Fund:
Payee:
Agenda: 10/23/12
Current Claims
City of Dearborn Heights Voucher Approval
General Fund
AccuMed Billing, Inc
Number:W
APPROVED FOR AGENDA OF
Description: Ambulance Billing For September 2012 Invoice Dated 10/01/2012
Account Account Title Amount 101-000-626-000 Ambulance Runs $3,550.72
Amount Budget Before Payment $716,031.63
Requested By: Fire Dept.
Comptroller Official
Concurrence
Daniel s:Paletko '
Authorized
Invoice
Billing Office P.O. Box 2122 Riverview, Ml48193
~:fllli·i~ DEARBOJ3NHEIGHTSFIRED
Total Collected EMS $ 46,842.89
AccuMed Fee 7.50%
Total $ 3,513.22
Total Collected Fire Service $ 500.00
AccuMed Fee 1.5Q0/Q
Total $ 37.50
Credit
Outstanding balance For the Following Month(s): $
OCT 0 3 2012 Please Make Clleci<s Pa,#able To: AccuMed Billing
**A lletailed brei!kdowl'l is listed"" tile Credit Type ::;.,mmary Report**
Fund:
Payee:
Description:
Agenda: 10/23/12 Number: tJ · ~ Current Claims
City of Dearborn Heights Voucher Approval
General Fund
Ajax Materials Corp.
Road Patching Supplies Various Invoices Dated 09/12
APPROVED FOR AGENDA OF
Amount Budget Account Account Title 101-440-782-000 Road Maint.
Amount Before Payment $5,039.93 $147,896.34
Requested By: DPW
Comptroller Authorized Official
Concurrence
IJ~ ,~, (~:, Daniel S. Paletko
Sold To:
Ticket#
09/11/12 5148256
Total
AJAX MATERIAlS CORPORATION AN EQUAL OPPORTUNITY EMPLOYER
1. 57895 Iafrate Dr. 2. 4875 Bald Mountain Road 3. 2240 Avon Industrial Dr. New Haven, Ml 48048 Auburn Hills, Ml 48326 Rochester Hills, Ml 48309
5. 8744 Inkster Road Romulus, Ml48174
6. 7392 Kensington Road Brighton, Ml48116
Dearborn Heights, City of 6045 Fenton Avenue Comptroller's Office Dearborn Hgts., Ml 48127
Quantity
10.57 TON
Prod#
098
7. 26400 Sherwood Warren, Ml 48091
Description
UPM Cold Mix
10.57 Plant: 05 Inkster
06!\t,,
":.\ ' .
n
Sales Terms: Net 30 Days
INVOICE
REMITTANCE ADDRESS
Ajax Materials Corpc>ra!ion P.O. Box 7053
Date
09/12/12
Customer#
40501
Troy. M! 48007 PhOnE!' 248-244-3300 Fax: 248-244-0800
Page
1 of 1
Job#
40501P
Invoice
157339
Plant#
05
UPM Pick Up/2011-POII'I-2-0000006
Price Amount
93.000 983.01
983.01
(.
Sales Tax 0.00
I Invoice Total 983.011
Sold To:
Ticket#
09/10/12 5148087
Total
AJAX MATERIALS CORPORATION AN EQUAL OPPORTUNITY EMPLOYER
1. 578951afrate Or. 2. 4875 Bald Mountain Road 3. 2240 Avon Industrial Dr. New Haven, Ml 48048 Auburn Hills, Ml 48326 Rochester Hills, Ml 48309
5. 8744 inkster Road Romulus, Ml48174
6. 7392 Kensington Road Brighton, Ml48116
Dearborn Heights, City of 6045 Fenton Avenue Comptroller's Office Dearborn Hgts., Ml 48127
Quantity
11.52 TON
11.52
Prod#
098
Plant: 05
7. 26400 Sherwood Warren, Ml 48091
Description
UPM Cold Mix
inkster
'
1 2
l::nl!\L
"''•
" ~ '''
i '4 ~ '•
Sales Terms: Net 30 Days
INVOICE
REMITTANCE ADDRESS:
Ajax Materials Corpc•raiion P.O. Box 7058
Date
09/11/12
Customer#
40501
Troy, Ml 48007 Phofle: 2'18-244-3300 Fax: 248-244-0800
Page
1 of 1
Job#
40501P
Invoice
157291
Plant#
05
UPM Pick Up/2011-POii12-0000006
Price Amount
93.000 1,071.36
1,071.36
·-··. , ·'
Sales Tax 0.00
I Invoice Total 1,071.361
Sold To:
Ticket#
09/13/12 5148397
Total
AJAX MATERIALS CORPORATION AN EQUAL OPPORTUNITY EMPLOYER
1. 57895 Iafrate Dr. 2. 4875 Bald Mountain Road 3. 2240 Avon Industrial Dr. New Haven, Ml 48048 Auburn Hills, Ml 48326 Rochester Hills, Ml48309
5. 8744 Inkster Road 6. 7392 Kensington Road 7. 26400 Sherwood Romulus, Ml48174 Brighton, Ml48116 Warren, Ml48091
Dearborn Heights, City of 6045 Fenton Avenue Comptroller's Office Dearborn Hgts., Ml 48127
Quantity
8.87 TON
8.87
Prod#
098
Plant:
Description
UPM Cold Mix
05 Inkster
''"""'':
,~,f"
Sales Terms·. Net 30 Days
INVOICE
·~ I
REMITTANCE ADDRESS
Ajax Materials Corporation
P.O. Box 7058
Date
09/14/12
Customer#
40501
Troy, Ml48007 Poqne 248-244-33qo Fax: 248-244-0800
Page
1 of 1
Job#
40501P
UPM Pick Up/2011-P0#12-0000006
Price
93.000
:
1 :
o···
Sales Tax
I Invoice Total
Invoice
157438
Plant#
05
Amount
824 91
824.91
0.00
824.911
Sold To:
Ticket#
09117112 5148773
Total
AJAX MATERIALS CORPORATION AN EQUAL OPPORTUNITY EMPLOYER
1. 578951afrate Dr. 2. 4875 Bald Mountain Road 3. 2240 Avon Industrial Dr. New Haven, Ml48048 Auburn Hills, Ml 48326 Rochester Hills, Ml 48309
5. 87441nkster Road Romulus, Ml 48174
6. 7392 Kensington Road Brighton, Ml 48116
Dearborn Heights, City of 6045 Fenton Avenue Comptroller's Office Dearborn Hgts., Ml 48127
Quantity
1203 TON
12.03
Prod#
098
Plant: 05
R1
7. 26400 Sherwood Warren, Ml 48091
Description
UPM Cold Mix
Inkster
\V ~0
DBN,HiS.COMP.Orf.
Sales Terms: Net 30 Days
INVOICE
REMITTANCE ADDRESS
Ajax Materials Corporation P.O. Box 7058
Date
09/18/12
Customer#
40501
Troy, Ml 48007 Phof\e: 248-244-33QQ Fax: 248-244-0800
Page
1 of 1
Job#
40501/Dev.
#090000276-001/UPM Delv'd
Price
95.650
Sales Tax
I Invoice Total
Invoice
157555
Plant#
05
Amount
1,150.67
1,150.67
0.00
1,150.67!
Sold To:
Ticket#
09/20112 5149040
Total
AJAX MATERIALS CORPORATION AN EQUAL OPPORTUNITY EMPLOYER
1. 578951alrate Dr. 2. 4875 Bald Mountain Road 3. 2240 Avon Industrial Dr. New Haven, Ml 48048 Auburn Hills, Ml 48326 Rochester Hills, Ml 48309
Dearborn Heights, City of 6045 Fenton Avenue Comptroller's Office Dearborn Hgts ... Ml 48127
Quantity
10.86 TON
10.86
Prod# Description
098 UPM Cold Mix
Plant: 05 Inkster
Sales Terms·. Net 30 Days
INVOICE
REMITTANCE ADDRESS:
Ajax Materials Corporation
P.O. Box 7058
Troy, Ml 48007 Pnone: 248-244-3300 Fax: 248-244-0800
Date Page Invoice
09121112 1 of 1
Customer# Job#
40501 40501P
UPM Pick Up/2011-P0#12-0000006
Price
93.000
Sales Tax
Invoice Total
157663
Plant#
05
Amount
1,009.98
1,009.98
0.00
1,009.981
Fund:
Payee:
Description:
Agenda: 10/23/12 Number: &~ 3 Current Claims
City of Dearborn Heights Voucher Approval
General Fund
Bureau Veritas North America Inc.
Loss Control Services for 7/1/12-6/30/13 Invoice 1167096, Dated 10/12/12
APPROVED FOR AGEt<DAOF
Account Account Title Amount $3,600.00
Amount Budget Before Payment $142,925.02 101-200-724-000 Work. Comp.
Requested By: General Govt
Comptroller Authorized Official
Concurrence
Daniel S. Paletko
INVOICE
Tax ID# 06-1689244
Remit checks to: Bureau Veritas North America. Inc 13905 Collections Center Drive Chicago, IL 60693
Mr. Vince Macari City of Dearborn Heights 6045 Fenton Dearborn Heights, Ml 48127
Remit ACH Transfers to: ABA Routing Number 121000358 Account Number 14594-11058
Remit Wire Transfers to: ABA Routing Number 026009593 Account Number 14594-11058 Swift Code BOFAUS3N
October 12,2012 Project No: 11012-000179.00 Invoice No: 1167096
loss Control Services for !he City of Dearborn Heights, MI. July 1 2012 through June 30, 2013 Proposal# 1109.12.342
Professional Services
Fee
Total this Invoice
3,600.00
$3,600.00
For billing inquiries, please contact Emily Petrusky at (847) 726-3748 or emily.pet[\1$1\[email protected]\<i>A;om
Please include invoice number with payment remittance.
Payment Terms: Net 30 Days P!ease Reference Our tnvoice Number On Your Check
Fund:
Payee:
Description:
Account
Agenda: 10/23/12
Current Claims
City of Dearborn Heights Voucher Approval
General Fund
Number:
Cummings, McCiorey, Davis & Acho
Labor Matters Through August 31,2012 Invoice 197551, Dated 09/25/2012
/;J-4
APPROVED FOR AGENDA OF
Amount Budget Account Title Amount Before Payment
101-200-817-000 Prof/Con $3,982.50 $335,691.76
Requested By: General Govt
~· Comptroller Authorized Official
Concurrence
Daniel S. Paletko
CuMMINGs•McCLOREY
DAvIs & A c li 0 'P.L.C.
33900 SCHOOLCRAFT ROAD LIVONIA Ml 48150-1392
734-261-2400
TAX IDENTIFICATION: 38-3444579
DEARBORN HEIGHTS, CITY OF KRYSTINA KRAMARZ
September 25, 2012
Invoice 197551 6045 FENTON DEARBORN HEIGHTS, Ml 48127
Page 1
Our File# 82265: LABOR MATTERS- DEARBORN HEIGHTS OCT 02
For Services Through August 31, 2012
(Please Note: Hours are billed in tenths. Ex: .1 = 6 Minutes, .2 = 12 Minutes)
08/02/12 TJL
08/02/12 TJL
08/02/12 TJL
08/07112 TJL
08/07/12 TJL
08/13/12 TJL
08/14/12 TJL
08114/12 TJL
08/20/12 TJL
08/21/12 TJL
08/21/12 TJL
08/22/12 TJL
08/27/12 TJL
08/27/12 TJL
08/28/12 TJL
08/28/12 TJL
08/28/12 TJL
Receipt and review documentation from client re: Treasurer's office personnel issues
Telephone conference with client re: internal investigation and related issues
Correspondence to client re: investigatory issues
Attend meeting at City Hall with Management Team to discuss Act 57 and related issues
Attend afternoon meeting at City Hall with POAM re: manpower issues.5
Telephone conference with Police Chief re: Pension grievance, Overtime issue and disciplinary issue
Appear for Grievance Hearing at Mayor's level with POAM.
Meeting with Mayor and staff re: various Union and employment related issues
Correspondence and multiple phone calls to Police Chief and Human Resources re: Union Grievance issues and Police Labor Agreement
Preparation for meeting with clients on several separate Union labor issues Attend meeting with administrative staff re several Union labor issues
Conference with clients re: overtime and staffing issues in Police Department, develop strategy for plan of action
Research and analysis of documentation for Fire Fighters Arbitration case in anticipation of meetings with client to prepare for Arbitration Hearing
Telephone conference with Human Resources re: internal investigation and strategy for handling
Correspondence via email to Police Chief and Mayor's office
Telephone conversation with Police Chief re: Union related issues
Receipt and review documentation from client re: past Policies on overtime and cost saving measures
.000
0.7 hrs
0.5 hrs
0.7 hrs
3.5 hrs
3.5 hrs
1.0 hrs
2.0 hrs
2.0 hrs
1.5 hrs
1.0 hrs
3.5 hrs
1.2 hrs
3.5 hrs
0.8 hrs
0.5 hrs
0.5 hrs
0.6 hrs
CUMMINGS, MCCLOREY, DAVIS & ACHO P.L.C.
DEARBORN HEIGHTS, CITY OF KRYSTINA KRAMARZ 6045 FENTON DEARBORN HEIGHTS, Ml 48127
08/28/12 TJL Preparation of draft response letter to Union leaders
Subtotal: Fees Billed
SUMMARY OF FEES BILLED
September 25, 2012 Invoice 197551 Our File # 82265
Billable Hrs Rate/Hr
Thomas J. Laginess
TOTAL
Associate 29.5
29.5
Total Fees & Reimbursable Costs through 08/31/2012
135.00
Fees & Reimbursable Costs after Adjustments through 08/31/2012
3,982.50
$3,982.50
Page2
2.5 hrs
$3,982.50
$3,982.50
CUMMINGS, MCCLOREY, DAVIS & ACHO P.L.C.
DEARBORN HEIGHTS, CITY OF KRYSTINA KRAMARZ 6045 FENTON DEARBORN HEIGHTS, Ml 48127
September 25, 2012 Invoice 197551 Our File # 82265
Summary of Amounts Due for this Matter
Total Current Balance due for this file: $3,982.50
Page3
Grand Total Balance due for this file: $3,982.50
**ALL UNPAID ACCOUNTS SHALL BEAR SIMPLE INTEREST AT A RATE OF 0.5833% PER MONTH (7% PER YEAR) ON ANY UNPAID BALANCE AFTER FOURTEEN (14) DAYS.'* Please disregard your past due balance due if you paid within the last 10 days.
CUMMINGS, MCCLOREY, DAVIS & ACHO P.L.C.
DEARBORN HEIGHTS, CITY OF KRYSTINA KRAMARZ 6045 FENTON DEARBORN HEIGHTS, Ml 48127
REMITTANCE SUMMARY
September 25, 2012 Invoice 197551 Our File # 82265
Page4
TO ENSURE PROPER CREDIT, PLEASE RETURN THIS ENTIRE PAGE WITH YOUR PAYMENT
Total Fees & Reimbursable Costs this Period $3,982.50
Total balance due for this file: $3,982.50
**ALL UNPAID ACCOUNTS SHALL BEAR SIMPLE INTEREST AT A RATE OF 0.5833% PER MONTH (7% PER YEAR) ON ANY UNPAID BALANCE AFTER FOURTEEN (14) DAYS.** Please disregard your past due balance due if you paid within the last 10 days.
PLEASE REMIT TO: Cummings, McCiorey, Davis & Acho 33900 Schoolcraft Road
CREDIT CARD:
Livonia Ml 48150-1392
Tax ID: 38-3444579
Charge my __ VISA __ MASTERCARD __ DISCOVER
Exp date:--------- Amount $----------
Cardholder name: ---
Account#:
Signature _______________ Date _____ _
THANK YOU FOR YOUR PATRONAGE!
Fund:
Payee:
Description:
Agenda: 10/23/12
Current Claims City of Dearborn Heights
Voucher Approval
General Fund
Downriver Community Conference
Number:
Membership Dues Oct 2012- Sept 2013 Invoice Dated 9/02/12
APPROVED FOR AGENDA OF
Account Account Title Amount $4,750.00
Amount Budget Before Payment
$20,984.00 101-200-958-000 Dues
Requested By: General Govt
Comptroller
tk (V"!
~dOfficial Concurrence
Daniel S. Paletko
15100 North line Road Southgate, Ml 48195 Phone: (734) 362-7070 T.T.Y. 1 (800) 649-3777 Fax: (734) 407-0202 www.dccwf.org COMMUNITY CONFERENCE
James S. Perry Executive Director
Equal Opportunity Employer/Programs " AuxHiary Aids and Services are available upon request to individuals with Disabilities.
INVOICE #4005
DATE: 2-0ct-12
BILL TO: City of Dearborn Heights 6045 Fenton Dearborn Heights, Ml 48127 Attn: John J. Riley
Total Descriotion Cost
Downriver Community Conference Membership Dues $ 4,750.00
October 2012 - September 2013
Total Due to DCC: $ 4,750.00 Make check payable to: Downnver Commumty Conference
Send to: Downriver Community Conference
ATIN: lorree Smith 15100 Northline Rd.
Southgate, MI 48195
(734) 362-3444
MEMBER COMMUNITIES Allen Park o Brownstown Township .. Dearborn<~< Dearborn Heights o Ecorse" Flat Rock" Gibraltar"' Grosse lie Township Ill Huron Township
Lincoln Park<~~ Melvindale e River Rouge o Riverview,. Romulus" Rockwood<~~ Southgate o Taylor .. Trenton$ Woodhaven e Wyandotte
Fund:
Payee:
Description:
Agenda: 10/23/12 Number:
Current Claims
City of Dearborn Heights Voucher Approval
General Fund
Eager Beaver Landscaping
Grass & Weed Cutting Charges Invoice Dated September 16, 2012
Amount Budget Account Account Title Amount Before Payment 101-200-963-000 Weeds $4,023.88 $115,353.33
Requested By: Bldg. Eng.
