE 'jr :.:;'t r�,�.S., r ✓f y .( s.: �s;'Y1 • �. ..LLY .�'��.•. F,h.n•4t.�.-.r..,...:li'1?�'.;,.;,.,.,.�.....•..,,:v,iu;;sctiikl::.._.:V.•'t...,,.:.u.,..:tai:-:.,:.�..;::'rK�4:?�.wir?�^+.�<c5?r.,:ni:tT.w',;dtia-'a1'.'»:k�`>,^,:K,V-�.'r�.�.�t�ryre` •f`Fs�>r t'•'o`x�Jt:�:: •F• orest Green Metallic GG - ,.i.'-r�.""4.S y�'•r,.1N.'1 M1:f�', Tk^:.-:.`...'�'.:...�Y+n.. ..iG� <Cf:• y;S.::JJY rrr :c:'r� r :f' z'•�.4 .,(.:,. ,SI?'K -�s.' .t4'^'; ,i"+-:itE�i�;.. :.Q.. a�� 'UU6.7V1ete 1 G <7t=:: ..t.: ::s•. ,ci.; 'C�' -,k?•t3,: ..�a,^t": t.: .,. rC'L;��'Y... • *Tuxedo Black Metallic uti v`•= . ... .._ ._t...: . .... . :•Yj • • Royal Red Metallic UK •:. . ..: 1.L c+: a P•`i'�' t *Golden Bronze Metallic �. 'A�� :+ .,. ...:...::-..f. Is:::is`:.,.k•.,:� i^4,-. .��u��.��.. ^:Pr'•'i'.R!•••. ..1�'•:t.v :-Tli. r'xI' K1i: ate::,' s'; .,;: .yYf�._ v _.u•'.'. t'F...r..,._:._,.rti�.f'ri+r,:r..1:x!_._...r�. .,.,..,_-,',i� %i<z,..r..,mc, x-.,.r'1gat• ° r• :�J.�s-<,.-+.:..}•=��` • • • • �G .� W�arS. Nn 1 • • • • • • • • • • • • • • • • • • • • **New for this model year • • •=Available • • -16- - Ford Division . . • . .. . . - . n reviewed with me by the selling dealer and will be given to me upon delivery of the product. • YES/NO The correct operator's manual has been given to me.YES/NO • The selling dealer explained safety precautions to me.YES/NO The selling dealer explained safety features of the product to me.YES/NO The selling dealer explained the warranty terms and coverage to me.YES/NO . The answers circled above are correct.I acknowledge that I have read and I accept thls.warranty policy statement Model- Product identification number Operator's manual form number- Customer name(Please Print)- Purchaser Address Dealer Name City,Slate,Zip City,State,Zip • Purchaser . . Signature Date Dealer' . Signature • Date• • Mail original signed cony to 360 Services Inc.12623 Newburgh Road.Livonia.MI 48150.USA DOUGLAS COUNTY REQUEST FOR BID & BID SHEET • ON: CITY OF OMAHA PORTABLE CHEMICAL RESTROOM SERVICE NOT AN ORDER Page 7 QUANTITY DESCRIPTION UNIT PRICE EXTENSION SECTION B-PARKS (conti ued% Swimming Pool Field, 600 Hilcrest St., Elkhorn. April 15-Sept. 1, 2011 Portable unit with ONCE A WEEK SERVICE. Unit to be staked in the ground. Call 616-6594 for placement. 1 unit Regular BID/per unit per month: $ 70.00 TOTAL BID: $385.00 (BID/per unit per month x 1 unit x 5.5 months) Chapel Hill Park, 21701 Leavenworth, Elkhorn. April 15-Sept. 1, 2011 Portable unit with ONCE A WEEK SERVICE. Unit to be staked in the ground. Call 616-6594 for placement. 1 unit Regular BID/per unit per month: $70.00 TOTAL BID: $385.00 (BID/per unit per month x 1 unit x 5.5 months) Fontenelle Park Spray Ground, 4405 Fontenelle Blvd. (Memorial weekend through Labor Day weekend) Portable unit with ONCE A WEEK SERVICE. Call 699-1701 for placement. 1 unit Regular BID/per unit per month: $ 70.00 TOTAL BID: $245.00 (BID/per unit per month x 1 unit x 3.5 months) Riverfront Bridge Plaza, 705 Riverfront Drive(Year Round Serivice) Portable unit(see below service schedule for unit). To be placed in 1 unit ADA Accessible TWICE A WEEK SERVICE: October 1, 2011 - February 28, 2012 $ BID/per unit per month with twice a week service: $ 125.00 TOTAL BID: $ 625.00 • (BID/per unit per month x 1 unit x 5 months) SEVEN TIMES A WEEK SERVICE: March 1 -September 30, 2012 $ BID/per unit per month with seven times a week service: $400.00 TOTAL BID: $2800.00 (BID/per unit per month x 1 unit x 7 months) 1 unit ADA Accessible THREE TIMES A WEEK SERVICE: October 1, 2011 -February 28, 2012 $ BID/per unit per month with three times a week service: $ 175.00 TOTAL BID: $875.00 (BID/per unit per month x 1 unit x 5 months) SEVEN TIMES A WEEK SERVICE: March 1 -September 30, 2012 $ BID/per unit per month with seven times a week service: $400.00 TOTAL BID: $2800.00 (BID/per unit per month x 1 unit x 7 months) SIGN ALL COPIES • Firm -Pc'}-1t,{'L By , - . Title .(/ Gt, -,c,. CONTINUATION SHEET U /93. The tank capacity shall be 50 gallons minimum, and the inside area shall be 13 square feet minimum. Unit shall be essentially equal to"Aquazyme." A location shall be considered to be a given park or recreation area, such as:Johnny Goodman, Benson, Elmwood, Fonterielle,Warren Swigart,Spring Lake, Westwood,etc. SECTION A. ALL OR NONE TOTAL BID (GOLF): $4.466.00 SECTION B. ALL OR NONE TOTAL BID (PARKS): $26.141.00 TOTAL BID(SECTION A&B): $30.607.00 (5%Bid Bond is to be based upon this total amount) All bidders awarded a contract in the amount of$5,000 or more must comply with the Contract Compliance Ordinance and have on file with the Human Rights& Relations