The URL can be used to link to this page

RES 2011-0328 - Subdivision agmt, Whispering Ridge Replat Two 0 othHA,NF �� , �,,..5„,......_ R EC El V E 0 Public Works Department �,ps., �r , Omaha/Douglas Civic Center z t t r „ March 22, 2011 j p 1819 Famam Street,Suite 601 • ® ' f1 �, it ) � ( Omaha,Nebraska 68183-0601 '0oy CITY "� yi (402)444-5220 aZ&b FEBRJt4 C*r I ? C L `?' Fax(402)444-5248 City of Omaha. N c ,A S K A Robert G.Stubbe,P.E. Jim Suttle,Mayor Public Works Director Honorable President and Members of the City Council, The attached Resolution approves the Subdivision Agreement among Woodland Homes, Inc., Sanitary and Improvement District (S.&I.D.) 549 of Douglas County, Nebraska and the City of Omaha. This Subdivision Agreement covers the public improvement of Whispering Ridge Replat Two, a subdivision located southwest of 175t'& Emmet Streets. The Subdivision Agreement Amendment covers the change in interceptor sewer fees due by S.&I.D. 549. The Public Works Department requests your consideration and approval of the attached Resolution and Subdivision Agreement. Respectfully submitted, This action has been reviewed and found to b ' formance with th aster Plan. 674.4.,-1414e16_, 2 -z8 -// alGPideoll ,\.Nc Robert G. Stubbe, P.E. Date .E. Cunningham F. E Date Public Works Director Planning Directo Referred to City Council for Consideration: .1 M r s Office Date P:\msp\1209msp.doc roved. l FURTHER THAT, the Finance Director is authorized to provide payment of $50,000.00 from the 2011 General Fund 11111, Organization 126015 in accordance with the contract terms. APPROVED AS TO FORM: avvv(.-- — I CITY ATTORNEY DATE ... '�AIr % P:\MYR\1109ajg By • Councilme ber Adopted MAR 2 2 2011 Q' .. :... . .. . 7-6 ...( a'adea...:` . .::: . . " 5/-// Approved.'._, , ,y/.:"'�,- Mayor n the immediate crisis but also to make long-term changes . The main goals for YWCA Omaha's 24-hour Crisis Line in 2011 is to increase callers' knowledge about domestic violence, dating violence, sexual assault, and stalking services and options and to increase callers' safety levels in crisis situations. The primary outcomes for the 24-hour crisis hotline in 2011 are: 1) provide 100%of callers with at least one service or option and 2) increase hotline volunteers' knowledge regarding domestic violence, sexual assault, dating violence and stalking through initial,40-hour, coalition-required training and regular, ongoing training through meetings and newsletters. • Feb. 7, 2011 2011 City of Omaha -Community Services Funds—YWCA Page 1 of 2 enship 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 AMENDMENT TO SUBDIVISION AGREEMENT FOR "WHISPERING RIDGE REPLAT TWO" THIS AMENDMENT, made and entered into this lay of i4por, , 2011, by and between WOODLAND HOMES, INC. (hereinafter referred to as "Subdivider"), and SANITARY AND IMPROVEMENT DISTRICT NO. 549 of DOUGLAS COUNTY, NEBRASKA, (hereinafter referred to as "SID"), and the CITY OF OMAHA, a Municipal Corporation in the State of Nebraska (hereinafter referred to as "City"). WITNESSETH WHEREAS, Subdivider is the owner of the land included with the proposed plat attached hereto as Exhibit "A", which parcel of land (hereinafter referred to as the "Area to be Developed") is outside the corporate limits of the City, but within the City's zoning and platting jurisdiction; and, WHEREAS, the area to be developed is a replat of Lots 28 thru 56, inclusive, and also Outlot A, Whispering Ridge West, a platted and recorded subdivision in Douglas County, Nebraska for which the Subdivider, the City, and the SID, have previously entered into a Subdivision Agreement (hereinafter referred to as the "Agreement"), adopted by the City Council of the City on December 18, 2007 with Resolution No. 1503, setting forth certain conditions; and WHEREAS, Exhibit "A" entitled "Final Plat", (Exhibit "A" of the Agreement is hereby revised as shown per said Exhibit"A" of this Amendment attached hereto), and WHEREAS, additional