Comptroller Authorized Official
Concurrence
Daniel S. Paletko
APPROVED FOR AGENDA OF
10:17 AIVI
C?'Z0/12
Type Date
CITY OF FEARBORN HEIGHTS Invoice 911612012 Invoice 9/16/2012 Invoice 9/16/2012 Invoice 911612012 Invoice 9/16/2012 Invoice 9/16/2012 Invoice 9/16/2012 Invoice 9/1612012 Invoice 9/16/2012 Invoice 9/16/2012 Invoice 9/16/2012 Invoice 9116/2012 Invoice 9/16/2012 Invoice 9/16/2012 Invoice 9/16/2012 Invoice 9116/2012 Invoice 9/16/2012 Invoice 9/16/2012 Invoice 9/16/2012 Invoice 9/16/2012 Invoice 9116/2012 Invoice 9116/2012 Invoice 9/16/2012 Invoice 9116/2012 Invoice 9/16/2012 Invoice 9116/2012 Invoice 9/16/2012 Invoice 9116/2012 Invoice 9116/2012 Invoice 9/16/2012 Invoice 9/16/2012 Invoice 9/16/2012 Invoice 9/16/2012 Invoice 911612012 !nvolce 9/1612012 Invoice 9/16/2012 Invoice 9/1612012 Invoice 9116/2012 Invoice 9116/2012
EAGER BEAVER LAWN CARE Customer QuickReport
September 16, 2012
Num
14385 14389 14423 14424 14425 14426 14427 14428 14429 14430 14431 14432 14433 14434 14435 14436 14437 14438 14439 14440 14441 14442 14443 14444 14445 14446 14447 14448 14449 14450 14451 14452 14453 14454 14455 14456 14457 14458 14460
Memo Account
Accounts Receivable Accounts Receivable Accounts Receivable Accounts Receivable Accounts Receivable Accounts Receivable Accounts Receivable Accounts Receivable Accounts Receivable Accounts Receivable Accounts Receivable Accounts Receivable Accounts Receivable Accounts Receivable Accounts Receivable Accounts Receivable Accounts Receivable Accounts Receivable Accounts Receivable Accounts Receivable Accounts Receivable Accounts Receivable Accounts Receivable Accounts Receivable Accounts Receivable Accounts Receivable Accounts Receivable Accounts Receivable Accounts Receivable Accounts Receivable Accounts Receivable Accounts Receivable Accounts Receivable Accounts Receivable Accounts Receivable Accounts Receivable Accounts Receivable Accounts Receivable Accounts Receivable
Clr Split
-SPLIT--SPLIT--SPLIT--SPLIT--SPLIT--SPLIT--SPLIT--SPLIT--SPLIT--SPLIT--SPLIT--SPLIT--SPLIT--SPLIT--SPLIT--SPLIT--SPLIT--SPLIT--SPLIT--5PLIT--SPLIT--SPLIT--SPLIT--SPLIT--SPLIT--SPLIT--SPLIT--SPLIT--SPLIT--SPLIT--SPLIT--SPLIT--SPLIT--SPLIT--SPLIT--SPLIT--SPLIT--SPLIT--SPLIT-
Amount
9@-,BQ-<-;;:~ 168.26 . / 102.1QV 96.00/ 00:00' W4 gs,oo-<f..S 71.60...--
2!l'i':56- !7 I 63.00/
46£r.'8tt" ( ?.. 2... 89.20'/
172.48/
~:;:0, 99.20/
264.20/ 126.77•./ 3320~ 66.20'" 99.20/
4i'!HlEr '{ (., 1~ ';:_<; 1?. 30.26/
.;~~~'f3 96 oo·./ ~ /! 3>.'6'\ 108.00,/ 97.20 j'
173.2(} / 105.17 •/
~ \0 """"' 66.20 v -~ V'it~cO
63.oo'-/ 67.4~ 38.05V
11B.6o·./ 166.00,/
Page 1
Fund:
Payee:
Description:
Agenda: 10/23/12 Number:~ 7 Current Claims
City of Dearborn Heights Voucher Approval
Water 0/M
EJ USA, Inc.
Fire Hydrants and Parts September 2012, Several Invoices
r:c"-----·· APPROVED FOR-AGENDA OF
Account Account Title Amount $6,576.08
Amount Budget Before Payment
592-000-111-002 Inventory/Pipe
Requested By: Water Dept
Comptroller Authorized Official
Concurrence
Daniel S. Paletko
s 0 L D
T 0
•
8J
City of Dearborn Heights Attention Accounts Payable
6045 Fenton Avenue Dearborn Heights, Ml 48127
Invoice Invoice Number
Invoice Date
Invoice Due
Order Number
Customer Number
Ship Date
Shipping Branch
Page Number
s City of Dearborn Heights
7 DEPARTMENT OF PUBLIC WORKS ~ 24600 VAN BORN E Dearborn Heights, M I 48127 D
T 0
Customer P.O. Number Job Name Job Number Sales Office Shipping Method
Detroit Branch Our Truck
Line UM Quantity Unit Price
1 83405D EJ 5BR250-DFD HYD 5'6" CONV 1HSTZ EA 1 2240.31 Non-cancelable, Non-returnable
A monthly FINANCE CHARGE will be added to any unpaid balance which is not paid when due. The FINANCE CHARGES are computed by a periodic rate of 1 1f2% per month
Remit Payment To-Amount
(from and after the due date) which is an ANNUAL PERCENTAGE RATE OF 18% applied EJ USA, Inc. to the unpaid balances after deducting payments made before the due dates and/or TAX .000 % credits. Payments received on account are applied against the amounts first due. P 0 BOX 644873
PITTSBURGH, PA Freight 15264-4873
Total Due: EJ USA, Inc. Terms and Conditions apply. ejco.com 800 626 4653
3534818 9127112
10127112
3534818 18070
9126112
020
1
Ex1Amount
2,240.31
2,240.31
.00
.00
2,240.31
s 0 L D
T 0
• 8J
City of Dearborn Heights Attention Accounts Payable 6045 Fenton Avenue Dearborn Heights, Ml 48127
Customer P.O. Number Job Name Job Number
s H I p p E D
T 0
Invoice Invoice Number
Invoice Date
Invoice Due
Order Number
Customer Number
Ship Date
Shipping Branch
Page Number
City of Dearborn Heights DEPARTMENT OF PUBLIC WORKS 24600 VAN BORN Dearborn Heights, M I 48127
Sales Office Shipping Method
3532448 9/28/12
10/28/12
3532448 18070
9/24/12
020
1
Detroit Branch Direct Prepay/Add
Line UM Quantity Unit Price Ext Amount
1 99180180 AY 5614L PLUG TY 1-1/4" COVER EA 25 11.38 284.50 NON-RETURNABLE, NON-REFUNDABLE
2 99175944 AY 4755T 3/4" CPL CTS X FFLR EA 50 11.99 599.50 NON-RETURNABLE, NON-REFUNDABLE
3 99175945 AY 4755T 1" CPL CTSX FFLR EA 25 17.62 440.50 NON-RETURNABLE, NON-REFUNDABLE
A monthly FINANCE CHARGE will be added to any unpaid balance whicll is not paid Remit Payment To: Amount 1,324.50 when due. The FINANCE CHARGES are computed by a periodic rate of 1 112% per month
(from and after the due date) which is an ANNUAl PERCENTAGE RATE OF 18% applied EJ USA, Inc. TAX .000 .00 to !he unpaid balances after deducting payments made before the due dates and/or % credits. Payments received on account are applied against the amounts first due. P 0 BOX 644873
PITTSBURGH, PA Freight 55.67 15264-4873
Total Due; 1,380.17
EJ USA, Jnc. Tenns and Ccnd!!fOns apply. SJCO.com 800 626 4653
s 0 L D
T 0
• BJ
City of Dearborn Heights Attent'1on Accounts Payable 6045 Fenton Avenue Dearborn Heights, Ml 48127
s H I p p E D
T 0
Customer P.O. Number Job Name Job Number
Une
1 00942330 6D7SEAL PL T BSHG ASY 2 00942331 6D SEAL PLT GKT 3 00944421 0-RG 1-220 UL1/8 1-3/8 4 00942430 8D7SEAL PL T BSHG ASY
5 00942431 8D SEAL PL T GKT 6 00942538 0-RG 1-222 UL1/8,1-1/2 7 00942411 EJ 6-8D10 OP NUT OR
* * *DIRECT SHIPMENT FROM EAST JORDAN*
A monthly FINANCE CHARGE will be added to any unpaid balance which is not paid Remit Payment To: when due. The FINANCE CHARGES are computed ~ a periodic rate of 1 112% per month (from and after the due date) which !San ANNUAL P RCENTAGE RATE OF 18% applied
EJ USA, Inc. to the unpaid balances after deducting payments made befOre the due dates andfor
Invoice Invoice Number
Invoice Date
Invoice Due
Order Number
Customer Number
Ship Date
Shipping Branch
Page Number
Cily of Dearborn Heights DEPARTMENT OF PUBLIC WORKS 24600 VAN BORN Dearborn Heights, Ml 48127
Sales Office Shipping Method
Detroit Branch R&L Preoaid
UM Quantity Unit Price
EA 12 40.90 EA 12 3.29 EA 24 2.18 EA 12 44.88 EA 12 3.29 EA 24 1.85 EA 24 11.74
Amount
TAX credits. Payments received on account are applied against the amounts ft!St due. P 0 BOX 644873
.000 %
PITTSBURGH, PA Freight 15264-4873
Total Due:
EJ USA, Inc Terms and Cond1t1ons apply. eJCO.com 800 626 4653
3534814 9/27/12
10/27/12
3534814 18070
9/25/12
020
1
Ext Amount
490.80 39.48 52.32
538.56 39.48 44.40
281.76
1,486.80
00
.00
1,486.80
~N ~
• 8J EJ USA. Inc PO Box 644873 Pittsburgh, PA 15264-4873
SOLD TO:
28111 AB 0.374 E0050X 10083 0551733661 P1187385 0001:0001
ll''llllllllll'l'llllllll•l'''l'llllll''lliiii••••JI•I•IIIIIIIIII CITY OF DEARBORN HEIGHTS Attention Accounts Payable 6045 FENTON ST DEARBORN HEIGHTS Ml48127-3287
I Custon)er P.O. Nu:n_,ber I Job Name ! Job .N.urnb:er
I I I I. Safes B,'ranch
\ Detroit Branch
INVOICE Invoice Number
Invoice Date
Invoice Due
Order Number
Customer Number
Ship Date
Shipper Location
Page Number
SHIPPED TO:
City of Dearborn Heights DEPARTMENT OF PUBLIC WORKS 24600 VAN BORN Dearborn Heights, Ml48127
I ~·~.hip.p(n9 Metp:rkJ . •.· l Our Truck
3532444
9/21/12
10/21/12
3532444
18070
9/20/12
020
1 of 1
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line Pi"od~0l ~.Ymber/Descripti_on UM QuantitY Uriil Price Extended· Amount
1 99180103 AY 5615WB CURB BX MINN W/BUSH 5-1/2 EA 40 36.72 1,468.80 NON-RETURNABLE, NON-REFUNDABLE
~E ]\/ ~= !,~,
1 !!' ,I 20:2
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EJ is transitioning to electronic delivery of all customer invoices. Please provide the email address or fax number where your invoices can be delivered. This information, along with your customer number, should be emailed to [email protected] or faxed to 231.536.4619. Thank you.
A monthly FINANCE CHARGE will be added to any unpaid balance which is not paid when due. B.:Eirnit Payment To: Amount 1,468.80 The FINANCE CHARGES are computed by a periodic rate of 1 1/2% per month (from and after the due date) which is an ANNUAL PERCENTAGE RATE OF 18% applied to EJ USA, Inc. Tax 0.00% .00 the unpaid balances after deducting payments made before the due dates ar~d/or credits. P 0 BOX 644873 Payments received on account are applied against the amounts first due.
PITTSBURGH, PA 15264-4873 We hereby certify that these goods were produced in compliance with all applicable requirements of Sec. 6, 7, & 12 of the Fair Labor Standards Act, as amended, and of regulations and orders of the
Freight .00 United States Department of Labor issued under Sec. 14 thereof. Total Due 1.468.80 EJ USA, Inc. Tenns & Collditiolls app!y. ejco.com 800 626 4653
0001:0001
CITY OF DEARBORN HEIGHTS 6045 FENTON • DE;ARBORN HEIGHTS, MICHIGAN 48127 TELE?HONE (313) 791-3443 • FAX (313) 791-3442_
Ship To: ~~--
[UiVoF DEARORN HEIGHTS-DPW
. 24600 VAN BORN DEL 7-1 UO/NOON-3PM DEARBORN HEIGHTS Ml 48125 ~~·-·---------------_j
VENDOR NO. 10460
~ I':J USA, INC. N P 0 BOX 644873 D 0 R PITTSBURGH
Unit !Description
PA 15264-448
PURCHASE ORDER
NO. 13-00154
Date: O:Z:/01/12 *+*+*+*+*+*+*+*+*+*+
BLANKET PURCHASE ORDERS JULY 1, 2012 THROUGH JUNE 30,2013 TO BE PAID MONTHLY
TO COVER THE COST OF:
[Ouantnltlr l EACH TO COVER THE COST OF FIRE HYDRANTS
AND MISCELLANEOUS PARTS AND SUPPLIES
Unit Cost $0.00
Total Cost ] $0.00
592-000-111.002
Total PO Amount 0.00]
DIRECT INQUIRIES TO
JJ I ,,
' ' :f,i~ Mtf' J DIRECTOR
SEAN MOYLAN
PURCHASE ORDER NUMBER MUST APPEAR ON INVOICE, OR INVOICE WILL NOT BE PAID!
M.S .. D.S. REQUIRED ON HAZARDOUS MATERIA.L NOTE: ANY DEVIATION IN PRICE ON THIS ORDER MUST BE APPROVED BY THE CITY PURCHASING DIVISION PRIOR TO DELIVERY
ORIGINAL INVOICES TO: COY!PUTROLLER'S OFFICE 6045 FENTO, DEN. HTS., MI. 48127
2. EXEMPT FROM STATE/LOCAL AND FEDERAT ... TAXES: 38-1712300
3 PU_RCHASE ORDER NUMBER MUST APPEAR ON ALL INVOICES, SHIPPERS, AND CORRESPONDENCES.
4. SUBSTITUTIONS NOT ACCEPTED WITHOUT !?FUOR APPROVAL.
5. PARTIAL SHIPMENT WILL BE ACCEPTED IF INVOICED SEPARATELY. PAYMENT MADE UPON COMPLETION OF PURCHASE ORDER.
6. ACKNOWLEDGMENT COPY MUST BE RETURNED BEFORE ORDER IS BINDING.
Fund:
Payee:
Description:
Account
Agenda: 10/23/12 Number:_""'&_~ 8 Current Claims
City of Dearborn Heights Voucher Approval
General Fund/Water 0/M
E & N Cement
Pavement Repairs Invoices Dated 10/16/2012
Account Title Amount
APPROVED FOR AGENDA OF
Amount Budget Before Payment
592-537-818-000 Contractual Serv. $41,732.00 101-440-880-000 Road Rep $47,831.87 $109,795.75
Requested By: DPW
Comptroller Authorized Official
Concurrence
Daniel S. Paletko
E & N Cement Co. Inc. 23938 Woodham
Novi, Michigan 48374 248-348-9485
City of Dearborn Heights October 16, 2012 DPW.