Department the Contract Compliance Report(Form CC-1). This report shall be in effect for 24 months from the date received by the Human Rights& Relations Department. Any questions regarding the Contract Compliance Ordinance should be directed to the Human Rights&Relations Department at (402)444 5055. (PLEASE PRINT LEGIBLY OR TYPE) Payment Terms % Firm:Deffenbaugh Industries,Inc. lircorporated lI Delivery(or completion) Name:Cynthia Bryant Signature: /= calendar days following award Title:Sales and Marketing Manager Phone:402-731-3333 Fa402-451-7'230 Address: 5902 N 16'h Street Street/P.O.Box City Omaha State NE Zip 68110 Email Address: cbryant©deffenbaughinc.com gi .. cy ,n�... T;a ¢ . � .•t<u^s'�:4r'T"�, ':a'€`` t�" r�e�S4'f"rs '':',�f3s;•''::�'�5�`".,� 2�'`•� ..k�..r�' • Dark Blue Pearl Metallic DX • 'jt•y.-.:a� Y-y r�-,'.Y.-nl:: :f F:-'c.41:•Y" v,.�,, -L� ,C�'Z. ..3•,:;'S`;-w�-� v'F>5,.+;G _ .:�"., L:^:>hc..c`f...(.i ._v ,d1,. rE '.t:�- o-.,t,r':s::-tt F : n. _'BE 'jr :.:;'t r�,�.S., r ✓f y .( s.: �s;'Y1 • �. ..LLY .�'��.•. 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Nn 1 • • • • • • • • • • • • • • • • • • • • **New for this model year • • •=Available • • -16- - Ford Division . . • . .. . . - . n reviewed with me by the selling dealer and will be given to me upon delivery of the product. • YES/NO The correct operator's manual has been given to me.YES/NO • The selling dealer explained safety precautions to me.YES/NO The selling dealer explained safety features of the product to me.YES/NO The selling dealer explained the warranty terms and coverage to me.YES/NO . The answers circled above are correct.I acknowledge that I have read and I accept thls.warranty policy statement Model- Product identification number Operator's manual form number- Customer name(Please Print)- Purchaser Address Dealer Name City,Slate,Zip City,State,Zip • Purchaser . . Signature Date Dealer' . Signature • Date• • Mail original signed cony to 360 Services Inc.12623 Newburgh Road.Livonia.MI 48150.USA DOUGLAS COUNTY REQUEST FOR BID & BID SHEET ON: CITY OF OMAHA PORTABLE CHEMICAL RESTROOM SERVICE NOT AN ORDER Page 8 QUANTITY DESCRIPTION UNIT PRICE EXTENSION SECTION B-PARKS(continuedl: Heartland Park of America, 8th &Douglas April 15-.August 31, 2011 Portable unit with TWICE A WEEK SERVICE. Call 699-1709 for placement. 2 units Regular BID/per unit per month: $ 110.00 TOTAL BID: $990.00 (BID/per unit per month x 2 units x 4.5 months) Standing Bear Lake,to be placed at Entrance 5, Entrance 3, Boat Ramp and Main Picnic Area. April-October, 2011 • Portable unit with TWICE A WEEK SERVICE. Call 699-1704 for placement. 4 units Regular BID/per unit per month: $ 110.00 TOTAL BID: $ 3080.00 (BID/per unit per month x 4 units x 7 months) Seymour Smith Skate Park, 68th &Harrison May 1 -August 31, 2011 Portable unit with TWICE A WEEK SERVICE. Call 699-1702 for placement. 1 unit Regular BID/per unit per month: $ 110.00 TOTAL BID: $440.00 (BID/per unit per month x 1 unit x 4 months) SECTION B(Parks)ALL OR NONE TOTAL BID: $26.141.00 Questions regarding this portion of the bid may be directed to: Jeanne Yates at(402)444-5960. SIGN ALL COPIES Firm1C ,f b �Z (,d /�p Title , S' i ��-- CONTINUATION SHEET February 28, 2012 $ BID/per unit per month with twice a week service: $ 125.00 TOTAL BID: $ 625.00 • (BID/per unit per month x 1 unit x 5 months) SEVEN TIMES A WEEK SERVICE: March 1 -September 30, 2012 $ BID/per unit per month with seven times a week service: $400.00 TOTAL BID: $2800.00 (BID/per unit per month x 1 unit x 7 months) 1 unit ADA Accessible THREE TIMES A WEEK SERVICE: October 1, 2011 -February 28, 2012 $ BID/per unit per month with three times a week service: $ 175.00 TOTAL BID: $875.00 (BID/per unit per month x 1 unit x 5 months) SEVEN TIMES A WEEK SERVICE: March 1 -September 30, 2012 $ BID/per unit per month with seven times a week service: $400.00 TOTAL BID: $2800.00 (BID/per unit per month x 1 unit x 7 months) SIGN ALL COPIES • Firm -Pc'}-1t,{'L By , - . Title .