improvements are not required to be constructed. WHEREAS, all provisions of the original Agreement are valid and shall remain in effect except the following paragraphs which are revised as follows: Section IX, Paragraph A. The Subdivision Agreement is amended to provide for changes in the amount and payment method of interceptor sewer fees. AREAS OF REPLAT: Lot 1, Whispering Ridge West Replat Two Mem. Care & Assist. Living, 90 Units @ $858.00 = $77,220.00 TOTAL REPLAT AMOUNT = $77,220.00 PREVIOUSLY PAID: Lots 28-56, inclusive, Whispering Ridge West 29 lots @,947.00 = $27,463.00 1 immediate crisis but also to make long-term changes . The main goals for YWCA Omaha's 24-hour Crisis Line in 2011 is to increase callers' knowledge about domestic violence, dating violence, sexual assault, and stalking services and options and to increase callers' safety levels in crisis situations. The primary outcomes for the 24-hour crisis hotline in 2011 are: 1) provide 100%of callers with at least one service or option and 2) increase hotline volunteers' knowledge regarding domestic violence, sexual assault, dating violence and stalking through initial,40-hour, coalition-required training and regular, ongoing training through meetings and newsletters. • Feb. 7, 2011 2011 City of Omaha -Community Services Funds—YWCA Page 1 of 2 enship 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 Payment for Construction of Interceptor Sewers. For the amount previously paid to the City, $27,463.00, the Owner of Lot 1, Whispering Ridge West Replat Two shall pay this amount TO SID 549 and a receipt of payment • issued as documentation to the City of Omaha in order to issue a building permit for Lot 1, Whispering Ridge West Replat One. For the difference in the amount of Interceptor Sewer Fees previously paid and the amount due at the time of building permit or $77,220.00 - $27,463.00 = $49,757.00, the _ City shall collect this amount of Interceptor Sewer Fees at the time of building permit application for Lot 1, Whispering Ridge West Replat Two. If the Interceptor Sewer Fee amount is changed by action of the City Council, the lots shall be assessed the then current fee for Interceptor Sewers. This Amendment to the Subdivision Agreement shall be binding upon the parties, their respective successors and assigns and shall run with the land as shown on Exhibit "A". IN WITNESS WHEREOF, we the executing parties, by our respective duly authorized agents, hereby enter into this Agreement, effective on the day and year first above written. ATTEST: ;: CITY OF OMAHA • C L K AT MA ,'`'' D' E ATTEST: SANITARY AND IMPROVEMENT DISTRICT NO. 549 OF DOUGLAS COUNTY,NEBRASKA 51, 9 CLERK DATE CHAIRMAN DATE WOODLAND HOMES, INC. By: Gerald L. orczo resident DATE APPROVED AS TO FORM ASSISTANT CITY ATTOR EY 2 ent are valid and shall remain in effect except the following paragraphs which are revised as follows: Section IX, Paragraph A. The Subdivision Agreement is amended to provide for changes in the amount and payment method of interceptor sewer fees. AREAS OF REPLAT: Lot 1, Whispering Ridge West Replat Two Mem. Care & Assist. Living, 90 Units @ $858.00 = $77,220.00 TOTAL REPLAT AMOUNT = $77,220.00 PREVIOUSLY PAID: Lots 28-56, inclusive, Whispering Ridge West 29 lots @,947.00 = $27,463.00 1 immediate crisis but also to make long-term changes . The main goals for YWCA Omaha's 24-hour Crisis Line in 2011 is to increase callers' knowledge about domestic violence, dating violence, sexual assault, and stalking services and options and to increase callers' safety levels in crisis situations. The primary outcomes for the 24-hour crisis hotline in 2011 are: 1) provide 100%of callers with at least one service or option and 2) increase hotline volunteers' knowledge regarding domestic violence, sexual assault, dating violence and stalking through initial,40-hour, coalition-required training and regular, ongoing training through meetings and newsletters. • Feb. 7, 2011 