26024 Wilson s. side 93 sq. yds. Pavement repair wl hook bolts @ $50.24 $4,671.86 93 sq. yds. Fill sand @ $12.94 $1,203.77 93 sq. yds. 7 sax concrete @ $11.21 $1,042.51
$6,918.14 26036 Wilson s. side
49 sq. yds. Pavement repair wl hook bolts @ $50.24 $2,461 .52 49 sq. yds. Fill sand @ $12.94 $634.25 49 sq. yds. 7 sax concrete @ $11.21 $549.28
$3,645.04 26048 Wilson s. side
91 sq. yds. Pavement repair w/ hook bolts @ $50.24 $4,571.39 91 sq. yds. Fill sand @ $12.94 $1,177.89 91 sq. yds. 7 sax concrete @ $11.21 $1,020.09
$6,769.36 26074 Wilson
40 sq. yds. Pavement repair w/ hook bo~s @ $50.24 $2,009.40 40 sq. yds. Fill sand @ $12.94 $517.75 40 sq. yds. 7 sax concrete @ $11.21 $448.39
$2,975.54 261 02 Wilson
47 sq. yds. Pavement repair w/ hook bolts @ $50.24 $2,361.05 47 sq. yds. Fill sand @ $12.94 $608.36 47 sq. yds. 7 sax concrete @ $11.21 $526.86
$3,496.26 26118 Wilson
39 sq. yds. Pavement repair w/ hook bolts @ $50.24 $1,959.17 39 sq. yds. Fill sand @ $12.94 $504.81 39 sq. yds. 7 sax concrete @ $11 .21 $437.18
$2,901 '16 26234 Wilson
96 sq. yds. Pavement repair w/ hook bolts @ $50.24 $4,822.56 96 sq. yds. Fill sand @ $12.94 $1,242.60 96 sq. yds. 7 sax concrete @ $11.21 $1,076.14
$7,141.31 26338 Wilson
58 sq. yds. Pavement repair w/ hook bolts @ $50.24 $2,913.63 58 sq. yds. Fill sand @ $12.94 $750.74 58 sq. yds. 7 sax concrete @ $11.21 $650.17
$4,314.54 26352 Wilson
37 sq. yds. Pavement repair w/ hook bolts @ $50.24 $1,858.70 37 sq. yds. Fill sand @ $12.94 $478.92 37 sq. yds. 7 sax concrete @ $11.21 $414.76
$2,752.38 26366 Wilson
93 sq. yds. Pavement repair w/ hook bolts @ $50.24 $4,671.86 93 sq. yds. Fill sand @ $12.94 $1,203.77 93 sq. yds. 7 sax concrete @ $11.21 $1,042.51
$6,918.14
to 1- £f Cfv ~ 9 Et9 -e oO! w; TOTAL $47,831.87
E & N Cement Co. Inc. 23938 Woodham
Novi, Michigan 48374 248-348-9485
City of Dearborn Heights October 16,2012 Water Dept
26012-25896 - Wilson s. side 144 sq. yds. Pavement repair w/ hook bolts @ $50.24 $7,233.84 144 sq. yds. Fill sand @ $12.94 $1,863.91 144 sq. yds. 7 sax concrete @ $11.21 $1,614.21
$10,711.96 NE Wilson & Kinloch
132 sq. yds. Pavement repair w/ hook bolts @ $50.24 $6,631.02 132 sq. yds. Fill sand @ $12.94 $1,708.58 132 sq. yds. 7 sax concrete @ $11.21 $1,479.69
1 Manhole adj. @ N/C $9,819.30
NW Wilson & Kinloch 105 sq. yds. Pavement repair w/ hook bolts @ $50.24 $5,274.68 105 sq. yds. Fill sand @ $12.94 $1,359.10 105 sq. yds. 7 sax concrete @ $11.21 $1 '177.03
1 Watergate adj. @ N/C $7,810.80
26254 Wilson 34 sq. yds. Pavement repair w/ hook bo~s @ $50.24 $1,707.99 34 sq. yds. Fill sand @ $12.94 $440.09 34 sq. yds. 7 sax concrete @ $11.21 $381.13
$2,529.21 26360 Wilson
20 sq. yds. Pavement repair w/ hook bolts @ $50.24 $1,004.70 20 sq. yds. Fill sand @ $12.94 $258.88 20 sq. yds. 7 sax concrete @ $11.21 $224.20
$1,487.77 26208 Wilson s. side
45 sq. yds. Pavement repair w/ hook bolts @ $50.24 $2,260.58 45 sq. yds. Fill sand @ $12.94 $582.47 45 sq. yds. 7 sax concrete @ $11.21 $504.44
$3,347.49 26224 Wilson s. side
13 sq. yds. Pavement repair w/ hook bolts @ $50.24 $653.06 13 sq. yds. Fill sand @ $12.94 $168.27 13 sq. yds. 7 sax concrete @ $11.21 $145.73
$967.05 26224-26238 Wilson s. side
68 sq. yds. Pavement repair w/ hook bolts @ $50.24 $3,415.98 68 sq. yds. Fill sand @ $12.94 $880.18 68 sq. yds. 7 sax concrete @ $11.21 $762.27
$5,058.42
TOTAL $41,732.00
Fund:
Payee:
Description:
Agenda: 10/23/12
Current Claims
City of Dearborn Heights Voucher Approval
General Fund
J.L.S. Property Maintenance
Grass Service September 2012
Number:
Invoice Number 9152012, Dated 09/20/12 Invoice Number 9222012, Dated 09/24/12
APPROVED FOR AGENDA OF
Account Account Title Amount Amount Budget Before Payment $115,353.33 101-200-963.000 Sidewalk/Weed $1,878.45
Requested By: Bldg & Eng.
~· Comptroller Authorized Official
Concurrence
Daniel S. Paletko
~ __ _City_c>f Dear_l:>orrJ_H~ightsfOrdinance Violations J.L.S. Property Maintenance -- ·------- ----- ----- -- --,- -- --
_ ~- ~-fit1_anc~D~partment L~cc()_unE_Pa_ya_b_l_e ____ 1
__ _ · 6045 Fenton
P.O, Box 1851 ~- --1~- -- - --
Taylor,_M I _LI8180 --------- - -- ---- - -··· -- ~---- ---+------ --- ------ ----
Invoice# 9152012
Street# Street Address Cut Date
Billing Rate
~~ ~~--~ _i ~~;,-A~b~rJr~il_ ---~__i;[l2/2_(ll~-1862 i Inkster ! 9/12/2012
Lot Size
6886
19401
8~-ruJc;:~~~bindal~----___~--,9~zj2cJ1_z i~ 54oo
~ 67~5_______ _ ____ Heyden_ _ ____ _ ~;9/13/2012 )_ 5551
Extra Services i
J 6773 :_f:l_eyden ______ _ J/1~2012 j _-:-= ... ' ---+-
5563 _ _JI:Ieyd er1_ 9/13/2012 i ---·--·--'-------------·- .---------;
9/13/2012 I 5563
5440 - -----
Dearborn Heights, Ml 48127 -- --'--- ---~-- ------- _____ .. ·T·------·· ----------
Proposal #1 <
5000 Sq Ft
$30.00
Proposal# 3 i Proposal Proposal# 5 :Total Amount . #4 Invoiced
Proposal# 2 lots> Commercial Removal of Lawn .
5000 Sq Ft 100 Sq Ft Lots of< 200 sq DebriS $33.00 area> .
It or less $23.00 (per Cubtc Yard, 2QJl.>g_ft •
Commercia~Ommercial J $1.oo: $23.oo, $0.5o: $33.oo!
ota Cubic Yards
of Debris
-••-· ·-w '' •--· --····-----·- ' _,,,.~•·•~---~•• -;----,---·· --------··•-,, ----~
$30.00 1 $18.86 . $48.86 0 -· -----~ .. -----------------------; --- --------- +-- --~--------- _, ________________________ , _______ _
__ gO,OQc ~ _ _2144.01; _ _ ____ , __ $174:01J_ __ _
_ _$30,QQI _ -~ $4.()0_'_ - - - -- - - -'---- - _$34,00 i. -~$3_0.0Ql_
$30.00~ $3o.oo:~
$5.51 .... -·· . .. . $198.00! ... .. $233.51! 6
-~$~,s1!= :::-__:_" ___:- [ -=$132.oovo~9-J~51:-~4 $5.63; ' ' ' $35.63 -------- --, ------ - -·--------------'------------------r--------- -~------:------------ -------------------·)-------~-·
$30.00 $5.63 i i $33.00: $68.63' 1 ·- ·-- -------··-- --- , ___________ , _________ -------'---- -----------. -------------~ ----+-- --------------------------,-------
_. i 9/1.3;2oJ.2~ i~/13/201_2
9/4/2012
5940
6900
- _ $3o.o_o_,_ _ ~-~4A_oj_ -------~ __ j~~ \CU7~.l~(<!_o~_Z;~ ----·-~ __ ~3_o,oo,~ ----~~40! . ~--~---- --'- _j _ _$_33ooo; _ ____j369~4o,_ .JQ
Northmore
! Fenton
_ _ _ $3o.o~ _ . __ $19.go_L
$19.00! --------------------; --------- $49.00
- - T ;:=Tz_:; ~----:
$66.00 "t>' ~' 19/6/2012 6900 . . -- $30.00 ,Jj7401
1 uta! Invoice $1,461.9~ 25 ~-----~-----
f- . - - --- ---~-- ---------
-... -~-- ----- -- ----27104 Northmore Owner came home half way through and called the police, I called Keith & hussan they said the get the pic's we can, cut and leave Owner also came down to city to talk with keith and we agreed to not charge for debrie removal -·---~-- ~· --
9/20/20121
~ ~d11 ., Jlu-L-1r- ~--1
I
Invoice#
Street#
J.L.S. Property_tv1aintenance ____ _ I City of Dearborn Heights I Ordinance Violations ,_____
1
Finance Department 1 Accounts Payable --------------- '------------ ---: 6-o4s i'eni:on ~------ -------------------------. ·--····· ------ -- _, _______ _
P.O, Box 1851 . h_aylor: M I -4:-:c8c-18c-O:--- -f
9222012
Street Address Cut Date
-~;Dearbornf:Jeights, Ml48127
-
:Extra
Lot Size I Services
I
--PfoposaT#T3 'Proposal P 1 #
5 Total Amount
; roposa Commercial #4 Invoiced
Proposal #1 < Proposal# 2 lots> ~ Removal of 5000 Sq Ft j 5000 Sq Ft 100 Sq Ft Lots of< 200 sq, Lawn Debris $33.00
ft or less '. area > ( C b' y d 1 per u 1c ar
S23.0.0_; 200 soft Commercial pmmerci I
Billing Rate $30.00 1 $1.00 I $23.00 $0.50 $33.00'
lffilT
Cubic
Yards
of Debris
------r~-~~~~~~-----~~~- ~1~[2()12 -~~--:_ ~~- $30.Q~; __ _ $43.~5~ _ _ j--~ _ ___ ___ --=-$73_,7~~ x !west Hills _ _ ,9/18/2012 : 5745 $3o.oo! $7.451 l(o> . ...s-:$.;~7 qr;'
-------- ------- ~--- --- -- f--'------ ----- ---- -·----------~, I -- ,-!Annapolis 9/20/2012 18312 $30.00 I $133.12' ' $163.121 -------- ~---;------ - ·--------- "----- --------------- ---~- ·t -·- --- ------·--, --- - ----- ·------------~ -----~-------- "·-·-'--- .,, ______________________ _
____ '-{_S'_5_-l ___ l3eechdaly _ --19/20{~012 __1r7_10 ! _____ ·___ $30.00 $37.101 _ _ '--··· $33,ooF_'-_IO_Jlaa,1a ..... _1
___ "Highview _ !9/20/2012 6000 ! , $30.00! $10.00' . $40.001 ----- ;~cDonald -- -9/20/2012 5240 -- . -$3o~oo ···----- $;:;;-- I 1' ~ ----S32.40j
- -~-------· ····~·- ------- - ----- - ------ .,------ -~-------------- _,_--,- --------- --~--" --- -->------- --- - -------L-- - ---------·
5670 Vernon 19/20/2012 5480 $30.00' $4.80• . $99.oo! $133.801 3 "'~ 5 <,; -j() Beechdaly 8/10/2012 6160 ·--- i $3o:Oo~ - $11.-60~- - -c- -----~----
Totallnvoice
$41.60 1
$622.22 4
1.L.r1
-,
9/24/20121 1
Fund:
Payee:
Description:
Agenda: 10/23/12
Current Claims
City of Dearborn Heights Voucher Approval
General Fund
Johnson Controls
HVAC Parts and Repairs
Number:
PPROVED FOR AGENDA OF
' I 0·;;1.3-1
Various Invoices Dated 07/12 through 09/12
Amount Budget Account Account Title Amount Before Payment 101-265-931.000 Rpr/Maint Bldg Grnds $2,280.34 $79,424.31
Requested By: Bldg. Maint.
Comptroller Authorized Official
Concurrence
Daniel S. Paletko
Johnson ~Jf1 Controls
ORIGINAL INVOICE
Invoice#: PO #/Auth: Customer WO#: Customer Acct:
Bill To:
1-5786189277 13-00070
1016931
CITY OF DEARBORN HEIGHTS 6045 FENTON DEARBORN HEIGHTS Ml 48127
Johnson Controls Building Efficiency FederaiiD 39-0380010
Invoice Date: Service Request: SRType: Branch Name:
09/14/2012 1-5775593756 L&M Detroit South - 0277
Service Site: DEARBORN HEIGHTS FIRE STATION #2 1999 N BEECH DALY RD, DEARBORN HEIGHTS Ml 48127-3487
Requested By: Phone:
Ray Winowiecki 3137177446
Invoice Comments: Materia! Sale: (1) fluid power gas valve. Thank you for your business.
Qty Description UOM Unit Price Sub Total Tax I Net Price
Materials --
1 ~?160 13 Sec Opng Time Each S625.DO $625.00 $0.00 1- $625.00
Damper Sh
Sub-Total $625.00 $0.00 $625.00
Invoice Sub-Total $625.00 Taxes $0.00
Total Due $625.00
Direct Billing Inquiries: (248) 276-6000
Terms: If any invoice is not paid in full upon receipt, the Customer hereby agrees to pay interest at a rate of 1.5% per month (18% annually) upon
the unpaid portion of the invoice. If action or suit is brought by Johnson Controls to collect any amount due or owing under this bill, Customer
agrees to pay all costs of collection including attorney's fees.
Disposable, Environmental & Usage (DEU) fee listed on this invoice may include charges for one or more of the following miscellaneous: Electrical,
pneumatic, welding supplies, hardware materials, cleaning supplies, or refrigerant reclaim disposal. A lump sum charge was applied rather than
itemizing usage.
We hereby certify that these goods are produced in compliance with all applicable requirements of sections 6, 7 and 12 of the Fair Labor Standards
Act of 1938, as amended, and of regulations and orders of the Administrator of the Wage and Hour Division issued under scioq_w.U ,~ JIW_rE;Pk" ~:"·'·"
Rrt; ~ij ~, . ' c J';fr¥111'!1~ "'
SEP 1 9 20\2
DBN.HTS.COMP.OFF.
Please reference our Invoice Number and amount with your payment and send ONLY to the address on this invoice.
Payment Terms: Due Upon Receipt Of Invoice Direct Billing Inquiries To Service Department: (248) 276-6000
To Remit Via Credit Card: Call the phone number listed above.
INVOICE#: 1-5786189277
AMOUNT DUE: $625.00
Remit Payment To: JOHNSON CONTROLS
PO BOX 905240 CHARLOTTE, NC, 28290-5240
To Remit Via ACH Wire Transfers: JP Morgan Chase One Chase Manhattan Plaza New York, NY 10005 Credit to: Johnson Controls Inc. ABA# 071-000013 Depositor Acct #55-14347 Type of Account: Checking
Page 1 of 1
Johnson Controls
SERVICE REPAIR REPORT
Service Request Number: 1-5775593756 Status: Completed
Requestor: Ray Winowiecki
Service Site: DEARBORN HEIGHTS FIRE STATION #2 DEARBORN HEIGHTS FIRE STATION #2 1999 N Beech Daly Rd Dearborn Heights, M148127-3487
Bill To: CITY OF DEARBORN HEIGHTS 1016931 6045 Fenton Dearborn Heights, Ml48127
Detroit South - 0277 2875 High Meadow Cir Auburn Hills. Mt 48326-2773 (248) 276-6000
Report Date: 09/1412012 Page 1 of 2
Purchase Order: 13-00070 Blanket Purchase Order:
Customer Authorization:
Customer Work Order:
serViCe:PrO-Vfdti'd: > --"~· -·-· ;t;:_:'-
Date Activity Number Activity Status Work Performed By
09/13/2012 1-2NINOOV Completed Picked up the fluid power gas valve for fire headquarters. Lawrence Ladochi
Labor. Detalls::.Y'· · .. : • :' :.:;:. '"' •• · .. · : ··•·· ! .. ; • ·• ... •.·: i ; :·,;;.· ..... ,,.,; .. ·•·;·.;·<;.•.:; .. ·•'i.•/Ji <; •;;c;:;; ;v· ;s,;L> Date Activity# Hours Type Miles Asset ID Customer Tag Serial Number Model Number
1-2NINOOV 1
TOTALS TO DATE 1
Q UOM Description 1 Each 120/60 13 SEC OPNG TIME W/DAMPER SH
Tool Charges: 0 Disposal, Environmental & Usage Charges* 0 Fuel Surcharge: 0 Miscellaneous: 0
Zone/Trip/Truck Charges: lSI Shipping /Handling Charges: 0 Per Diem: 0 * Disposal, Environmental & Usage Charges may include one or more of the following: miscellaneous electrical, pneumatic, welding supplies, hardware materials, cleaning supplies, or refrigerant reclaim disposal.
Refrigerant Tracking: Activity# Action Taken Type
For Questions Regarding Service, Please Contact Version: Release# PHL 3
Amount Asset ID Customer Tag Serial Number Model Number Leak Location No Refrigerant Activity Recorded To Date
Laura Allick
RE~e·v~o, \,;I it:' SEP 1 9 20t2
OSN.HTS.COMP.OFF.
Leak Rate
(248) 276-6000
Johnson ~jg, Controls
ORIGINAL INVOICE
Invoice#: PO #/Auth: Customer WO#: Customer Acct:
Bill To:
1-5757113243 Ray Winowiecki
1016931
CITY OF DEARBORN HEIGHTS 6045 FENTON DEARBORN HEIGHTS Ml48127
Johnson Controls Building Efficiency FederaiiD 39-0380010
Invoice Date: 09/07/2012 Service Request: 1-5750744449 SR Type: L&M Branch Name: Detroit South - 0277
Service Site: DEARBORN HEIGHTS FIRE STATION #2 1999 N BEECH DALY RD , DEARBORN HEIGHTS Ml 48127-3487
Requested By: Ray Winowiecki Phone: 3137177446
Invoice Comments: Material Sale: (1) Pulley. Thank you for your business.