(/ Gt, -,c,. CONTINUATION SHEET U /93. The tank capacity shall be 50 gallons minimum, and the inside area shall be 13 square feet minimum. Unit shall be essentially equal to"Aquazyme." A location shall be considered to be a given park or recreation area, such as:Johnny Goodman, Benson, Elmwood, Fonterielle,Warren Swigart,Spring Lake, Westwood,etc. SECTION A. ALL OR NONE TOTAL BID (GOLF): $4.466.00 SECTION B. ALL OR NONE TOTAL BID (PARKS): $26.141.00 TOTAL BID(SECTION A&B): $30.607.00 (5%Bid Bond is to be based upon this total amount) All bidders awarded a contract in the amount of$5,000 or more must comply with the Contract Compliance Ordinance and have on file with the Human Rights& Relations Department the Contract Compliance Report(Form CC-1). This report shall be in effect for 24 months from the date received by the Human Rights& Relations Department. Any questions regarding the Contract Compliance Ordinance should be directed to the Human Rights&Relations Department at (402)444 5055. (PLEASE PRINT LEGIBLY OR TYPE) Payment Terms % Firm:Deffenbaugh Industries,Inc. lircorporated lI Delivery(or completion) Name:Cynthia Bryant Signature: /= calendar days following award Title:Sales and Marketing Manager Phone:402-731-3333 Fa402-451-7'230 Address: 5902 N 16'h Street Street/P.O.Box City Omaha State NE Zip 68110 Email Address: cbryant©deffenbaughinc.com gi .. cy ,n�... T;a ¢ . � .•t<u^s'�:4r'T"�, ':a'€`` t�" r�e�S4'f"rs '':',�f3s;•''::�'�5�`".,� 2�'`•� ..k�..r�' • Dark Blue Pearl Metallic DX • 'jt•y.-.:a� Y-y r�-,'.Y.-nl:: :f F:-'c.41:•Y" v,.�,, -L� ,C�'Z. ..3•,:;'S`;-w�-� v'F>5,.+;G _ .:�"., L:^:>hc..c`f...(.i ._v ,d1,. rE '.t:�- o-.,t,r':s::-tt F : n. _'BE 'jr :.:;'t r�,�.S., r ✓f y .( s.: �s;'Y1 • �. ..LLY .�'��.•. 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Nn 1 • • • • • • • • • • • • • • • • • • • • **New for this model year • • •=Available • • -16- - Ford Division . . • . .. . . - . n reviewed with me by the selling dealer and will be given to me upon delivery of the product. • YES/NO The correct operator's manual has been given to me.YES/NO • The selling dealer explained safety precautions to me.YES/NO The selling dealer explained safety features of the product to me.YES/NO The selling dealer explained the warranty terms and coverage to me.YES/NO . The answers circled above are correct.I acknowledge that I have read and I accept thls.warranty policy statement Model- Product identification number Operator's manual form number- Customer name(Please Print)- Purchaser Address Dealer Name City,Slate,Zip City,State,Zip • Purchaser . . Signature Date Dealer' . Signature • Date• • Mail original signed cony to 360 Services Inc.12623 Newburgh Road.Livonia.MI 48150.USA DOUGLAS COUNTY • REQUEST FOR BID ON: CITY OF OMAHA PORTABLE CHEMICAL RESTROOM SERVICE NOT AN ORDER Page 9 DESCRIPTION INSURANCE For City projects where the scope of work will be less than $200,000.00, the following levels of insurance will be required: The successful contractor shall provide a certificate of insurance indicating(1)adequate workers' compensation; (2) public liability in an amount not less than$250,000 for injuries including accidental death to any person and subject to the same limit to each person in an amount of not less than$500,000 where more than one person is involved in any one accident; and(3) property damage insurance in an amount not less than$500,000; and naming the City of Omaha an additional insured. For City projects where the scope of work will exceed$200,000.00, the following levels of insurance will be required: The successful contractor shall provide a certificate of insurance indicating(1) adequate workers' compensation; (2)public liability in an amount not less than$1,000,000 for injuries including accidental death to any person and subject to the same limit to each person in an amount of not less than$5,000,000 where more than one person is involved in any one accident; and(3) property damage insurance in an amount not less than$500,000; and naming the City of Omaha an additional insured. REQUIREMENTS FOR BID BOND: The surety company issuing the bid bond or the performance bond should be licensed by the State of Nebraska and listed on the current edition of Circular 570 of the United States Department of the Treasury. A certified check, an official bank check, or cashiers check drawn on a national bank or a bank chartered under the laws of the state, payable to the city, or lawful money of the United States, or a United States Governement Bond(negotiable)are acceptable substitutes for bond requirements. You are hereby on notice that as of October 1,2009, Contractors are required to use E-Verify to determine work eligibility of new employees who are physically performing services within the State of Nebraska. If you have any questions go to the Department of Administrative Services website at www.das.state.ne.us New Employee Work Eligibility Status(Neb. Rev. Stat.