2011 City of Omaha -Community Services Funds—YWCA Page 1 of 2 enship 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 *' STATE OF NEBRASKA ) )SS COUNTY OF DOUGLAS ) On this day ofc-0v�p�i(hV__{ , 2011, before me, a Notary Public in and for said County and State, personally appeared Gerald L. Torczon, President of Woodland Homes, Inc., who is personally known by me to be the identical person whose name is affixed to this Subdivision Agreement, and acknowledged the execution thereof to be his voluntary act and deed as such officer of said corporation. GENERAL NOTARY-State of Nebraska R LESLIE PIERCE '�,n CVO r//� My Comm.EV.MaY 23,2014 1'\ //� 0 A" ARY P O U LIC My Com�ission Expires III • 3 - ..L'\ . . \�\ r • - • ,. 1.,?, k. \ Af W • Services lerk Approved... OF,.. Mayor C-25A CITY OF OMAHA LEGISLATIVE CHAMBER Omaha,Nebraska RESOLVED BY THE CITY COUNCIL OF THE CITY OF OMAHA: WHEREAS, Woodland Homes,Inc.proposes to build a subdivision to be known as Whispering Ridge Replat Two, which will be located southwest of 175th & Emmet Streets; and, WHEREAS, Woodland Homes, Inc. will build public and private improvements in this subdivision; and, WHEREAS, S.&I.D. 549 has paid $27,463 in interceptor sewer fees in accordance with the original agreement adopted by the City Council of the City of Omaha on December 18,2007 via Resolution No. 1503; and, WHEREAS, S.&I.D. 549 is subject to interceptor sewer fees of$77,220 based on the replat; and, WHEREAS, the City shall collect the difference between the previously paid interceptor sewer fee amount and the amount based on the replat, $49,757, at the time of building permit application; additionally, the City shall be provided with documentation of the previously paid interceptor sewer fee; and, WHEREAS,an Amendment to the Subdivision Agreement has been prepared setting forth all the provisions mentioned above. NOW,THEREFORE,BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF OMAHA: THAT, the Subdivision Agreement among the City of Omaha, Woodland Homes, Inc.,and Sanitary and Improvement District 549 of Douglas County,Nebraska,as recommended by the Mayor, providing for the application of previously paid interceptor sewer fees to new fees resulting from the replat,is hereby approved. The Subdivision is to be known as Whispering Ridge Replat Two and is located southwest of 175th & Emmet Streets. P:\msp\1210msp.doc APPROVED AS TO FORM: t /i _z‘,(...„ 44.44.7,4--!4,4444. TY ATTORNEY DATE By Councilmember Adopted , R - 5 2011 .7 .•. • • - ity Clerk /ja Approved...."ci 1 Mayor Mem. Care & Assist. Living, 90 Units @ $858.00 = $77,220.00 TOTAL REPLAT AMOUNT = $77,220.00 PREVIOUSLY PAID: Lots 28-56, inclusive, Whispering Ridge West 29 lots @,947.00 = $27,463.00 1 immediate crisis but also to make long-term changes . The main goals for YWCA Omaha's 24-hour Crisis Line in 2011 is to increase callers' knowledge about domestic violence, dating violence, sexual assault, and stalking services and options and to increase callers' safety levels in crisis situations. The primary outcomes for the 24-hour crisis hotline in 2011 are: 1) provide 100%of callers with at least one service or option and 2) increase hotline volunteers' knowledge regarding domestic violence, sexual assault, dating violence and stalking through initial,40-hour, coalition-required training and regular, ongoing training through meetings and newsletters. • Feb. 7, 2011 2011 City of Omaha -Community Services Funds—YWCA Page 1 of 2 enship 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 \k Z) -. .... -, - <. '° `3 OC ,y O O c;$ — -I t D cD ,--,• Z : :. ih,ghhsl.s, k c=, t.. - (.14 r O aq O ?� N uiu d O CD % ,C-,)• P n R ` UHuIiJ A\ Cl, En c 1-1-) 1-,-, 1-h• • • •, t ' ficer of said corporation. GENERAL NOTARY-State of Nebraska R LESLIE PIERCE '�,n CVO r//� My Comm.EV.MaY 23,2014 1'\ //� 0 A" ARY P O U LIC My Com�ission Expires III • 3 - ..L'\ . . \�\ r • - • ,. 1.,?, k. \ Af W • Services lerk Approved... OF,.. Mayor