·-·--·----~· - , ____ ·-
Qty Description UOM Unit Price Sub Total Tax Net Price
Materials 1 !Pulley EA $263.97 $263.97 $0.00 $263.97
Sub-Total $263.97 $0.00 $263.97
Invoice Sub-Total $263.97 Taxes $0.00
Total Due $263.97
Direct Billing Inquiries: (248) 276-6000
Terms: If any invoice is not paid in full upon receipt, the Customer hereby agrees to pay interest at a rate of 1.5% per month {18% annually) upon
the unpaid portion of the invoice. If action or suit is brought by Johnson Controls to collect any amount due or owing under this bill, Customer
agrees to pay all costs of collection including attorney's fees.
Disposable, Environmental & Usage (DEU) fee listed on this invoice may include charges for one or more of the following miscellaneous: Electrical,
pneumatic, welding supplies, hardware materials, cleaning supplies, or refrigerant reclaim disposal. A lump sum charge was applied rather than
itemizing usage.
We hereby certify that these goods are produced in compliance with all applicable requirements of sections 6, 7 and 12 of the Fair Labor Standards
Act of 1938, as amended, and of regulations and orders of the Administrator of the Wage and Hour Division issued under section 14 thereof.
Please reference our Invoice Number and amount with your payment and send ONLY to the address on this invoice.
Payment Terms: Due Upon Receipt Of Invoice Direct Billing Inquiries To Service Department: (248) 276-6000
To Remit Via Credit Card: Call the phone number listed above.
INVOICE#: 1-5757113243
AMOUNT DUE: $263.97
Remit Payment To: JOHNSON CONTROLS
PO BOX 905240
CHARLOTTE, NC, 28290-5240
To Remit Via ACH Wire Transfers: JP Morgan Chase One Chase Manhattan Plaza New York, NY 10005 Credit to: Johnson Controls Inc. ABA# 071-000013 Depositor Acct #55-14347 Type of Account: Checking
Page 1 of 1
Johnson ~Jt~ Controls
SERVICE REPAIR REPORT
Service Request Number: 1-5750744449 Status: Completed
Requestor: Ray Winowiecki
Service Site: DEARBORN HEIGHTS FIRE STATION #2 DEARBORN HEIGHTS FIRE STATION #2 1999 N Beech Daly Rd Dearborn Heights, Ml48127-3487
-;g--rYiCC!XPri>Vldfid~;:-:: Date Activity Number
Bill To: CITY OF DEARBORN HEIGHTS 1016931 6045 Fenton Dearborn Heights, M I 48127
Activity Status Work Performed
Detroit South ~ 0277 2875 High Meadow Cir Auburn Hills, Ml 48326-2773 (248) 276-6000
Purchase Order: Blanket Purchase Order:
Report Date: 09/07/2012 Page 1 of 2
Customer Authorization: Ray Winowiecki
Customer Work Order:
By
09/07/2012 1-2N3UEVJ Completed Picked up a pulley for a rooftop units main indoor fan motor at the fire headquarters.
Lawrence Ladochi
I Date Activity # Hours Type Miles Asset ID Customer Tag Serial Number Model Number
I 1-2N3UEVJ
TOTALS TO DATE
; Used: Activity# 1-2N3UEVJ
Tool Charges:
Zone/Trip/Truck Charges:
D
[g)
Qty 1
0
UOM Each
Disposal, Environmental & Usage Charges*
Shipping /Handling Charges:
D
D
PULLEY
Fuel Surcharge: Miscellaneous: D
Per Diem: D
* Disposal, Environmental & Usage Charges may include one or more of the following: miscellaneous electrical, pneumatic, welding supplies, hardware materials, cleaning supplies, or refrigerant reclaim disposaL
L Refrigerant Tracking: ! Activity# Action Taken Type Amount Asset 10 Customer Tag Serial Number Model Number Leak Location Leak Rate
I No Refrigerant Activity Recorded To Date
For Questions Regarding Service, Please Cont8ct: Laura Allick (248) 276-6000 Version: Release# PHL 3
Johnson ~J~ Controls
ORIGINAL INVOICE
Invoice#: PO #/Auth: Customer WO#: Customer Acct:
Bill To:
1-5477997025 Ray Winowiecki
1016931
Johnson Controls Building Efficiency FederaiiD 39-0380010
Invoice Date: 07/11/2012 Service Request: 1-5429312187 SR Type: L&M Branch Name: Detroit South - 0277
Service Site: CITY OF DEARBORN HEIGHTS 6045 FENTON
RICHARD A YOUNG RECREATION CTR 5400 MCKINLEY ST ,
DEARBORN HEIGHTS Ml 48127 DEARBORN HEIGHTS Ml 48125-2553
Invoice Comments:
Qty ' ' Labor
3.25 12 Oven:me
Fees 1 I •o•
1 Trip Charge
1 Fuel ',. .~,.
I
Requested By: RAY WINOWIECKI Phone: 3137177446
SERVICE REQUESTED: 3 RTU's and 1 on a pad won't start after a power interruption. Call Ray Winowiecki (313) 717-7446 with estimated time of arrival. SERVICE PROVIDED: Had to reset three thermostats and had to reset phase monitor on guy unit Thank you for your business.
UOM Unit Price Sub Total ' Tax Net Price
I I Light Hour $162.00 $526.50 $0.00 ~oLb.oU
• I Ulal $526.50 $0.00 I
1 & Usage Charge Each MUUU ~4U 00 i woo $40.00
Each $60.00 $60.00 $0.00 $60.00
Each $35.00 $35.00 ' $0.00 $35.00
<>UU· I Ulal i <1:1~~ nn , $0.00 ~·w~O
I i
, Sub--1ma1 $6:~:~g Taxes Total Due $661.50
Direct Billing Inquiries: (248) 276-6000
Terms: If any invoice is not paid in full upon receipt, the Customer hereby agrees to pay interest at a rate of 1.5% per month (18% annually) upon the unpaid
portion of the invoice. If action or suit is brought by Johnson Controls to collect any amount due or owing under this bill, Customer agrees to pay all costs of
collection including attorney's fees.
Disposable, Environmental & Usage (DEU) fee listed on this invoice may include charges for one or more of the following miscellaneous: Electrical,
pneumatic, welding supplies, hardware materials, deaning supplies. or refrigerant reclaim disposal. A lump sum charge was applied rather than itemizing
usage.
We hereby certify that these goods are produced in compliance with all applicable requirements of sections 6, 7 and 12 of the Fair Labor Standards Act of
1938, as amended, and of regulations and orders of the Administrator of the Wage and Hour Division issued under section 14 thereof.
f; '·~; '!' qr-1""' '''•''t+>
"
Page 1 of 2
Johnson Controls
SERVICE REPAIR REPORT Report Date: 07/11/2012 Page 1 of 3
Service Request Number: 1-5429312187
Status: Completed Requestor: RAY WJNOWIECKI
Service Site: RICHARD A YOUNG RECREATION CTR RICHARD YOUNG RECREATION 5400 Mckinley St Dearborn Heights, M! 48125-2553
Bill To: CITY OF DEARBORN HEIGHTS 1016931 6045 Fenton Dearborn Heights, M148127
Detroit South - 0277 2875 High Meadow Cir Auburn Hills, Ml48326-2773 (248) 276-6000
Purchase Order: Ray Winowiecki Blanket Purchase Order:
Customer Authorization:
Customer Work Order:
3 RTUS AND 1 ON A PAD WON'T START AFTER A POWER INTERRUPTION. CALL RAY WINOWIECKI (313) 717-7446 W/ETA. ' __ == s-e-pAce-:Requiiistetr:---------- -------- __,._,..-_..., ... _,., __ ---~ --3 1 serv1c~ ·ProVfd~a:· ·-~.-,
Date Work Performed By 06/30/2012
Activity Number 1-2HSH06Z
Activity Status Completed Had tO reset three tstats and had to-reSBTPh.ase montor on gu-y·unu:---~- Daryl.i3rydie -
10/; G-\~vL,[}
--- . Accepted by RAY WINOWJECKI ·-·-·
LabOr·oetaiiS': - . ····· ... · .... ·.· . .·.·
Date Activity# Hours Type -·-r;;iiJes- Asset ID Customer-Tag -- Serial Number ·---··-··--~ .. ~-···
1-2HSH06Z 49 ·-····-- ---
06/30/2012 3.25 Overtime --~-·-----·
TOTALS TO DATE 3.25 49
-~--------~~------~-~~~-·
~aterials U,_s,e,_,d'-''-----1 Activity# Ot:t UOM Description
~-·-··~~-
-Model Number
··------·
I
L___ ______ --------No Material recoccr.::dc::e.::d__:tc::o__:D:ca:ct:::e _________________________ _
···-~
Tool Charges: D Disposal, Environmental & Usage Charges* IZl Fuel Surcharge: IZl Miscellaneous:
Zone/Trip/Truck Charges: IZl Shipping /Handling Charges: Per Diem: D
* Disposal, Environmental & Usage Charges may include one or more of the following: miscellaneous electrical, pneumatic, welding supplies, hardware materials, cleaning supplies, or refrigerant reclaim disposal
For Questions Regarding Service, Please Contact: Laura A!lick (248) 276-6000 Version: Release# PHL 3
Johnson Controls
Service Request Number: 1-5429312187 Status: Completed
Requestor: RAY WINOWIECK!
--·--·---------~
SERVICE REPAIR REPORT
Detroit South - 0277 2875 High Meadow Cir Auburn Hills, Ml 48326-2773 (248) 276-6000
Service Order Warrailty Terms ··and Conditions
PARTS WARRANTY:
Report Date: 07/11/2012 Page 3 of 3
Johnson Controls, Inc {JCI) warrants that original equipment, parts or components manufactured or labeled by JCI shall be free from defects in material and workmanship under normal usage and proper installation and maintenance for a period of one (1) year from the date of shipment. Equipment, parts or components not manufactured or labeled by JCI shall carry a warranty from defects in material and workmanship under normal usage and proper installation and maintenance for a period of ninety (90) days from the date of shipment. Notwithstanding the foregoing, in the event JCI is reasonably able to identify a warranty for a period longer than the ninety (90) days applicable to equipment, parts or components not manufactured or labeled by JC!, it will assign all assignable rights under such warranty to Customer and reasonably cooperate in the enforcement of any warranty claim. Recertified or replacement paris installed on equipment and still under the original equipment manufacturer's warranty are covered for ninety (90) days or the remainder of the original equipment manufacturer warranty period, whichever is longer. For large tonnage chillers, JCI will warrant under normal usage and proper installation and maintenance for a period of one (1) year from the date of shipment: screw compressors, motors, control panels and components, VFD's and components and Liquid Cooled Solid State Starters and components. For small tonnage ch!llers, JCI will warrant under normal usage and proper installation and maintenance for a period of one (1) year from the date of shipment: scroll compressors, condenser coils, control panels and components, screw compressors (DXS and Mustang), and fan motors. In the event of a valid warranty claim, the Customer's remedy shall, at JCI's sole discretion and subject to the exclusions herein, be limited to repair or replacement of the subject equipment, part or component conditioned upon the return to JCI of any defective equipment, part or component. This Parts Warranty does not cover any shipping, handling or transportation charges or any associated labor costs.
LABOR WARRANTY: Johnson Controls, Inc. (JCI) warrants its workmanship or that of its agents in relation to installation of materials for a period of ninety (90) days from date of installation or with respect to service work for a period of ninety (90) days from the date of service. Customer acknowledges that re-performance Shall be its exclusive and only remedy with regards to any services provided by JCI. Customer shall bear all labor costs associated with the repair or replacement of failed material that is outside the scope of this express labor warranty. All warranty labor shall be executed during JCI normal business hours.
These warranties do not extend to any equipment which has been repaired by others, abused, altered, or misused in any way, or which has not been properly and reasonably maintained.
THESE WARRANTIES ARE IN LIEU OF ALL OTHER WARRANTIES, EXPRESSED OR IMPLIED. INCLUDING BUT NOT LIMITED TO THOSE OF MERCHANTABILITY AND FITNESS FOR A SPECIFIC PURPOSE. UNDER NO CIRCUMSTANCES SHALL JCI BE LIABLE FOR ANY SPECIAL, INDIRECT, OR CONSEQUENTIAL DAMAGES ARISING FROM OR RELATING TO ANY DEFECT IN MATERIAL OR WORKMANSHIP OF EQUIPMENT OR THE PERFORMANCE OF SERVICES
----------~"
For Questions Regarding Service, Please Contact: Laura A!lick (248) 276-6000 Version: Release# PHL 3
Johnson ~}~1 Controls
ORIGINAL INVOICE
Invoice#: PO #/Auth: Customer WO#: Customer Ace!:
Bill To:
1-5472546900 Ray Winowiecki
1016931
Johnson Controls Building Efficiency Federal ID 39-0380010
Invoice Date: 07/10/2012 Service Request: 1-5449959578 SRType: L&M Branch Name: Detroit South- 0277
Service Site: CITY OF DEARBORN HEIGHTS 6045 FENTON
DEARBORN HEIGHTS FIRE STATION #2 1999 N BEECH DALY RD,
DEARBORN HEIGHTS Ml48127 DEARBORN HEIGHTS Ml48127-3487 Requested By: Phone:
Ray Winowiecki 3137177446
Invoice Comments: SERVICE REQUESTED: #3; High pressure switch needs to be replaced.
SERVICE PROVIDED: Replaced bad high pressure switch. Thank you for your business.
Qty Description UOM Unit Price Sub Total Tax Net Price Labor
2 07/05/2012 Regular Mechanical Heavy Hour $108.00 $216.00 $0.00 $216.00
Sub-Total $216.00 $0.00 $216.00
Materials 1 ~Smr41 0 High Press Ctrl M Each $77.46 $77.46 $0.00 $77.46
Sub-Total $77.46 $0.00 $77.46
Fees 1 Disposal, Environmental & Usage Charge Each $40.00 $40.00 $0.00 $40.00
1 Trip Charge Each $70.00 $70.00 $0.00 $70.00
1 Fuel Surcharge Adjustment Each $35.00 $35.00 $0.00 $35.00
Sub-Total $145.00 $0.00 $145.00
Invoice Sub-Total $438.46 Taxes $0.00
Total Due $438.46
Direct Billing Inquiries: (248) 276-6000
Terms: If any invoice is not paid in full upon receipt, the Customer hereby agrees to pay interest at a rate of 1 .5% per month (18% annually) upon the unpaid
portion of the invoice. ff action or suit is brought by Johnson Controls to collect any amount due or ow"1ng under this bill, Customer agrees to pay all costs of
collection including attorney's fees.
Disposable, Environments! & Usage (DEU) fee listed on this invoice may include charges for one or more of the following miscellaneous: Electrical,
pneumatic, welding supp!fes, hardware materials, cleaning supplies, or refrigerant reclaim disposal. A lump sum charge was applied rather than itemizing
usage.
We hereby certify that these goods are produced in compliance with aH applicable requirements of sections 6, 7 and 12 of the Fair Labor Standards Act of
1938, as amended, and of regulations and orders of the Administrator of the Wage and Hour Division issued under section 14 thereof.
Page 1 of2
Johnson ~jg1 Controls
Bill To: CITY OF DEARBORN HEIGHTS 6045 FENTON DEARBORN HEIGHTS Ml 48127
Service Site: DEARBORN HEIGHTS FIRE STATION#2 1999 N BEECH DALY RD DEARBORN HEIGHTS Ml, 48127-3487
Problem Description:
Not to Exceed Amount Quoted I Flat Rate Price: $0.00
Requestor: Ray Winowiecki 3137177446
#3; Hi Pressure switch needs to be replaced.
Purchase Order Number: Customer Authorization #: Ray Winowiecki
Customer Work Order#:
Credit Card Type: Credit Card Number:
Asset ID
Equipment ID Manufacturer
Model Number Serial Number
Page 1 of 2
Detroit South - 0277 2875 HIGH MEADOW CIR, AUBURN HILLS Ml 483262773 (248) 276-6000 (248) 276-6001
Repair Service Request
Service Request No. 1-5449959578
Service Request Type L&M Service Request Sub~ Type Labor & Material
Service Request Status Audit
As of Date 07/10/2012
Agreement Ref 1-3374834758
lll:tivitiel<., ;)>v• /!;).;}. i .· .; ! •' ,....... •. • >.'.• ..•. ··· •.• • • ,' . . · .. · .. ·.·. • . . ., •. •. (1-"l• . ·.· .. .-; •. ,'• '.'( .... :. . 'l· . • ,.;.
Date Activity No. Reg Hrs 1,5 OT Hrs I 2.0 OT Hrs Work Performed Customer Signature 07/05/2012 1-214RJR1 2 0 I 0
Technician Miles/Km Activity Status
Replaced bad high pressure switch. Complete.
David Completed
Nunnelley 60
Total To Date Reg Hrs 1.5 OT Hrs I 2.00T Hrs Miles/Km 2 0 I 0 60 I
Johnson ~jg1 Controls
ORIGINAL INVOICE
Invoice#: PO #/Auth: Customer WO#: Customer Ace!:
Bill To:
1-5560082880 RAY WINOWIECKI
1016931
CITY OF DEARBORN HEIGHTS 6045 FENTON DEARBORN HEIGHTS Ml48127
Johnson Controls Building Efficien~~ Federal ID 39-03811'!::
Invoice Date: Service Request: SR Type: Branch Name: Detroit
Service Site: BERWYN SENIOR CENTER 26155 RICHARDSON ST, DEARBORN HEIGHTS Ml48127-1959
Requested By: RAY WINOWIECKI Phone: 3137177446
Invoice Comments: Material Sale: Picked up parts for the Berwyn Center. Thank you for your business.