§4-108-114) The Contractor is required and hereby agrees to use a federal immigration verification system to determine the work eligibility status of new employees physically performing services within Douglas County. A federal immigration verification system means the electronic verification of the work authorization program authorized by the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.C. 1324a, known as the E-Verify Program, or an equivalent federal program designated by the United States Department of Homeland Security or other federal agency authorized to verify the work eligibility status of a newly hired employee. If the Contractor is an individual or sole proprietorship, the following applies: 1. The Contractor must complete the United States Citizenship Attestation Form, available on the Department of Administrative Services website at www.das.state.ne.us . 2. If the Contractor indicates on such attestation form that he or she is a qualified alien, the Contractor agrees to provide the US Citizenship and Immigration Services documentation required to verify the Contractor's lawful presence in the United States using the Systematic Alien Verification for Entitlements(SAVE)Program. • 3. The Contractor understands and agrees that lawful presence in the United States is required and the Contractor may be disqualified or the contract terminated if such lawful presence cannot be verified as required by Neb. Rev. Stat. §4-108. • SIGN ALL COPIES Firm DeSIA,j r T}-)du,By Qz Title CONTINUATION SHEET one:402-731-3333 Fa402-451-7'230 Address: 5902 N 16'h Street Street/P.O.Box City Omaha State NE Zip 68110 Email Address: cbryant©deffenbaughinc.com gi .. cy ,n�... T;a ¢ . � .•t<u^s'�:4r'T"�, ':a'€`` t�" r�e�S4'f"rs '':',�f3s;•''::�'�5�`".,� 2�'`•� ..k�..r�' • Dark Blue Pearl Metallic DX • 'jt•y.-.:a� Y-y r�-,'.Y.-nl:: :f F:-'c.41:•Y" v,.�,, -L� ,C�'Z. ..3•,:;'S`;-w�-� v'F>5,.+;G _ .:�"., L:^:>hc..c`f...(.i ._v ,d1,. rE '.t:�- o-.,t,r':s::-tt F : n. _'BE 'jr :.:;'t r�,�.S., r ✓f y .( s.: �s;'Y1 • �. ..LLY .�'��.•. F,h.n•4t.�.-.r..,...:li'1?�'.;,.;,.,.,.�.....•..,,:v,iu;;sctiikl::.._.:V.•'t...,,.:.u.,..:tai:-:.,:.�..;::'rK�4:?�.wir?�^+.�<c5?r.,:ni:tT.w',;dtia-'a1'.'»:k�`>,^,:K,V-�.'r�.�.�t�ryre` •f`Fs�>r t'•'o`x�Jt:�:: •F• orest Green Metallic GG - ,.i.'-r�.""4.S y�'•r,.1N.'1 M1:f�', Tk^:.-:.`...'�'.:...�Y+n.. ..iG� <Cf:• y;S.::JJY rrr :c:'r� r :f' z'•�.4 .,(.:,. ,SI?'K -�s.' .t4'^'; ,i"+-:itE�i�;.. :.Q.. a�� 'UU6.7V1ete 1 G <7t=:: ..t.: ::s•. ,ci.; 'C�' -,k?•t3,: ..�a,^t": t.: .,. rC'L;��'Y... • *Tuxedo Black Metallic uti v`•= . ... .._ ._t...: . .... . :•Yj • • Royal Red Metallic UK •:. . ..: 1.L c+: a P•`i'�' t *Golden Bronze Metallic �. 'A�� :+ .,. ...:...::-..f. Is:::is`:.,.k•.,:� i^4,-. .��u��.��.. ^:Pr'•'i'.R!•••. ..1�'•:t.v :-Tli. r'xI' K1i: ate::,' s'; .,;: .yYf�._ v _.u•'.'. t'F...r..,._:._,.rti�.f'ri+r,:r..1:x!_._...r�. .,.,..,_-,',i� %i<z,..r..,mc, x-.,.r'1gat• ° r• :�J.�s-<,.-+.:..}•=��` • • • • �G .� W�arS. Nn 1 • • • • • • • • • • • • • • • • • • • • **New for this model year • • •=Available • • -16- - Ford Division . . • . .. . . - . n reviewed with me by the selling dealer and will be given to me upon delivery of the product. • YES/NO The correct operator's manual has been given to me.YES/NO • The selling dealer explained safety precautions to me.YES/NO The selling dealer explained safety features of the product to me.YES/NO The selling dealer explained the warranty terms and coverage to me.YES/NO . The answers circled above are correct.I acknowledge that I have read and I accept thls.warranty policy statement Model- Product identification number Operator's manual form number- Customer name(Please Print)- Purchaser Address Dealer Name City,Slate,Zip City,State,Zip • Purchaser . . Signature Date Dealer' . Signature • Date• • Mail original signed cony to 360 Services Inc.12623 Newburgh Road.Livonia.MI 48150.USA SPECIFICATIONS FOR PORTABLE CHEMICAL REST ROOM SERVICE SCOPE OF SERVICE: Contractor shall provide all labor, equipment, services and knowledge to maintain the highest quality of standards possible in providing a chemical toilet service for the City of Omaha, Nebraska. REST ROOM EQUIPMENT: Each portable chemical toilet unit shall be a self-contained unit with space ample enough to accommodate an adult and a small child at the same time. Entrance door of unit shall be equipped with self-closing spring and latching device. Openings around unit shall be of sufficient size to give adequate ventilation. These openings shall be not less than six feet above ground level and shall be tightly screened to exclude insects or rodents. A vent pipe extending above roof shall vent the holding tank urinal system. Building unit and plumbing system shall be designed for maximum cleaning ease. DELIVERY and PICK UP: Portable chemical toilets shall be delivered or picked up within a 24-hour period, to or from the location prescribed by the various City departments involved. SERVICE PROCEDURES: Complete service shall be provided to each unit on a weekly basis. If service is required more often than once a week, such conditions shall be brought to the attention of personnel of the City department involved. Weekly service shall consist of the following: 1. Units shall be completely pumped and recharged with fresh chemical. 