Qty Description UOM Unit Price Sub Total Tax Net Price Materials
1 !Mars Contactr 40a 2p 24v Each $75.60 $75.60 $0.00 $75.60
1 jMars 45/5 Mfd 440v Run Each $52.50 $52.50 $0.00 $52.50
Sub-Total $128.10 $0.00 $128.10
Invoice Sub-Total $128.10 Taxes $0.00
Total Due $128.10
Direct Billing Inquiries: (248) 276-6000
Terms: If any invoice is not paid in full upon receipt, the Customer hereby agrees to pay interest at a rate of 1.5% per month (18% annually) upon
the unpaid portion of the invoice. If action or suit is brought by Johnson Controls to collect any amount due or owing under this bill, Customer
agrees to pay all costs of collection including attorney's fees.
Disposable, Environmental & Usage (DEU) fee listed on this invoice may include charges for one or more of the following miscellaneous: Electrical,
pneumatic, welding supplies, hardware materials, cleaning supplies, or refrigerant reclaim disposal. A lump sum charge was applied rather than
itemizing usage.
We hereby certify that these goods are produced in compliance with a!l applicable requirements of sections 6, 7 and 12 of the Fair Labor Standards
Act of 1938, as amended, and of regulations and orders of the Administrator of the Wage and Hour Division issued under section 14 thereof.
Please reference our Invoice Number and amount with your payment and send ONLY to the address on this invoice.
Payment Terms: Due Upon Receipt Of Invoice Direct Billing Inquiries To Service Department: (248) 276-6000
To Remit Via Credit Card: Call the phone number listed above.
INVOICE#: 1-5560082880
AMOUNT DUE: $128.10
Remit Payment To: JOHNSON CONTROLS
PO BOX 905240
CHARLOTTE, NC, 28290·5240
To Remit Via ACH Wire Transfers: JP Morgan Chase One Chase Manhattan Plaza New York, NY 10005 Credit to: Johnson Controls Inc. ABA# 071-000013 Depositor Acct #55-14347 Type of Account: Checking
Page 1 of 1
Johnson ~J!~ Controls
SERVICE REPAIR REPORT
Service Request Number: 1-5531966715 Status: Completed
Requestor: RAY WJNOWIECK!
Service Site: BERWYN SENIOR CENTER BERWYN SENIOR CENTER 26155 Richardson St Dearborn Heights, Ml 48127-1959
Date Activity Number
Bill To: CITY OF DEARBORN HEIGHTS 1016931 6045 Fenton Dearborn Heights, Ml 48127
Activity Status Work Performed
Detroit South - 0277 2875 High Meadow Cir Auburn Hills, Ml 48326-2773 (248) 276-6000
-
07/27/2012 1-2JHL8UL Completed Picked up parts for the berwyn center.
Report Date: 07/27/2012 Page 1 of2
Purchase Order: Blanket Purchase Order:
Customer Authorization: RAY W!NOWIECKI
Customer Work Order:
By Lawrence Ladochi
---
•.•/. ·-··;,;.. < •..•• . ;,:;; Date Activity# Hours Type Miles Asset JD Customer Tag Serial Number Model Number
1-2JHL8UL 0
TOTALS TO DATE
Materials Used: Activity# Qty UOM Description 1-2JHL8UL 1 Each MARS CONTACTR 40A 2P 24V 1-ZJHLBUL 1 Each MARS 4515 MFD 440V RUN
Tool Charges: 0 Disposal, Environmental & Usage Charges* 0 Fuel Surcharge: 0 Miscellaneous: 0
Zone/Trip/Truck Charges: [8] Shipping /Handling Charges: 0 Per Diem: 0
* Disposal, Environmental & Usage Charges may include one or more of the following: miscellaneous electrical, pneumatic, welding supplies, hardware materials, cleaning supplies, or refrigerant reclaim disposal.
Refrigerant Tracking: Activity# Action Taken T~ee Amount AssetiD Customer Tag Serial Number Model Number Leak Location Leak Rate
No Refrigerant Activity Recorded To Date
For Questions Regarding Service, Please Contact: Laura Allick (248) 276-6000 Version: Release# PHL 3
ORIGINAL INVOICE
Invoice#: PO #/Auth: Customer WO#: Customer Acct:
Bill To:
1-5560255031 Ray Winowiecki
1016931
CITY OF DEARBORN HEIGHTS 6045 FENTON DEARBORN HEIGHTS Ml48127
Johnson Controls Building Efficiency Federal 10 39-0380010
Invoice Date: Service Request: SR Type: Branch Name:
07/27/2012 1-5550900854 L&M Detroit South - 0277
Service Site: CITY OF DEARBORN HEIGHTS 6045 FENTON ST , DEARBORN HEIGHTS Ml48127-3287
Requested By: Phone:
Ray Winowiecki 3137177446
Invoice Comments: Material Sale: Quantity 1- RNCO head pressure cont. Thank you for your business.
Qty Description UOM Unlt Price Sub Total Tax Net Price Materials
1 !Hnco Head Pressure Cant Each $163.31 $163.31 $0.00 $163.31
Sub-Total $163.31 $0.00 $163.31
Invoice Sub-Total $163.31 Taxes $0.00
Total Due $163.31
Direct Billing Inquiries: (248) 276-6000
Terms: !f any invoice is not paid in full upon receipt, the Customer hereby agrees to pay interest at a rate of 1.5% per month (18% annuaUy) upon
the unpaid portion of the invoice. lf action or suit is brought by Johnson Controls to collect any amount due or owing under this bill, Customer
agrees to pay all costs of collection including attorney's fees.
Disposable, Environmental & Usage (DEU) fee listed on this invoice may include charges for one or more of the following miscellaneous: Electrical,
pneumatic, welding supplies,- hardware materials, cleaning supplies, or refrigerant reclaim disposal. A Jump sum charge was applied rather than
itemizing usage.
We hereby certify that these goods are produced in compliance with all applicable requirements of sections 6, 7 and 12 of the Fair labor Standards
Act of 1938, as amended, and of regulations and orders of the Administrator of the Wage and Hour Division issued under section 14 thereof.
,~,.,_ ·v·E·' AUG 0 1 2012
DBN.HTS.COMP.OFE Please reference our Invoice Number and amount with your payment and send ONLY to the address on this invoice.
Payment Terms: Due Upon Receipt Of Invoice Direct Billing Inquiries To Service Department: (248) 276-6000
To Remit Via Credit Card: Call the phone number listed above.
INVOICE#: 1-5560255031
AMOUNT DUE: $163.31
Remit Payment To: JOHNSON CONTROLS
PO BOX 905240
CHARLOTTE. NC, 28290-5240
To Remit Via ACH Wire Transfers: JP Morgan Chase One Chase Manhattan Plaza New York, NY 10005 Credit to: Johnson Controls Inc. ABA# 071-000013 Depositor Acct #55-14347 Type of Account: Checking
Page 1 of 1
Johnson ~J<~ Controls
Service Site:
Service Request Number: 1-5550900854 Status: Completed
Requestor: Ray Winowiecki
Bill To:
SERVICE REPAIR REPORT
Detroit South - 0277 2875 High Meadow Cir Auburn Hills, Ml 48326-2773 (248) 276-6000
Purchase Order:
Report Date: 07/27/2012 Page 1 of2
CITY OF DEARBORN HEIGHTS DEARBORN HEIGHTS CITY HALL 6045 Fenton St
CITY OF DEARBORN HEIGHTS 1016931
Blanket Purchase Order:
Customer Authorization: Ray Winowiecki
Customer Work Order: Dearborn Heights, Ml48127-3287
:t:setvic~----Pr6Vi"d~d:-- -, Date Activity Number
07/26/2012 1-2JSV21J
·- ''f/1'(
6045 Fenton Dearborn Heights, Ml 48127
Activity Status Completed
'( ·"'"'' '·· '"'·'' '· '
Work Performed Picked up a new high pressure control for the workout room at fire headquarters_
<<' / .;: >·:>: . > '''/ . ' C! <>t::· Yi .•• •·::<:'!"•
By Lawrence Ladochi
: /,, ... Date Activity# Hours Type Miles Asset ID Customer Tag Serial Number Model Number
1-2JSV21J 35
TOTALS TO DATE 35
Materials Used: Activity# Qty UOM Description 1-2JSV21J 1 Each RNCO HEAD PRESSURE CONT
Tool Charges: D Disposal, Environmental & Usage Charges* D Fuel Surcharge: D Miscellaneous: D
Zone/Trip/Truck Charges: IZI Shipping /Handling Charges: D Per Diem: D
* Disposal, Environmental & Usage Charges may include one or more of the following: miscellaneous electrical, pneumatic, welding supplies, hardware materials, cleaning supplies, or refrigerant reclaim disposal.
Type Amount Asset ID Customer Ta Serial Number Model Number Leak Location Leak Rate No Refrigerant Activity Recorded To Date
For Questions Regarding Service, Please Contact: Laura Alllck (248) 276-6000 Version: Release# PHL 3
CITY OF DEARBORN HEIGHTS 6045 :E'ENTON e DEARBORN HEIGHTS, MICHIGA..I\J 48127 TELEPHONE (3l3) 791-3443 • FAX (313) 191-3441
Ship To: [DEARBORN HEIGHTS-BLDG. MAINT.
,
1
'24600VAN BORN, DPW YARD DEL 7- i 130/NOON-3PM ~EJ1RBORN HEIGHTS Ml 48125
VENDOR NO. 24832
·~ JOHNSON CONTROLS, INC. N P 0 BOX 905240 D D R CHARLOTTE
Unit !Description
NC 28290-052
EACH TO COVER THE COST OF HVAC PARTS AND REPAIRS
101-265-931.000
RAYWINOWIECKI DIRECT INQUIRIES TO
PURCHASE ORDER
NO. 13-00070
Date: 07/01/12 *+*+*+*+*+*+*+*+*+*+
BLANKET PURCHASE ORDERS JULY 1, 2012 THROUGH JUNE 30,2013 TO BE PAID MONTHLY
Unit Cost $0.00
Total PO Amount
f DIRECTOR
Total Cost ] $0.00
0.00:·
PURCHASE ORDER NUMBER MUST APPEAR ON INVOICE. OR INVOICE WILL NOT BE PAID!
M.S.D.S. REQUIRED ON HAZARDOUS MATERIAL NOTE: ANY DEVIATION IN PRICE ON THIS ORDER MUST BE APPROVED BY THE CITY PURCHASING DIVISION PRIOR TO DELIVERY
ORIGINAL INVOICES TO: Cot1PUTROLLER' S OFFICE 6045 FENTO, DBN. HTS., MI 48127
,.._. EXEMPT FROJYI STATE/LOCAL AND FEDERAL TAXES: 38-1712300
3. PURCHASE ORDER NUMBER MUST APPEAR ON AI"L INVOICES, SHIPP£RS, AND CORRESPONDENCES.
4. SUBSTITUTIONS NOT ACCEPTED WITHOUT PRIOR APPROVAL.
5. PARTIAL SHIPMENT WILL BE ACCEPTED IF INVOICED SEPARATELY. PAYMENT MADE UPON COMPLETION OF PURCHASE ORDER.
6. ACKNOWLEDGMENT COPY MUST BE RETURNED BEFORE ORDER IS BINDING.
Agenda: 10/23/12
Current Claims City of Dearborn Heights
Voucher Approval
Number:
Fund: General Fund & Water Fund
Payee:
Description:
Account 1 01-200-911-000 592-536-911.000
Comptroller
M.M.R.MA
Liability Insurance 07/01/12 Through 07/01/13 Policy Number M0001000, Dated 09/12/12
Account Title Insurance Insurance
Amount $612,997.50 $150,000.00
Amount Budget Before Payment $725,000.00
Requested By: Gen Gov't & Water
Authorized Official
Concurrence
Daniel S. Paletko
Invoice Date
9/12/2012
Donald Barrow
City of Dearborn Heights
6045 Fenton
Dearborn Heights, Ml 48127
Poi icy Number MOOOlOOO
-
Policy Number
Policy Term
Policy Period General Fund Contribution
Policy Period Annual Contribution
$1,225,995.00
Installment Due
10/26/2012
11/26/2012
12/28/2012
TOTAL
POLICY SUMMARY
ACCOUNT SUMMARY
Payments
$0.00
BILLING SUMMARY
FIRST INSTALLMENT
REMITTANCE ADV!CE
MICHIGAN MUN[CIPAl
RISK MANAGEMENT AUTHORITY
14001 Merriman
livonia, Ml 48154
734.513.0300 /800.243.1324
M0001000
12
7/1/2012 - 7/1/2013 $1,225,995.00
Balance Due for Policy Period
$1,225,995.00
General Fund
$612,997.50
$306,498.75
$306,498.75
$1,225,995.00
Please detach and return with your payment
MICHIGAN MUNICIPAL
RISK MANAGEMENT ---~ --~·~~oM
AUTHORITY
City of Dearborn Heights
6045 Fenton
Dearborn Heights, Ml 48127
Policy Number# M0001000
Amount Past Due $0.00
Installment Due $612,997.50
Drawer# 64458- Detroit, Ml48264 -734.513.0300- Fax 734.513.0318
Invoice Date
9/12/2012
Due Date Due Now
10/26/2012
Invoice Date
9/12/2012
Donald Barron
City of Dearborn Heights
6045 Fenton
Dearborn Heights, Ml 48127
Policy Number ROOOlOOO
Policy Number
Policy Term
Policy Period Retention Fund Contribution
Policy Period Annual Contribution
$300,000.00
Installment Due
10/26/2012
11/26/2012
12/28/2012
TOTAL
POLICY SUMMARY
ACCOUNT SUMMARY
Payments
$0.00
BILLING SUMMARY
FIRST INSTALLMENT
MH::;HUGAN MUN 1121 PAl
RJSK MANAGEM.ENT '="''''"'·"=='=··'""- =="'--="""""'"'"~=,-,-.,_'"""'=~-~="~'~J"--·
AUTHORITY
14001 Merriman
livonia, Ml 48154
734.513.0300 /800.243.1324
ROOOlOOO 12
7/1/2012 - 7/1/2013 $300,000.00
Balance Due for Policy Period
$300,000.00
Retention Fund
$150,000.00
$75,000.00
$75,000.00
$300,000.00
REMITTANCE ADVICE ~~--------------~
Please detach and return with your payment
MICHIGAN MUNICIPAL
R.ISK MANAGEMENT AUlfHORJT'Y
City of Dearborn Heights
6045 Fenton
Dearborn Heights, Ml 48127
Policy Number# ROOOlOOO
Past Due
Installment Due
Amount
$0.00
$150,000.00
Drawer# 64458- Detroit, Ml48264 -734.513.0300 ·Fax 734.513.0318
Invoice Date
9/12/2012
Due Date Due Now
10/26/2012
Fund:
Payee:
Description:
Account
Agenda: 10/23/12 Number:
Current Claims City of Dearborn Heights
Voucher Approval
General Fund
Matt's Auto Service
Vehicle Repairs Aug/Sept, 2012 Various Invoices Blkt PO 13-81
EfPROVED FOR GENOA OF ---
D·d.3-l
Amount Budget Account Title Amount Before Payment
101-300-932-000 Repair/Maint Eqpt $1,922.06 $147,743.29
Requested By: Police Dept.
Comptroller Authorized Official
Concurrence
Daniel S. Paletko
;\ddn::ss
City
Matt's Auto .~~'~l"Vice ~21 002 Vari Born
Dearborn Heights .. 11m 48125 (313) 724 :>J?B
F1426/'l
of Dearborn Hts Poli.•1. •.: 2.5637 i\clkhigan Ave llearbom Ht~. M[ 48125
YE.4H/MAKEIII!IODEL
0'\ C' hevy Trailblazer LS
>:6(:Jl"CtP Gray
Horne#
Work#
MILEAGE
6HKRl2
277-7478
107465
Invoice Invoice Nurnbor
20207
Invoice Date:
8/28/2012
r~""7~.)~~,(~;·~-1~~::~."'_~~~~>~~'"I~;~--~~-----~=~ r,,,,,,,;,,;nwl" lll~~···~lii>!W'''''~~~~-r~;~!~~~~.f~~~?!~;'~I-O•~Jt,l1111~1.'=~~' --~-· 1
t · Labor M .( Engine ()il/Fill<:n 2 Rotor From Brilke Rotor
"""'"'"'"""='~"""'?
Unit Price ... T11 __ _Extens1on .. j 15.00 15.00 49.89 99.78 59.62 59.62 i':tds FnHrt Brake pac!s I
L.11bor M i< Front Brai•:es 50.00 75.00
90 DAYS PARTS & LABOR
!
SHOULD YOU FAIL TO AUTHORIZE COMPLETION OF REPAIRS OR SERVICES AT THE TIME YOUR APPROVAL IS RE· QUESTED, A CHARGE MAY BE IMPOSED FOR VEHICLE DISASSEMBLY, RE·ASSEM· BLY OH PARTIALLY COMPLETED WORK
A DAILY STORAGE CHARGE MAY tlE ADDED FOR VEHICLES NOT PICKE-D UP AFTER NOTIFICATlO~< 0~ COMPLETION OF f!EPAiflli COM-MENCING ~--~ .. ---~-·· " ................ _.. HOUF!Sil)AYSAFTER N01'1FICM10il
Matt's Auto Se·rvice 21002 Van 13orn
Dearborn Heights, Ml 48"125 1'<1 C<\ 7?.<L?370 \'-' '.._..., '.._--, <- IV
F142674
r~ame City of Dearborn Hts Police Addmss 25637 Jvlidrigan Ave City Dearborn Hts. MJ 48125
Rotor Pads Brake Rotor Pads LaborM
Front Brake Rotor From Bral<e pads Rear Brake Rotor Rear Brake pads R&R .Front/ Rear Brakes.