2. Units shall be thoroughly cleaned, scrubbed and the toilet seat and urinal area completely disinfected. 3. Odor shall be controllable with the type of chemical used at temperatures through 100 degrees Fahrenheit. 4. Deodorant blocks shall be placed in the urinals and interior of unit shall be thoroughly sprayed with an effective insecticide capable of killing both flying and crawling insects of all varieties. 5. Toilet paper dispensers shall be completely refilled at each servicing. 6. All minor repairs shall be done on a weekly basis. Work Eligibility Status(Neb. Rev. Stat.§4-108-114) The Contractor is required and hereby agrees to use a federal immigration verification system to determine the work eligibility status of new employees physically performing services within Douglas County. A federal immigration verification system means the electronic verification of the work authorization program authorized by the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.C. 1324a, known as the E-Verify Program, or an equivalent federal program designated by the United States Department of Homeland Security or other federal agency authorized to verify the work eligibility status of a newly hired employee. If the Contractor is an individual or sole proprietorship, the following applies: 1. The Contractor must complete the United States Citizenship Attestation Form, available on the Department of Administrative Services website at www.das.state.ne.us . 2. If the Contractor indicates on such attestation form that he or she is a qualified alien, the Contractor agrees to provide the US Citizenship and Immigration Services documentation required to verify the Contractor's lawful presence in the United States using the Systematic Alien Verification for Entitlements(SAVE)Program. • 3. The Contractor understands and agrees that lawful presence in the United States is required and the Contractor may be disqualified or the contract terminated if such lawful presence cannot be verified as required by Neb. Rev. Stat. §4-108. • SIGN ALL COPIES Firm DeSIA,j r T}-)du,By Qz Title CONTINUATION SHEET one:402-731-3333 Fa402-451-7'230 Address: 5902 N 16'h Street Street/P.O.Box City Omaha State NE Zip 68110 Email Address: cbryant©deffenbaughinc.com gi .. cy ,n�... T;a ¢ . � .•t<u^s'�:4r'T"�, ':a'€`` t�" r�e�S4'f"rs '':',�f3s;•''::�'�5�`".,� 2�'`•� ..k�..r�' • Dark Blue Pearl Metallic DX • 'jt•y.-.:a� Y-y r�-,'.Y.-nl:: :f F:-'c.41:•Y" v,.�,, -L� ,C�'Z. ..3•,:;'S`;-w�-� v'F>5,.+;G _ .:�"., L:^:>hc..c`f...(.i ._v ,d1,. rE '.t:�- o-.,t,r':s::-tt F : n. _'BE 'jr :.:;'t r�,�.S., r ✓f y .( s.: �s;'Y1 • �. ..LLY .�'��.•. F,h.n•4t.�.-.r..,...:li'1?�'.;,.;,.,.,.�.....•..,,:v,iu;;sctiikl::.._.:V.•'t...,,.:.u.,..:tai:-:.,:.�..;::'rK�4:?�.wir?�^+.�<c5?r.,:ni:tT.w',;dtia-'a1'.'»:k�`>,^,:K,V-�.'r�.�.�t�ryre` •f`Fs�>r t'•'o`x�Jt:�:: •F• orest Green Metallic GG - ,.i.'-r�.""4.S y�'•r,.1N.'1 M1:f�', Tk^:.-:.`...'�'.:...�Y+n.. ..iG� <Cf:• y;S.::JJY rrr :c:'r� r :f' z'•�.4 .,(.:,. ,SI?'K -�s.' .t4'^'; ,i"+-:itE�i�;.. :.Q.. a�� 'UU6.7V1ete 1 G <7t=:: ..t.: ::s•. ,ci.; 'C�' -,k?•t3,: ..�a,^t": t.: .,. rC'L;��'Y... • *Tuxedo Black Metallic uti v`•= . ... .._ ._t...: . .... . :•Yj • • Royal Red Metallic UK •:. . ..: 1.L c+: a P•`i'�' t *Golden Bronze Metallic �. 'A�� :+ .,. ...:...::-..f. Is:::is`:.,.k•.,:� i^4,-. .��u��.��.. ^:Pr'•'i'.R!•••. ..1�'•:t.v :-Tli. r'xI' K1i: ate::,' s'; .,;: .yYf�._ v _.u•'.'. t'F...r..,._:._,.rti�.f'ri+r,:r..1:x!_._...r�. .,.,..,_-,',i� %i<z,..r..,mc, x-.,.r'1gat• ° r• :�J.�s-<,.-+.:..}•=��` • • • • �G .