Home#
Work# 277-7478
49.00 48.89 49.00 48.89 55.00
Subtotal YOU ARE ENTITLED BY LAW TO THE RETURN OF All PAR'fS REPLAC. CEPTTHOSE WHICH ARETOO HEAVY OR LARGE, S 1 T AND \HOSE REQUIRED TO BE SENT BACK TO THE MANUFACTURER R DISTRIBUTOR BECAUSE OF WARRANTY WORK OR a es ax
, AN EXCHANGE AGREEMENT. YOU ABE ENTITLED TO INSPECT THE PARTS WHICH CANNOT BE RETURNED TO YOU. Total Invoice Amount
\../
90 DAYS PARTS & LABOR
Invoice Invoice Number
20220
Invoice Date:
8/3112012
98.00 48.89 98.00 4g.89
165 00
$458.78
Name Address City
Matt's Auto Service 21002 Van Born
Dearborn Heights, Ml 48125 (313) 724-2379
F142674
City of Dearborn Hts Police 25637 l'vfidrigan Av~ Dearborn Hts. Ml 4X125
I YEAR/MAKE/MODEL I
I VEHICLE IDENJ:Jf.~Il9~V28Xl62975 ' 08 Ford Crown Victmia
COLOR Bl<t~k II 41
Quantity
1 u ')
Item
Part LaborM Patt LaborM
. ·-tiCENSE#-010 X 934
Description
New Cooling Fan Assembly R&R Cooling Fan, Fill Cooling System. New Battery Jump Box. Deliver Vehicle To Station. No Charge.
Home#
Work# 277-7478
MILEAGE 72926
Unit Price
368.90 55.00
199.98 0.00
Subtotal Sales Tax
Total Invoice Amount
90 DAYS PARTS & LABOR
Invoice Invoice Number
20247
Invoice Date: 9112/2012
Extension
368.90 82.50
399.96 0.00
[\)arne
Address City
Matt's Auto Ser-vice·· 2 i 002 Van Born
Dearborn Heights, M I 48125 (313) 724-2379
F142674
City of De arb om Hts Police 25637 Midugan Ave Dearbom Hts. Mf 48125
it"~~,.~ ' , . E.AR/MAKE/MODEL .
1
VEHICLE IDE11f~Y?r6 -1 sLA63556 I 08 I'ord Expechtmn XLT . . ;,
Home#
Work#
MILEAGE
277-7478
28897
Invoice Invoice Number
20296
Invoice Date:
9/27/2012
L~-------·---.. -· ____ [ _____ .. .,. COLOR . . - I LICENSE II
---------+-------·-----... ---!
1 Black 114·J · 066 X 369 ;...
Quantity --- - -----------
2 l
Item Description ~- -t--- - ---- .::.:=::..::.:.:_ ___ ,
Seru;or 1 Front Motorcraft 02 Sensors Labor M Dma Scan Scope R&R Sensors Clean
Throttl0 Body Clean MAF
•
Unit Price
98.76 55.00
Subtotal Sales Tax
Total Invoice Amount
90 DAYS PARTS & LABOR
Extension
197.52 165.00
$362.52
6045 FENTON • DEARBORN HEIGHTS, MICHIGfu\T 48127 TELEPHONE (313), 791-3443 • FAX (313) 791-3441
Ship To: LICE DEPARTI\.1ENT Y OF DEARBORN HEIGHTS
37 MICHIGAN AVENUE
I DEARBORN HEIGHTS Ml 48125 ~
VENDOR NO. 31290
~ MATTS AUTO SERVICE 111 21002VANBORN [I
0 R DEARBORN HEIGHTS Ml
Unit !Description
48125
I Quant;ty
1 EACH TO COVER THE COST OF PARTS AND
PURCHASE ORDER
NO. 13-00081
Date: 07/01/12 *+*+*+*+*+*+*+*+*+*+
BLANKET PURCHASE ORDERS JULY 1, 2012 THROUGH JUNE 30, 2013 TO BE PAID MONTHLY
Unit Cost
$0.00 Total Cost -!
$0.00 FOR REPAIRS FOR THE POLICE DEPARTMENT VEHICLES
101-300-932.000
Total PO Amount L-.. ___ ooo]
LEE GAVIN rJ1' ~ f\ . · ,(/?(J).en ~~~ DIRECTOR DIREC'I' INQUIRIES TO
PURCHASE ORDER NUMBER MUST APPEAR ON INVOICE. OR INVOICE WILL NOT BE PAID!
M .. S.D.S. REQUIRED ON HAZARDOUS MATERIAL NOTE: ANY DEVIATION IN PRICE ON THIS ORDER MUST BE APPROVED BY THE CITY PURCHASING DIVISION PRIOR TO DELIVERY
ORIGINAL INVOICES TO; COMPDTROLLER'S OFFICE 6045 FENTO, DBN. HTS., Ml 48127
,~. EXEMPT FROM STATE/LOCAL AND ~EDERAL TAXES: 38-1712300
' PURCHASE ORDER NUMBER MUST APPEAR ON ALL INVOICES, SHIPPERS, AND CORRESPONDENCES.
4. SUBSTITUTIONS NOT ACCEPTED WITHOUT PRIOR APPROVAL.
5. PARTIAL SHIPMENT WILL BE ACCEPTED IF INVOICED SEPARATELY. PAYtvlENT MADE UPON COMP'LETION OF PURCHASE ORDER.
6. ACKNOWLEDGMENT COPY MUST BE RETURNED BEFORE ORDER IS BINDING.
Fund:
Payee:
Description:
Account 101-220-817.000
Comptroller
Agenda: 10/23/12
Current Claims City of Dearborn Heights
Voucher Approval
General Fund
Michigan Assn. Of Chiefs of Police
Number: u-13
APPROVED F::J. AGENDA OF
--~
!D-~.3-J:tj
Dispatcher Selection Tests/ Admin Guide/Shipping Invoice Number 1992, Dated 05/29/12
Account Title Prof/Con
Amount $1,705.00
Amount Budget Before Payment
$5,000.00
Requested By: Police Dept.
Authorized Official
Concurrence
Daniel S. Paletko
TO:
FROM:
DATE:
RE:
Human Resource Department
Vince Macari, Comptroller
Elisabeth Sobota-Perry, Director
October 11, 2012
Check issuance
Elisabeth Sobota-Perry Director
Daniel S. Paletko Mayor
Please issue a check for $1,705.00 to Michigan Association of Chiefs of Police (MACP). This is the fee for Dispatcher Simulation examination held in May.
Please charge this cost to: 220.8\7.000.
Remittance should be sent to: Michigan Association of Chiefs of Police, 2133 University Park Drive, Suite 200, Okemos, Michigan 48864-3975.
We have no record of receiving this invoice prior to October 11, 2012 - although it is dated May 29, 2012 and our original order was placed with Stanard & Associates (Chicago).
If you have any questions or concerns, please let me know.
Thank you! IV ocr 1 s 2012
Michigan Association of Chiefs of Police 2133 University Park Drive, Suite 200 Okemos, Ml 48864-3975 Phone 517-349-9420 Fax517-349-5823
Invoice No. 1992
INVOICE """" Customer
Name Elisabeth Sobota-Perry, C:ity of Dearborn Heights _____ _ Address 6045 Fenton
- -- - ---- ----- - -- --·-----~-.. ---~ City Dearborn Hei_~;~hts _ State Ml Zip 48127 Phone
Date Order No. Rep P.O.#
5/29/2012
~-Qty __ __ ... _[)ascription I Unit Price • TOTAL ···-· ___ , -- -- __ .. ___ L_.___:_-=-:_:_:::__-
60 1
60 2 1 6 15 1
I National Dispatcher Selection Tests (NDST) Ordered 04/30/12
; NDST Administration Guide Ordered 04/30/12 iNDST Answer Sheets (NO Charge) INDST CD's (NO charge) Shipping & Handling (for 04/30/12 order) NDST ordered 05/02/12
;NDST Answer Sheets (NO Charge) I Shipping & Handling (for 05/02/12 order)
I
$25.00 $10.00 $0.00 $0.00
$30.00 $25.00
$0.00 $15.00 I
$1,500.00 $10.00
$0.00 $0.00
$30.00 $150.00
$0.00 $15.00
L_ Payment Details
0 Cash
rJ#~ fJI»pl
-~-- ' SubTotal 1- --$f705-:Doj --------~ Shipping & Handling ~-
0 Check: make payble to MACP 0 Credit Card: Visa or MasterCard only
Name ___ .. ___ ...... -----··-------------CC
CV2# Expires ____________ _
PAST DUE NOTICE
This invoice is PAST DUE and needs to be paid lrnmediately.
ff you have made payment please contact Jamie Foster at 537.349.9420 or L~.fg.?_tgr@.!J1ichiganpolicechif;fs.org so that we can correct our records. Have the check number and the date it cleared your bank wher~ you calL
PAYMENT IS DUE NO lATER THAN OCTOBER 19, 2012.
Postage __ j ____________ _
TOTAL
---- -- ---- ---Office Use Only
erannum)
roice with your payment. )U/
$1,7os.oo I
Fund:
Payee:
Description:
Agenda: 10/23/12
Current Claims
City of Dearborn Heights Voucher Approval
WaterO/M
Michigan Meter Technology
Number:~/4
Clamps and Miscellaneous Supplies Blanket PO 13-181 Various Invoices Dated 09/2012
APPRO\iEDFCiRJ AGENDt, OF
--· }D·~B~J .;tj --~'--==•
Account Account Title Amount Amount Budget Before Payment
592-000-111.002 lnv-Piping/Transmtg $4,409.41
Requested By: Water Dept
Comptroller Authorized Official
Concurrence
Daniel S. Paletko
MICHIGAN METER TECHNOLOGY GRP., INC 799 E WHITCOMB AVE
Bill To:
Madison Heights, Ml 48071
248-585-3700 Fax: 248-585-3730
DEARBORN HEIGHTS CITY OF
6045 FENTON COMPTROLLER'S OFFICE Dearborn Heights, Ml 48127
customer 1 Pure ase ur er 1 lerms
DEARS 113.00181 J Net30 Days
Order Qty Shipped Qty U.O.M. Item Number
--------------- - -~i!C~ Q~~~ __ _Qty __ _p~p_!jQ_'l_ __________ . 1 1 EA RD2F41
i
I UPS
----··-··---·- --------- --------·-.... ---~"""-·--"~"-
Ship To:
,. .0.
I ORIGIN
Item Status .
Sale - - _ .. _, ______ , _______ "'''"
0 1 1/2 ECODER R900i C/F REGISTER INSIDE
REMIT TO: 799 E WHITCOMB AVE MADISON HEIGHTS Ml 48071
Sales Invoice 87521 Invoice Date: 09/28/2012
Due Date: 1 0/28/2012
Printed Date: 09/28/2012
Page: 1
DEARBORN HEIGHTS CITY OF 24600 VAN BORN ROAD Dearborn Heights, Ml 48125
1ent e I rom Source
I DG I MM I so 7072
Unit Price Discount Tax Extended Price
.. --·····-·-"----. , __ --··----147.00000 0.000 N 147.00
- ····------------
Non Taxable Subtotal 147.00 Taxable Subtotal 0.00
Order Discount 0.00 Shipping/Handling 7.25
Tax 0.00
Order Total 154.25
MICHIGAN METER TECHNOLOGY GRP., INC 799 E WHITCOMB AVE
Bill To:
Madison Heights, Ml 48071
248-585-3700 Fax: 248-585-3730
DEARBORN HEIGHTS CITY OF 6045 FENTON
COMPTROLLER'S OFFICE Dearborn Heights, Ml 48127
customer IU ll"'urcnase r er erms
DEARB 113·00181 I Net 30 Days
Order Qty Shipped Qty U.O.M. Item Number
----~---_§'!cKQrd~rQty Q~_!ptjg!!__~---·
16 16 EA FS1-939-75
0 9.39"X7.5" REPAIR CLAMP
REMIT TO: 799 E WHITCOMB AVE MADISON HEIGHTS Ml 48071
Ship To:
i ra .0.
I DENNY I ORIGIN
!tern Status
Sale ..
Sales Invoice 87495 Invoice Date: 09/26/2012
Due Date: 1 0/26/2012
Printed Date: 09/26/2012
Page: 1
DEARBORN HEIGHTS CITY OF 24600 VANBORN ROAD
Dearborn Heights, Ml 48125
tent Re .. l~nl> t-ram 1 ~ource
I DG I MM I so 7018
Unit Price Discount Tax Extended Price
- .. --.. ·-·---~--- .. ---------~--
89.66000 0.000 N 1,434.56 --~-----.. ----~
Non Taxable Subtotal 1,434.56 Taxable Subtotal 0.00
Order Discount 0.00 Shipping/Handling 0.00
Tax 0.00
Order Total 1,434.56
MICHIGAN METER TECHNOLOGY GRP., INC 799 E WHITCOMB AVE
Bill To:
Madison Heights, Ml 48071
248-585-3700 Fax: 248-585-3730
DEARBORN HEIGHTS CITY OF 6045 FENTON
COMPTROLLER'S OFFICE Dearborn Heights, Ml 48127
Customer urc ase r er erms
DEARS 113-00181 I Net 30 Days
i Via
I DENNY
Ship To:
.O.B.
I ORIGIN
Item Status
Sales Invoice 87 494 Invoice Date: 09/26/2012
Due Date: 1012612012
Printed Date: 09/26/2012
Page: 1
DEARBORN HEIGHTS CITY OF 24600 VAN BORN ROAD
Dearborn Heights, Ml 48125
ren e 1 rom ource
1 so 6965
Unit Price Discount Tax Extended Price Order Qty Shipped Qty U.O.M. Item Number -·~"~·------- _!!~tQr_~r-~~ _Q_~jp"'tio,ncc __ =-:--:=·-o::;:------;;:-;--------:-.-c-:::::·---··-...... -~··--··-- :--:-::-
10 10 EA FS1-939-125 Sale 143.74000 0.000 N 1,437.40 r-----t---- .. ---o 8-;x-12-:-s~RE'P'.A.iR'c!A'Mf'-si;\IC3l:E:8.A:;\io--- ····- -- -~ .......... -------
REMIT TO: 799 E WHITCOMB AVE MADISON HEIGHTS Ml 48071
Non Taxable Subtotal Taxable Subtotal
Order Discount Shipping/Handling
Tax
Order Total
1,437.40 0.00 0.00
0.00 0.00
1,437.40
Bill To:
customer
DEARS
MICHIGAN METER TECHNOLOGY GRP., INC 799 E WHITCOMB AVE
Madison Heights, Ml 48071
248-585-3700 Fax: 248-585-3730
DEARBORN HEIGHTS CITY OF
6045 FENTON
COMPTROLLER'S OFFICE
Dearborn Heights, Ml 48127
urc ase or er Terms
113-00181 J Net30 Days
StHpV!a
I DENNY
Ship To:
.0.~.
I ORIGIN
Order Qty Shipped Qty U.O.M. Item Number Item Status
:-- - -~!!_<!~~_QrQ~r,Qly_ ~!!P!i9_!l__~------~----- -------~----
2 2 EA FS1-1350-125 Sale
Sales Invoice 87 496 Invoice Date: 0912612012
Due Date: 1012612012
Printed Date: 0912612012
Page:
DEARBORN HEIGHTS CITY OF
24600 VANBORN ROAD
Dearborn Heights, Ml 48125
1 Client Rep Ship f'rom 1 source
I DG I MM Jso 6935
Unit Price Discount Tax Extended Price -~------ --~~-------~------ ·-~~------·----··-
197.60000 0.000 N 395.20 --···--·---· ,,_,.,_
---~""""""'-"'~---~~--~· .. ·--- --·---f--~- -·-0 12"X12.5" REPAIR CLAMP
REMIT TO: Non Taxable Subtotal 395.20 799 E WHITCOMB AVE Taxable Subtotal 0.00 MADISON HEIGHTS Ml 48071 Order Discount 0.00
Shipping/Handling 0.00
Tax 0.00
Order Total 395.20
Bill To:
ustomer
MICHIGAN METER TECHNOLOGY GRP., INC 799 E WHITCOMB AVE
Madison Heights, Ml 48071
248-585-3700
Fax: 248-585-3730
DEARBORN HEIGHTS CITY OF
6045 FENTON
COMPTROLLER'S OFFICE Dearborn Heights, Ml 46127
urc ase rer erms I Ship Via
Ship To:
f.O.~.
DEARB 113-00181 I Net 30 Days I DENNY I ORIGIN
Order Qty Shipped Qty UO.M. Item Number Item Status
Sales Invoice 87395 Invoice Date: 09/11/2012
Due Date: 10/11/2012
Printed Date: 09/12/2012
Page: 1
DEARBORN HEIGHTS CITY OF
24600 VAN BORN ROAD
Dearborn Heights, Ml 46125
1 Client Rep 1 Ship from 1 source
I DG I MM I so 6934
Unit Price Discount Tax Extended Price - - _I?~~-_ _9_!1~Q_ty_ p_~P!:iQ!L~-------~---- "---·-·--"~~ .. ---------·--··-·-.. ~- -· -~------·--·------~·--"----
5 5 EA FS1-1350-125 Sale 197.60000 0.000 N 988.00 . -·- - -·---=- ---··· ·--.. ~--- --------- --~----------
0 12"X12.5" REPAIR CLAMP
REMIT TO: Non Taxable Subtotal 988.00 799 E WHITCOMB AVE Taxable Subtotal 000 MADISON HEIGHTS Ml 48071 Order Discount 0.00
Shipping/Handling 0.00
Tax 0.00
Order Total 988.00
CITY OF DEARBORN HEIGHTS 6045 FENTON • DEARBORN HEIGHTS, MICHIGAN 48127 TELEPHONE (313) 791-3443 e FAX (313) 791-3441
Ship To: CITY OF DEARORN HEIGHTS-DPW
24600 VAN BORN DEL 7-11 :30/NOON-3PM DEARBORN HEIGHTS Ml 48125
VENDOR NO. 16026
v MICHIGAN METER TECHNOLOGY GROUP INC E N 799 EAST WHITCOMB D 0 R MADISON HEIGHTS Ml 48071
COuantity
1
Unit I Description EACH TO COVER THE COST OF REPAIR
CLAMPS AND MISCELLANEOUS PARTS
592-000-111.002
SEAN MOYLAN DIRECT INQUIRIES TO
PURCHASE ORDER
N0.13-00181
Date: OZ:/01/12 *+*+*+*+*+*+*+*+*+*+
BLANKET PURCHASE ORDERS JULY 1, 2012 THROUGH JUNE 30, 2013 TO BE PAID MONTHLY
Unit Cost $0.00
Total PO Amount
Total Cost J $0.00
oool '------~
PURCHASE ORDER NUMBER MUST APPEAR ON INVOICE, OR INVOICE WILL NOT BE PAID!
M.S,D.S. REQUIRED ON HAZARDOUS MATERIAL !NOTE: ANY DEVIATION IN PRICE ON THIS ORDER MUST BE APPROVED BY THE CITY PURCHASING DIVISION PRIOR TO DELIVERY
~- ORIGINAl..r INVOICES TO: CO!V!PUTROLLEH' S OFFICE 6045 FENTO, DBN. HTS., MI 48127
2. EXEBPT FROM STATE/LOCAL AND FEDEF~J<L TAXES: 38-1712300
3. PURCF..ASE ORDER NUMBER MUST APPEAR ON ALL INVOICES, SHIPPERS, AND CORRESPONDENCES.
4. SUBSTITUTIONS NO'I' ACCEPTED WITHOUT PRIOR APPROVAL.
5. PARTIAL SHIPMENT trJILL BE ACCEPTED IF INVOICED SEPARATELY. PAYMENT MADE UPON COMPLETION OF PURCHASE ORDER.
6. ACKNOWLEDGMENT COPY MUST BE RETURNED BEFORE ORDER IS BINDING.
Fund:
Payee:
Description:
Agenda: 10/23/12
Current Claims City of Dearborn Heights
Voucher Approval
General Fund
Miracle Recreation Equipment Co
Number:
Playscapes at Heather Ln Park & Central Park Invoice Number 726443, Dated 7/18/12 Invoice Number 726272, Dated 7/13/12 Invoice Number 727524, Dated 8/8/12
M'PROVED FOR AGENDA OF
----
Account Account Title 274-673-930.200 Rec.Center
Amount $121,000.00
Amount Budget Before Payment
$121,000.00
Requested By: Recreation
Comptroller Authorized Official
Concurrence
Daniel S. Palet o
INVOICE Page
1
SOLD TO
CITY OF DEARBORN HTS PA.ll.KS & RECREATION 6045 FENTON DEARBORN HEIGHT, MI 48125 RECREATION EQUIPMENT CQP.,tPANY
8445 SOLUTION CENTER- CHICAGO IL 60677-8004
I 0 9001 Certified SHIP SAF PLAY SERVICES
Fed. I .D. #43-1595099
Phone (417) 235-6917 TO 1200 N. MILFORD
HIGHLAND, MI 48357 REFER TO THESE NUMBERS ON ALL
227 2 1 2 1 5 1 2 1 1 5 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 4 4 2
BRWDFIBER 1266J 7145029 7145119 71453669 7145494 714552 714553 714621RR 7146242 7146251 7147196 714720 714734 71474969 714 7784 714850 7148502 7148502 71486725 7149661S 7149666 71497049 7149748 714994 714997 714999 2840TT 2990TT 7148524
CONTINUED
MULCH, PLAYGROUND, BR WOOD FIBER BENCH PARK 6' W/BACK MIRATHERM II-PERM DECK SQUARE ATTACHES TO 4 POSTS DECK TRIANGLE SPLT ATTCH TO 3 POSTS MTII DECK CS HEXAGON 6'6" DECK FOR ROOF MT II POST 5"0D 11 GA WALL X 124" 4' DECKS POST 5"0D X 136" 3'-5' DECKS POST 5"0D X 160" 5'6"-6'6" DECKS MOUNTAIN TRAIL-LOG-RH STEPS, RH TRANSFER CLIMBER, GRIZZ-LEE, DK TO DK 2' RISE BONGO STUMP PERCH CLIMBER CLIFF 6'6" DECK CLIMBER OUTRIGGER 5' & 6'6" DECK
SLIDE TYPH 6'6" 405 D 6' & 6'6'' DK MT II INCLINED SPIDER CLIMBER ASSY 3' & 4' DK SLIDE CHAMELEON ENTRY AND EXIT SLIDE CHAMELEON RIGHT TURN SECTION SLIDE CHAMELEON RIGHT TURN SECTION CLIMBER TWISTED VINE 5' DECK BIG TIMBER LOG SLIDE W/ENT PNL 6'&6'6"Dk BIG TIMBER HEX LEAF ROOF ARCH BRIDGE 4' BETWEEN DECKS MT II CLIMBER WIGGLY WORM 5', 6'6" OR 8' DECK FUN FONES GROUND TO GROUND CLIMBER CARGO 4' DECK INSTALLATION KIT KC SP SWING SEAT, 8' T/R W/TENS TOUGH CHAIN SP SWING CHAIR, 8' T/R W/TENS TOUGH CHAI SWING ARCH 5" OD FRAME 4 SEATS REQ
ROOF/BARREL/ROCKITE/SLIDE HTR GREEN; CANOPY SAND/HTR GREEN;POST/TIMBER/PVC/ 720/997/7196/7784/9748/86725 BROWN; ACCENTS/ROCK SAND;850 SAND/BROWN SWINGS/CHAINS HTR GREEN;284 TAN;299 GRN
16.25 439.00 763.00 543.00
5256.00 222.00 236.00 272.00
3272.00 2792.00
158.00 664.00
1418.00 225.0C
4498.00 634.00
1148.00 448.00 448.00 821.00
1433.00 2416.00 2256.00 1107.00
764.00 595.00
0.00 158.00 223.00
3263.00
3688.75 878.00 763.00
1086.00 5256.00 1110.00
236.00 544.00
3272.00 2792.00
790.00 664.00
1418.00 225.00
4498.00 634.00
1148.00 448.00 448.00 821.00
1433.00 2416.00 2256.00 1107.00
764.00 595.00
0.00 632.00 892.00
6526.00
Go to www. miracle-recreation. com/warrant@("'-"",':k~ ~,JJ"TI"'~·-·- ti"'''f\)\R~,-\ ii" register your product. To access your cu;#S:±r}~r.t1 :l ,.;&~r\,J''"'#"'''~'
TERMS OF SALE: NET 30 DAYS FROM INVOICE DATE 1.25% CHARGE PER MONTH FOR PAST DUE INVOICES -PLEASE ENCLOSE DUPLICATE COPY OF THIS INVOICE WITH PAYMENT
f REMIT TO: MIRACLE RECREATION EQUIPMENT CO _______ ) ~- ----- -- 8445 SOLUTION C~N-T~~. C~:=~~~ ~L-.:_0677 -80~- CUSTOMER
INVOICE f]J Page
2
SOLD TO
SHIP TO
CITY OF DEARBORN HTS PARKS & RECREATION 6045 FENTON DEARBORN HEIGHT, MI 48125
SAF PLAY SERVICES 1200 N. MILFORD HIGHLAND, MI 48357
MIRACLE® RECREATION EQUIPMENT COMPANY
8445 SOLUTION SENTER- CHICAGO IL 60677-8004
ISO 9001 C rtified
Fed. J.D. #43-1595099
Phone (417) 235-6917
REFER TO THESE NUMBERS ON ALL
cert. go to www.miracle-recreation.com/cpsia.
MARK FOR HEATHER LANE PK
SALES AMOUNT SALES TAX MISC CHARGES DISCOUNT COMMERCIAL FREIGHT INSTALL-CO
TOTAL
TERMS OF SALE: NET 30 DAYS FROM INVOICE DATE
47,340.75 0.00 0.00
12,663.10-4,034.00
19,000.00
57,711.65
1.25% CHARGE PER MONTH FOR PAST DUE INVOICES ·PLEASE ENCLOSE DUPLICATE COPY OF THIS INVOICE WITH PAYMENT
fREMIT TO: MIRACLE RECRE-ATION EQUIPMENT CO ---\ \ 8445 SOLUTION CENTER- CHICAGO IL 60677-8004 j CUSTOMER
"---------------------------------------------------------------______/
WARNING
Installation over hard surface such as concrete, asphalt, or packed earth may result in serious injury or death. All play equipment must be installed over an appropriate impact absorbing surfacing material.
It is the responsibility of the playground purchaser/ownerMoperator to ensure that the size, type and depth of impact absorbing surfacing material used complies with the U.S. Consumer Product Safety Commission "Handbook for Public Playground Safety'' (CPSC Handbook). This impact absorbing surfacing material must cover the entire "Fa!! Zone" area to a depth appropriate for the height of the play equipment. The "Fall Zone" is an area under and all around each piece of play equipment. Acceptable impact absorbing surfacing materials include manufactured safety surfacing such as Spectra Turf Safety Surface or natural loose fill materials such as bark nuggets, wood mulch, wood chips, pea gravel and sand. Appropriate thickness for the Spectra Turf materials can be obtained from your Miracle Sales Representative. For loose fill materials, consult the CPSC handbook for appropriate depth in relation to material type and fall height requirements. Unacceptable surfaces include, without !imitation, turf, undisturbed natural ground, undisturbed compacted sand, decomposed granite, asphalt, concrete or any other hard surfacing. The specific size of fall zones depends upon the type of play equipment. For regular swings, the fall zone must extend at least two (2) times the pivot point height to both the front and rear of the top rail. The fall zone must extend at least six (6) feet out in each end from the swing frame legs. For tire swings, the fall zone must extend at least six (6) feet plus the length of the suspension members in all directions. The fall zone must also extend at least six (6) feet out at each end from the swing frame legs. For slides, the fall zone must extend at least six (6) feet in all directions from the perimeter of the slide. Also, in front of the slide exit, measuring from the point where the slide slope is reduced to 5 degrees, the fa!! zone must extend a total of four (4) feet plus the height of the platform. For all other play equipment, the fall zone must extend at least six (6) feet in all directions from the pen meter of the play equipment. Refer to the CPSC Handbook for more specific requirements. This Handbook is available from the CPSC or Miracle free of charge.
The playground purchaser/owner~operator agrees to assemble, install, inspect, and maintain the play equipment in accordance with Miracle's installation and safety requirements, as set out in the "READ ME FIRST" booklet, the Installation Instruction booklets, the CPSC Handbook, and ali other materials accompanying the equipment. Any attempt to alter, adapt, change, attach to or assemble the play equipment in any manner other than set out in these documents, or to use the equipment in any manner other than the use intended in such documents, is strictly prohibited, and Miracle shall bear no responsibility for such actions.
During the installation, inspection and maintenance process, the playground purchaser/owner-operator must ensure that: A) There are no exposed concrete footings to trip over or fall on. The top of all footings must be at or below the bottom of the layer of impact absorbing surfacing material. B) All bolt threads protruding beyond the nut are cut and peened smooth to the touch. Sharp edges and/or pcints of any kind must be eiimmated. C) Ail bolts, screws, set screws or other fasteners are tightened securely. Missing bolts, set screws or other fasteners must be replaced immediately. D) All "S" hooks and clevises are free of any wear. That all "S" hooks are closed metal to metal and all clevises and supporting hardware are securely attached. A Miracle "S" hook for swing seat use has the dimensions of 2-3/4" x 4-1/2".
Purchaser and owner/operator acknowledge they have sole responsibility for inspection and maintenance of the playground equipment. All play equipment must be regularly inspected and maintained in good condition by the playground purchaser and owner/operator. Anything showing any sign or wear, fatigue or otherwise presenting an unsafe condition must be immediately replaced. If not immediately replaced, the play equipment must be removed from service and no one permitted to use the play equipment until the problems are corrected. This same procedure must be followed with respect to missing parts. Be sure to understand, apply and utilize the CPSC Handbook, all materials and information provided by Miracle, and your own knowledge, experience and common sense in determining if wear, fatigue or any other unsafe condition exists. You must develop a checklist specific to your needs as determined by equipment use, weather, etc.
WARNING
Purchaser and owner/operator agree to indemnify and hold Miracle harmless from and against all liabilities, losses, penalties, damages and expenses, including costs and attorney fees, resulting from all claims, liens, damages, obligations, actions, suits, judgments or settlements, or causes of action, of every kind, nature, and character for injuries, including personal injury and death, arising or alleged to arise out of their failure, or the failure of their architects, contractors, subcontractors, installers, employees, agents and assigns to assemble, install, inspect, and/or maintain the play equipment and impact absorbing surfacing in full compliance with Miracle's installation instructions and safety requirements as set out in the "READ ME FIRST" booklet, the Installation Instruction booklets, the CPSC Handbook, and all other materials accornpanying the equ!pmer:t, ami th~ir misuse andfor alterz.tion of th~ p!z.y equipment.
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CITY OF .JEARBOR._I>J BTS PARKS & RECRE..~TIO:tl 6045 FENTON DElillBOR..."J HEIGHT, MI
SAF PL~Y SERVICllS 1200 N, MILFOllD Hl>GHL...Th&;"'D, MI 48357
48125 MIRACLE. R£C.m~All0111 (QU!PfotEfH Cf.J!Nfi'll/.jy
&45 SOLUTIO~ CENTERm CHICAGO IL 6057?~SC04
ISO Mt\1 Ctirl!fiud
1>:~::L LD. !M-J..·J545t:~li
Pnon0 (417)23<'i··59i I
r REFER TO THfiSE NUMBERS ON ALL 1 ' PAYMENTS AND CORRESPONDENCE '
648817 12-000G?00-001 f 086 t>!IR.P.CLE OF MICE 4 Sl.2A13 "126::li1
___ , ___ ,_
TOTAL Il\\TO:CE
Go to \N't'l"'f..', miracle -recreat:ion.com/warranty to register your product. To accesa your CPSIA cert. go to W'o>Jt>i.miracle'-.cecr-eatioH.c:Cln(cpsia.
TERMS OF SAL!O' NET 30 DAYS FROII! INVOICE DATE
62,288.3::.
i,tmio CHARGE PER MOI'fTH FOR PA-ST .DUE iNVOICES -PLEASE ENCLOSE DUPLICATE COPY 01' THIS INVOICE: Wl1"H PAYMENT /-- .. ·····---. --- ---- ---····- ---- -- ····-- -- ------ ----, ( REMIT TO: MIRACLE RECREATION EQUIPMENT CO \ L 8445 SOLUTION CENTER • CHICAGO IL 50677-8004 _/I CUSTOMER
INVOICE *REPRINT*
~ Page
1
SOLD TO
CITY OF DEARBORN HTS PARKS & RECREATION 6045 FENTON DEARBORN HEIGHT, MI 48125
MIRACLE. RECREATION EQUIPMENT COMPANY
8445 SOLUTION CENTER -CHICAGO IL 60677-8004
ISO 9001 Certified SHIP SAF PLAY SERVICES
Fed.I.D. #43-1595099
Phone (417)235-6917 TO 1200 N. MILFORD
HIGHLAND, MI 48357 REFER TO THESE NUMBERS ON ALL
Go to www.mirac1e-recreation.com/warranty to register your product. To access your CPSIA cert. go to www.miracle-recreation.com/cpsia.
SALES AMOUNT SALES TAX MISC CHARGES INSTALL-CO
TOTAL
TERMS OF SALE: NET 30 DAYS FROM INVOICE DATE
0.00 0.00 0.00
1,000.00
1,000.00
1.25% CHARGE PER MONTH FOR PAST DUE INVOICES ·PLEASE ENCLOSE DUPLICATE COPY OF TEHIS INVOICE WITH PAYMENT
(REMIT TO: MIRACLE RECREATION E-QU-IPMENT co \ \~ 8445 SOLUTION CENTER- CHICAGO IL 60677-8004 _) CUSTOMER
--SHIP TO:
v E N 0'.,·'; :_ ;·<,:.,.: , 0 R
CITY OF DEARBORN HEIGHTS 6045 FENTON • DEARBORN HEIGHTS, MICHIGAN 48127
TELEPHONE (313) 791-3443 • FAX (313) 791-3441
VENDOR NO.
No.
DATE
F.O.B.
PURCHASE ORDER
RECEIVING COPY
VIA
DELIVERY REQUIRED TERMS
ITEM QUANTITY (JNfT DESCRIPTION UNITCOST TOTALCOST
**NOTE:
JD li-~OIJ bud!Ji APP OVE FOR
Pl'l MENT ji!YAJ :;;;. 6l3o. Ja
Copv£11:~&\~~~~#1 in the a ount of$ ,000.00 appi~~~~~~~~r 11, 2012.
OCT 0 2 2012
OBN.HTS.COMP.OFF.