� W�arS. Nn 1 • • • • • • • • • • • • • • • • • • • • **New for this model year • • •=Available • • -16- - Ford Division . . • . .. . . - . n reviewed with me by the selling dealer and will be given to me upon delivery of the product. • YES/NO The correct operator's manual has been given to me.YES/NO • The selling dealer explained safety precautions to me.YES/NO The selling dealer explained safety features of the product to me.YES/NO The selling dealer explained the warranty terms and coverage to me.YES/NO . The answers circled above are correct.I acknowledge that I have read and I accept thls.warranty policy statement Model- Product identification number Operator's manual form number- Customer name(Please Print)- Purchaser Address Dealer Name City,Slate,Zip City,State,Zip • Purchaser . . Signature Date Dealer' . Signature • Date• • Mail original signed cony to 360 Services Inc.12623 Newburgh Road.Livonia.MI 48150.USA Page 2—City of Omaha, 2010 Specifications Portable Chemical Rest Room Service • • CHEMICALS: The chemical solution used to recharge the holding tank shall be of a quality to act as an effective germicide, killing germs and insects on contact, discouraging vermin or rodents. The solution shall be of sufficient potency to achieve and maintain effective disinfectant - deodorant properties until tank is serviced. Vapors from solution shall be non-irritating to eyes or respiratory tract of potential users and be biodegradable. The cleaning and disinfecting chemical used on the interior of the unit for scrubbing and sanitizing shall also be an effective germicide rather than a masking agent. EXTRA SERVICE: When service is required more than once weekly, extra complete service shall then be provided upon approval of the using department. Extra complete service is intended to mean that service as described under"Service Procedures" above. DISPOSAL OF WASTE MATERIAL: Disposal of contents of unit serviced pursuant to this contract shall be in accordance with the requirements of the City of Omaha. INSURANCE: Unit shall be completely insured by contractor. GENERAL: Each city department using the Portable Rest Room Service shall reserve the right to refuse delivery of a unit which is not in good repair and/or poor in appearance. EXAMPLES OF AREAS REQUIRING SERVICE: Golf courses, parks, playgrounds and possible'construction sites. Revised 12-21-93 • 2010cquip-specs.dac ubbed and the toilet seat and urinal area completely disinfected. 3. Odor shall be controllable with the type of chemical used at temperatures through 100 degrees Fahrenheit. 4. Deodorant blocks shall be placed in the urinals and interior of unit shall be thoroughly sprayed with an effective insecticide capable of killing both flying and crawling insects of all varieties. 5. Toilet paper dispensers shall be completely refilled at each servicing. 6. All minor repairs shall be done on a weekly basis. Work Eligibility Status(Neb. Rev. Stat.§4-108-114) The Contractor is required and hereby agrees to use a federal immigration verification system to determine the work eligibility status of new employees physically performing services within Douglas County. A federal immigration verification system means the electronic verification of the work authorization program authorized by the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.C. 1324a, known as the E-Verify Program, or an equivalent federal program designated by the United States Department of Homeland Security or other federal agency authorized to verify the work eligibility status of a newly hired employee. If the Contractor is an individual or sole proprietorship, the following applies: 1. The Contractor must complete the United States Citizenship Attestation Form, available on the Department of Administrative Services website at www.das.state.ne.us . 2. If the Contractor indicates on such attestation form that he or she is a qualified alien, the Contractor agrees to provide the US Citizenship and Immigration Services documentation required to verify the Contractor's lawful presence in the United States using the Systematic Alien Verification for Entitlements(SAVE)Program. • 3. The Contractor understands and agrees that lawful presence in the United States is required and the Contractor may be disqualified or the contract terminated if such lawful presence cannot be verified as required by Neb. Rev. Stat. §4-108. • SIGN ALL COPIES Firm DeSIA,j r T}-)du,By Qz Title CONTINUATION SHEET one:402-731-3333 Fa402-451-7'230 Address: 5902 N 16'h Street Street/P.O.Box City Omaha State NE Zip 68110 Email Address: cbryant©deffenbaughinc.com gi .. cy ,n�... T;a ¢ . � .•t<u^s'�:4r'T"�, ':a'€`` t�" r�e�S4'f"rs '':',�f3s;•''::�'�5�`".,� 2�'`•� ..k�..r�' • Dark Blue Pearl Metallic DX • 'jt•y.-.:a� Y-y r�-,'.Y.-nl:: :f F:-'c.41:•Y" v,.�,, -L� ,C�'Z. ..3•,:;'S`;-w�-� v'F>5,.+;G _ .:�"., L:^:>hc..c`f...(.i ._v ,d1,. rE '.t:�- o-.,t,r':s::-tt F : n. _'BE 'jr :.:;'t r�,�.S., r ✓f y .( s.: �s;'Y1 • �. ..LLY .�'��.•. F,h.n•4t.�.-.r..,...:li'1?�'.;,.;,.,.,.�.....•..,,:v,iu;;sctiikl::.._.:V.•'t...,,.:.u.,..:tai:-:.,:.�..;::'rK�4:?�.wir?�^+.�<c5?r.,:ni:tT.w',;dtia-'a1'.'»:k�`>,^,:K,V-�.'r�.�.�t�ryre` •f`Fs�>r t'•'o`x�Jt:�:: •F• orest Green Metallic GG - ,.i.'-r�.""4.S y�'•r,.1N.'1 M1:f�', Tk^:.-:.`...'�'.:...�Y+n.. ..iG� <Cf:• y;S.::JJY rrr :c:'r� r :f' z'•�.4 .,(.:,. ,SI?'K -�s.' .t4'^'; ,i"+-:itE�i�;.. :.Q.. a�� 'UU6.7V1ete 1 G <7t=:: ..t.: ::s•. ,ci.; 'C�' -,k?•t3,: ..�a,^t": t.: .,. rC'L;��'Y... • *Tuxedo Black Metallic uti v`•= . ... .._ ._t...: . .... . :•Yj • • Royal Red Metallic UK •:. . ..: 1.L c+: a P•`i'�' t *Golden Bronze Metallic �. 'A�� :+ .,. ...:...::-..f. Is:::is`:.,.k•.,:� i^4,-. .��u��.��.. ^:Pr'•'i'.R!•••. ..1�'•:t.v :-Tli. r'xI' K1i: ate::,' s'; .,;: .yYf�._ v _.u•'.'. t'F...r..,._:._,.rti�.f'ri+r,:r..1:x!_._...r�. .,.,..,_-,',i� %i<z,..r..,mc, x-.,.r'1gat• ° r• :�J.�s-<,.-+.:..}•=��` • • • • �G .� W�arS. Nn 1 • • • • • • • • • • • • • • • • • • • • **New for this model year • • •=Available • • -16- - Ford Division . . • . .. . . - . n reviewed with me by the selling dealer and will be given to me upon delivery of the product. • YES/NO The correct operator's manual has been given to me.YES/NO • The selling dealer explained safety precautions to me.YES/NO The selling dealer explained safety features of the product to me.YES/NO The selling dealer explained the warranty terms and coverage to me.YES/NO . The answers circled above are correct.I acknowledge that I have read and I accept thls.warranty policy statement Model- Product identification number Operator's manual form number- Customer name(Please Print)- Purchaser Address Dealer Name City,Slate,Zip City,State,Zip • Purchaser . . Signature Date Dealer' . Signature • Date• • Mail original signed cony to 360 Services Inc.12623 Newburgh Road.Livonia.MI 48150.USA • DOUGLAS COUNTY PURCHASING DEPARTMENT 1819 FARNAM STREET 902 CIVIC CENTER OMAHA NEBR 68183 PHONE(402)444-7155 FAX(402)444-4992 January 31,2011 NOTICE TO BIDDERS: REQUEST FOR BID ON PORTABLE CHEMICAL RESTROOM SERVICE BID OPENING DATE: FEBRUARY 9, 2011 at 11:00 A.M. ADDENDUM NO. 1: Replace page two and three of bid sheets with the attached revised page two and three. END OF ADDENDUM ACKNOWLEDGE RECEIPT OF THIS ADDENDUM BY SIGNING BELOW AND RETURNING THIS ADDENDUM COVER SHEET WITH YOUR BID. Patrick Burke, Douglas County Assistant Purchasing Agent Name Firm Sign MA/kW Tit e Q Control No. 22325 "Q" Street Bridge, 26th—27th Streets Preliminary Engineering, NEPA Documentation and Final Design Services lerk Approved... OF,.. Mayor DOUGLAS COUNTY PURCHASING DEPARTMENT 1819 FARNAM STREET 902 CIVIC CENTER OMAHA NEBR 68183 PHONE(402) 444-4954 FAX(402)444-4992 February 4, 2011 NOTICE TO BIDDERS: REQUEST FOR BID ON Portable Chemical Restroom Service Bid Opening Date: February 9, 2011 at 11:00 a.m. ADDENDUM NO. 2: Replace page 6 and page 8 of bid with the attached revised page 6 and page 8. END OF ADDENDUM ACKNOWLEDGE RECEIPT OF THIS ADDENDUM BY SIGNING BELOW AND RETURNING THIS ADDENDUM COVER SHEET WITH YOUR BID. Patrick Burke Assistant Douglas County Purchasing Agent Name o Signe By ha Title Sign MA/kW Tit e Q Control No. 22325 "Q" Street Bridge, 26th—27th Streets Preliminary Engineering, NEPA Documentation and Final Design Services lerk Approved... OF,.. Mayor C-25A Cl -y OF OMAHA LEGISLATIVE CHAMBER Omaha,Nebraska RESOLVED BY THE CITY COUNCIL OF THE CITY OF OMAHA: r .� t t WHEREAS, bids were received on February 9, 2011, to furnish;portable chemical restroom service for the 2011 Park Season, for the Parks, Recreation£and Public Property Depaittnent; and, WHEREAS, Deffenbaugh Industries, Inc., submitted the lowest bid, within bid specifications, attached hereto and made a part hereof, in the total amount of $26,141.00; and, WHEREAS, Deffenbaugh Industries, Inc., has complied with the City's Contract Compliance Ordinance No. 28885 in relation to Civil Rights -Human Relations; and, WHEREAS, the Mayor has recommended acceptance of this bid. NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF OMAHA: THAT, as recommended by the Mayor, the bid in the total amount of $26,141.00 from Deffenbaugh Industries, Inc., to furnish portable chemical restroom service for the 2011 Park Season for the Parks, Recreation and Public Property Department is hereby accepted and the Purchasing Agent is authorized to issue a purchase order in conformance herewith. The Finance Department is authorized to pay for the portable chemical restroom service from the General Fund No. 11111 and Organization No. 115024, Parks and Community Centers. APPROVED AS TO FORM: r a p7-v DE_U CITY ATTORNEY DATE p:1396tmb By Councilmember Adopted....;. MAR.:2..2 201'1 v 6—O vi, -- _ .cam�,:i,' C. Clerk Approved irr /%i ayl1 pp / � � Mayor eratures through 100 degrees Fahrenheit. 4. Deodorant blocks shall be placed in the urinals and interior of unit shall be thoroughly sprayed with an effective insecticide capable of killing both flying and crawling insects of all varieties. 5. Toilet paper dispensers shall be completely refilled at each servicing. 6. All minor repairs shall be done on a weekly basis. Work Eligibility Status(Neb. Rev. Stat.§4-108-114) The Contractor is required and hereby agrees to use a federal immigration verification system to determine the work eligibility status of new employees physically performing services within Douglas County. A federal immigration verification system means the electronic verification of the work authorization program authorized by the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, 8 U.S.C. 1324a, known as the E-Verify Program, or an equivalent federal program designated by the United States Department of Homeland Security or other federal agency authorized to verify the work eligibility status of a newly hired employee. If the Contractor is an individual or sole proprietorship, the following applies: 1. The Contractor must complete the United States Citizenship Attestation Form, available on the Department of Administrative Services website at www.das.state.ne.us . 2. If the Contractor indicates on such attestation form that he or she is a qualified alien, the Contractor agrees to provide the US Citizenship and Immigration Services documentation required to verify the Contractor's lawful presence in the United States using the Systematic Alien Verification for Entitlements(SAVE)Program. • 3. The Contractor understands and agrees that lawful presence in the United States is required and the Contractor may be disqualified or the contract terminated if such lawful presence cannot be verified as required by Neb. Rev. Stat. §4-108. • SIGN ALL COPIES Firm DeSIA,j r T}-)du,By Qz Title CONTINUATION SHEET one:402-731-3333 Fa402-451-7'230 Address: 5902 N 16'h Street Street/P.O.Box City Omaha State NE Zip 68110 Email Address: cbryant©deffenbaughinc.com gi .. cy ,n�... T;a ¢ . � .•t<u^s'�:4r'T"�, ':a'€`` t�" r�e�S4'f"rs '':',�f3s;•''::�'�5�`".,� 2�'`•� ..k�..r�' • Dark Blue Pearl Metallic DX • 'jt•y.-.:a� Y-y r�-,'.Y.-nl:: :f F:-'c.41:•Y" v,.�,, -L� ,C�'Z. ..3•,:;'S`;-w�-� v'F>5,.+;G _ .:�"., L:^:>hc..c`f...(.i ._v ,d1,. rE '.t:�- o-.,t,r':s::-tt F : n. _'BE 'jr :.:;'t r�,�.S., r ✓f y .( s.: �s;'Y1 • �. ..LLY .�'��.•. F,h.n•4t.�.-.r..,...:li'1?�'.;,.;,.,.,.�.....•..,,:v,iu;;sctiikl::.._.:V.•'t...,,.:.u.,..:tai:-:.,:.�..;::'rK�4:?�.wir?�^+.�<c5?r.,:ni:tT.w',;dtia-'a1'.'»:k�`>,^,:K,V-�.'r�.�.�t�ryre` •f`Fs�>r t'•'o`x�Jt:�:: •F• orest Green Metallic GG - ,.i.'-r�.""4.S y�'•r,.1N.'1 M1:f�', Tk^:.-:.`...'�'.:...�Y+n.. ..iG� <Cf:• y;S.::JJY rrr :c:'r� r :f' z'•�.4 .,(.:,. ,SI?'K -�s.' .t4'^'; ,i"+-:itE�i�;.. :.Q.. a�� 'UU6.7V1ete 1 G <7t=:: ..t.: ::s•. ,ci.; 'C�' -,k?•t3,: ..�a,^t": t.: .,. rC'L;��'Y... • *Tuxedo Black Metallic uti v`•= . ... .._ ._t...: . .... . :•Yj • • Royal Red Metallic UK •:. . ..: 1.L c+: a P•`i'�' t *Golden Bronze Metallic �. 'A�� :+ .,. ...:...::-..f. Is:::is`:.,.k•.,:� i^4,-. .��u��.��.. ^:Pr'•'i'.R!•••. ..1�'•:t.v :-Tli. r'xI' K1i: ate::,' s'; .,;: .yYf�._ v _.u•'.'. t'F...r..,._:._,.rti�.f'ri+r,:r..1:x!_._...r�. .,.,..,_-,',i� %i<z,..r..,mc, x-.,.r'1gat• ° r• :�J.�s-<,.-+.:..}•=��` • • • • �G .� W�arS. Nn 1 • • • • • • • • • • • • • • • • • • • • **New for this model year • • •=Available • • -16- - Ford Division . . • . .. . . - . n reviewed with me by the selling dealer and will be given to me upon delivery of the product. • YES/NO The correct operator's manual has been given to me.YES/NO • The selling dealer explained safety precautions to me.YES/NO The selling dealer explained safety features of the product to me.YES/NO The selling dealer explained the warranty terms and coverage to me.YES/NO . The answers circled above are correct.I acknowledge that I have read and I accept thls.warranty policy statement Model- Product identification number Operator's manual form number- Customer name(Please Print)- Purchaser Address Dealer Name City,Slate,Zip City,State,Zip • Purchaser . . Signature Date Dealer' . Signature • Date• • Mail original signed cony to 360 Services Inc.12623 Newburgh Road.Livonia.MI 48150.USA 'o 2 O ON b _ � � o� � � 8 .- c p a, Fr N 5- = v�> b 0 g N , b c n a O O i-t0 `Cr Z `co" A v�• o Q O n O ,� P- ` ao cn 6. CDZ o b Iv ( oN d �O cD � o " \ 1,,, n O «y O O O 'Fr 0 N - o N CD O $ Pa PF O••0 n c . O . CN NS c c c vt.0 cr:i+• • e N. Signe By ha Title Sign MA/kW Tit e Q Control No. 22325 "Q" Street Bridge, 26th—27th Streets Preliminary Engineering, NEPA Documentation and Final Design Services lerk Approved... OF,.. Mayor