PURCHASE ORDER NUMBER MUST APPEAR ON INVOICE. OR INVOICE WILl. NOT BE PAID!
M.S.D.S. REQUIRED ON HAZARDOUS MATERIAL NOTE: ANY DEVIATION IN PRICE ON THIS ORDER MUST BE APPROVED BY THE CITY PURCHASING DIVISION PRIOR TO DEliVERY.
DIRECT INQUIRIES TO DIRECTOR ~t/,;11 DOO oc ,I '
PACKING ACCUMULATED ITEM .·:. PACKING OUANTil RECEIVED '' ' ITEM DATE SLIP NO. OUR COUNT VENDOR'S COUNT QUANTITY REG. TO DATE SLIP NO. OUR COUNT VENDOR'S COUNl OUAN1'JY R(C. TO. DATE
I .
•·.· ... . ...
Fund:
Payee:
Description:
Account 592-540-818-030
Comptroller
Agenda: 10/23/12 Number:_={y'--/ Ut
Current Claims
City of Dearborn Heights Voucher Approval
WaterO/M
Nagel Construction Inc
Sewer Cleaning Program Invoice Number 3150, Date 09/27/12
r;;:;;p'fiQi/Ei) FOB I AGENDA OF
L?-~1
Amount Budget Account Title Amount Before Payment Contr Serv.Cieaning $18,875.88
Requested By: Water Dept.
Authorized Official
Concurrence
n.n /) /-:? X!--~ c4], 12~ Daniel S. Paletko
NAGEL CONSTRUCTION INC PO BOX 10 MOLINE, Ml49335 616 877-4000
Invoice 3150
Bill to:
DEPARTMENT OF PUBLIC WORKS ATTN: WILLIAM ZIMMER 24600 VAN BORN ROAD DEARBORN HEIGHTS, Ml 48125
Job:
Invoice#: 3150 Date: 09/27/12 Customer P.O.#: ~--------------------- ---------------- -------------· -----------·-· . -- ··-----.-------·-·-Payment Terms: NET 30 Salesperson:
Customer Code: DEAR
Remarks: SEWER CLEANING FROM 9/17 · 9/28112
2,641.000 8" SEWER
12,582.000 10" SEWER
8,115.000 12" SEWER
679.000 18" SEWER
480.000 21" SEWER
1,437.000 24" SEWER
2,693.000 30" SEWER
67.000 CATCH BASINS
LFT LFT LFT LFT LFT LFT LFT EA
SEWER CLEANING
0.50 0.49 0.49 0.70 0.70 0.90 1.25
29.00
--------------- -------------
1,320.50 6,165.18 3,976.35
475.30 336.00
1,293.30 3,366.25 1,943.00
Subtotal: 18,875.88
Total: 18,875.88
Print Dale: 09/27/12 Page: 1
Office: FAX: Cell:
(616) 365.0501 (616) 365.0508 (616) 291.3846 (616) 291.3845
No.
Report N£ 88098 4j,J7 -"'0- ,. Date(s): / J I" - /, ~,y ~/"'
i ? /
"/ ~-Type of Work: d1"«r ~.;;·f:
1937 Sterling Ave., NW • Grand Rapids, Ml 49504 Page / of 2
' I 7
EquipmenVSupplies Comments:
Operator: X
Office: FAX: Cell:
(616) 365.0501 (616) 365.0508 (616) 291.3846 (616) 291.3845
1937 Sterling Ave., NW • Grand Rapids, Ml 49504
Report N~ 88099
Date(s) ~U,Z·~ ~~2~ ~?Type of Work :;;,.,,_rlr /?}??fi~
'
Page ---=:::__Of 2
V . /0 ) L,l Customer Information: _________ (""'}/;?'-•. _ _,c'-?_J~,,_.(!f?/,L£..:.. "-:'Y2"". ~'"'· cL'Y-"11'-'-. -"~'---.. 711il""'d'-"f~::.:{5'=--· ------
i
No. EquipmenUSupplies Comments:
' r.\ 1\ {, '~/ ~! ,v' Above work des~ =ately ')
1 "'\~Dnnei/Job and completed s ·sf torily. v
\ / Customer Rep.: i
/ Operator: X
I
Fund:
Payee:
Description:
Agenda: 10/23/12
Current Claims
City of Dearborn Heights Voucher Approval
WaterO/M
Nagel Construction Inc
Sewer Cleaning Program
Number: Uz -/7
APPROVED FOB AGENDA OF
Invoice Number 3159, Date 10/12/12
Account Account Title Amount Amount Budget Before Payment
592-540-818-030 Contr Serv.Cieaning $17,602.31
Requested By: Water Dept.
Comptroller Authorized Official
Concurrence
NAGEL CONSTRUCTION INC PO BOX 10 MOLINE, Ml49335
616 877-4000
Bill to:
DEPARTMENT OF PUBLIC WORKS ATIN: WILLIAM ZIMMER 24600 VAN BORN ROAD DEARBORN HEIGHTS, Ml 48125
Invoice#: 3159
Payment Terms: NET 30
Customer Code: DEAR
Invoice 3159
Date: 10/12/12
Job:
Customer P.O.#: I
Salesperson:
Remarks: SEWER CLEANING FROM 10/1 -10/12/12
SEWER CLEANING ..
Quan!t!y Descnptton U/M Untt Pnce Extenston
9,411.000 8"SEWER LFT 0.50 4,705.50 13,810.000 10" SEWER LFT 0.49 6,766.90 5,424.000 12" SEWER LFT 0.49 2,657.76 6,313.000 15" SEWER LFT 0.55 3,472.15
Subtotal: 17,602.31
Total: 17,602.31
Print Date: 10112/12 Page: 1
Office: FAX: Cell:
(616) 365.0501 (616) 365.0508 (616) 291.3846 (616) 291.3845
Customer Information:
No.
1937 Sterling Ave., NW • Grand Rapids, Ml49504
Equipment/Supplies Comments:
Report N~ 88125
Date(s) /?'/J -):?ftc? ,;;.;:-;z~ I " / ?
Type of Work <;/<"~..-"- -q?&// Page I of -"'--
hu:..L:._ __ LJZ&b.L.!::.'C:::...-":...L..:l!L'.'--IL.:._::._,,t-:-.:JL!""'---i Above work described accurately and completed satisfa)l.o'rily.
,·'"?
Customer Rep.: X
Operator: X
Office: FAX: Cell:
(616) 365.0501 (616) 365.0508 (616) 291.3846 (616) 291.3845
No.
1937 Sterling Ave., NW • Grand Rapids, Ml 49504
Equipment/Supplies Comments:
Report: ~~ o P~L •. 88126
Date(s) /~'/If ;c:/jz_ -e::~t:V/!::. Type of Work ·~ ~jjj
7 z Page <'- of ·
\
\.:'\:- / Customer Rep. X /
Operator: X
Fund:
Payee:
Description:
Agenda: 10/23/12 Number:
Current Claims
City of Dearborn Heights Voucher Approval
General Fund
Quad-Tran of Michigan
Data Processing, LEIN/SOS Access, UPS reimbursement, Various Notice Mailers and Postage for September, 2012. Invoice 5987, Dated 09/28/12 Invoice 5988, Dated 09/28/12
.iAPi;fiovEoFCij
AGENDA OF
--·~·
:l !lV;l .. 3~ ) ;;!. -~~~~~~=-~~-·
Amount Budget Account Account Title
101-130-818.000 Contractual Serv. 101-130-728.000 Office Supplies 1 01-200-728.000 Office Supplies
Amount Before Payment
$4,500.00 $1,262.55 $1,841.40
$59,875.00 $33,477.91 $81,056.81
Requested By: Disctrict Court
Comptroller Authorized Official
Agenda
~ Daniel S. Paletko
Quad-Tran of Michigan, Inc. 26899 Northwestern Highway Suite 220 Southfield, Ml 48033 USA
Voice: Fax:
248-353-4380 248-353-9052
Bill To:
Ms. Michelle Ml<ins 20th District Court 25637 Michigan Avenue Dearborn Heights, Ml 48125-3271
CustomerlD
20th
Customer PO
I
I
Due Date
9/28/12
Payment Terms
Due Upon Receipt
Quantity Description Data Processing ServiceE; f()r The Month of:
Septe1nber, 2012
1.00 l,B~TN/SOS Aecess Charge for the Month of:
&lptember, 2012 UPS REiinihursemerit fOrth~;- tlfi}Dih--Or: September, 20i2
:3.50 _Hearing Notim },;Iailer
lAO' Dc&mlt Notiee MnileJ'S
LOO i 14-day Notice Mailerr:;
1.20 i Free Form Court Notice Mailc-ws
0.05 i Parking Complaint Notice Mailers
I
I -·-···]
Invoice Number: 5987
Invoice Date:
Page:
Sep 28, 2012
1
___ L ____ ---------------- -,------~ ------'-- ------=-::=-1 5,762.551 Subtotal
~""""'_" __ , _______ _
] ~:::~~:::ice Amount ___ _
1 Payment/Credit Applied
I TOTAL I
--- ----------
·----f------1-----
I
-- ~- .. ·---~1
5, 762.551
5,762.55
Quad-Tran of Michigan, Inc. 26899 Northwestern Highway Suite 220 Southfie k:J, Ml 48033 USA
Voice: Fax:
248-353-4380 248-353-9052
Bill To:
Ms. Michelle Adkins 20th District Court 25637 Michigan Avenue Dearborn Heights, Ml 48125-3271
CUstomerlD
20th
Due Date
9/28112
Quantity Description
CUstomer PO
Payment Terms
Due Upon Receipt
/ &:~-ptembor Aetu.al Postage ($1841.40) ·October .2012 Postage AverPJ.ge
I --~-- - -------- ------------ - __ __j
I Subtotal I -
Sales Tax
j ____ T?t_~-~- ~-~Y_?_i~-~-~~??_~_nl_ ; Payment/Credit Applied ' [TOTAl '
Unit Price
Invoice Number: Invoice Date: Page:
Amount
5988 Sep 28, 2012 1
~658.60
2. 500. ()()
Fund:
Payee:
Description:
Agenda: 10/23/12
Current Claims City of Dearborn Heights
Voucher Approval
General Fund
Tire Discount House, Inc_
Vehicle Repairs
Number:
Various Invoices Dated October 2012
&·19
tPP~'iO\IE:o !'~oR~, AGENDA OF
-----~--~j
I D ~ i),3--l ::t.j" =-------~'~""'"'""""~'
Account Account Title Amount Amount Budget Before Payment $147,743,29 101-300-932-000 Vehicle Repair/Maint $1,982,81
Requested By: Police Dept
Comptroller Authorized Official
Concurrence
TOTAL PARTS ....
YOU MAY CHOOSE ANOTHER LICENSED SMOG CHECK FACILITY TO PERFORM ANY NEEDED J_Ht:t'AIH::.> OR ADJUSTMENTS 11-IAT T.-IE SMOG CHECK TEST INDICATES ARE NECESSARY. A CUSTOMER WILL
. - FOR INSPECTION REGARDLESS OF PASS OR FAIL
TIRE DISCOUNT HOUSE, INC. #046299 "Serving The Community For Nearly 50 Years"
25751 W. Warren Ave DEARBORN HEIGHTS, MICHIGAN 48127
(313) 565-5282 Mi. Reg. F127035
TOTAL LABOR
cost for teardown and reassembly, $ _ I =t TOTAL PARTS TEARDOWN ESTIMATE: I understand that my vehicle will be reassembled 1--cc===-=----L..._------+
AUTHORIZED BY r·--
wfthin days of the date shown above if I choose not to authorize the D~NERsoN l_]~~oNE TOTAL SUBLET services recommended. r>A"CC , • .,,.-; ---~~>" <>V ounw= ,... Jl.l"' ......
SIGNATURE X DATE
done along with the necessary materials. You and your employees may q:::.arate vehicle urposes ol testing, inspection, or delivery at my risk_ An express mechanics li acknowl ged on above vehicle to secure the amount of repairs thereto_ 11 is
de you w11i held responsible tor loss or damaqe to vehicle or articles left in vehicle in ,,,., ---.~ ~' ~•h~e ~-t ~~ h~ ~~.--! r
'0
f,U1HORI:ZED SY
DAlE Tlt~E CALLED 8Y
!__;,
-~
TOTAL PARTS
MAY CHOOSE ANOTHER LICENSED SMOG CHECK FACILITY TO PERFORM ANY NEEDED JJUSTMENTS THAT THE SMOG CHECK TEST INDICATES ARE NECESSARY. A CUSTOMER WILL
FOR INSPECIDN REGARDLESS OF PASS OR FAIL
TIRE DISCOUNT HOUSE, lNG. #046299 "Serving The Community For Nearly 50 Years"
25751 W. Warren Ave DEARBORN HEIGHTS, MICHIGAN 48127
(313) 565-5282 Mi. Reg. F127035
"9~6 1 l) j_ .l. .l..~
tVIM.L. "-'"'uovn ;l___:c_ f lL_"')
'!Estimated cost for teardown and reassembly, $ 'Ai)T' I "'0" Too" · TOTAL PARTS 180JD ~ I TEARDOWN ESTIMATE: I understand that my vehicle will be reassembled "zso'" .
>l. :) ::> lJ ::>
within days of the date shown above if I choose not to authorize the AUT\' O~o-;,,,CN o:~ONE TOTAL SUBLET I services· recommended. r.n"' \ 1 T'""' "A''"'" "'" ., ......... ~'" ...... ",... .......
SIGNATURE X __ DATE
I hereby authorize the aboVe repair work to be done along with the necessary materials. You and your employees may operate vehicle for purposes of testing, inspection, or de!lvery at my risk. An express mechanics lien is acknowled6ed on above vehicle to secure the amount of repairs thereto. Jt is
i<re;_po~ble for Joss or damage to vehicle or articles left in vehicle in · your controL
..... "'"'I ' ~ 1 # -- 1n 7\ _,. I ~
i 1111:. Ulili.UUI~ I nuUi:>t:, mv. +t-U.,O<.;;,;, "Serving The Community For Nearly 50 Years"
25751 W. Warren Ave DEARBORN HEIGHTS, MICHIGAN 48127
(313) 565-5282 Mi. Reg. F127035
2JP
BUS_PI-1QN.E EXT
tO.IE PHONE
L
cost for teardown and reassembly, $ ...._,.__--:::--TEARDOWN ESTIMATE: I understand that my vehicle will be reass~bled I I j j •v•"~ r"• .. ur2~ j with. d of th if . AUTHORIZED BY ,......._.1 tn ays e date shown above 1 choose not to ;::~uth A thP. 1 IN n sv .......... _ & • .... ...... ....... t
services recommended. ;: I SIGNATURE X
3 I hPrPhu ''"rthorize·the above repair work to be done along with the necessary materials. You inspection, or delivery at my risk. An secure the amount of repairs thereto. It is
or damage to vehicle or articles left in vehicle in
DATE TIME '~]w, I ~~ I ,,<fh ~
~ 0No
cost for teardown and reassembly, $ -c-:-:--:::--:TEARDOWN ESTIMATE: I understand that my~ within days of the date sho~~rt I choq services recommended.
DATE
CfTY
TIRE DISCOUNT HOUSE, INC. #046299 "Serving The Community For Nearly 50 Years"
25751 W. Warren Ave DEARBORN HEIGHTS, MICHIGAN 48127
(313) 565-5282 Mi. Reg. F127035
,:-A-/7 /So,L/J
STATE ~p
YEAR. MAKE AND MODEL oUlZ-SERIAL NO.N.I.N.
191656
EXT.
""""'" MILEAGE
NO
lt:RMS
/0
MINIMUM RACK CHARGE $24.00
TOTAL LABOR
TOTAL PARTS
EPA I WASTE DISPOSAL
SHOP SUPPUE,S
I
0'" 0" PERSON PHONE ~ CALLED BY PHONE ~ TIME &•u;.,, ;p
TOTAL PARTS ......
~~P~~ 6~~o~~~~HE~~~~o~HEE:ML~~E~~~gK s~~~~~~~~~~AA~~~~~~~sSARY.~A 'ClJST'QM~R"-WILL ~CHARGED FOR INSPECTION REGARDLESS OF PASS OR FAlL
TIRE DISCOUNT HOUSE, INC. #046299 "Serving The Community For Nearly 50 Years"
25751 W. Warren Ave DEARBORN HEIGHTS, MICHIGAN 48127
(313) 565-5282 Mi. Reg. F127035
SERIAL NON LN
MINIMUM RACK CHARGE $24.00
... --~ __ , -u·lnu::; ~ ,~i -~ '-'
EXT
MilEAGE
TOTAL LABOR
····..C:stimated cost for teardown and reassembly, $ I 1 I I TOTAL PARTS TEARDOWN ESTIMATE: I understand that my vehicle will be reassembled
0 . ·•
AUTH RIZED SY IN BY within -days of the date shown above if I choose not to authorizE! the o,"'CN DeHO" TOTAL SUBLET I I services recommended. \ ,..,,.,., l "'"" ! ,-, '"" DV I DLH'''"' .... a.... ..... ..
SIGNATURE X DATE
~ SO!~
CITY OF DEARBORN HEIGHTS 6045 FENTON e DEARBORN HEIGHTS·, MICHIGAN 48127 TE~EPHONE (313) .791-3443 e FAX (313) 791-3441
Ship To: POLICE DEPARTMENT CITY OF DEARBORN HEIGHTS
256:17 MICHIGAN AVENUE
DE!lHBORN HEIGHTS Ml 48125
VENDOR NO. 50271
v TIRE DISCOUNT HOUSE/WESTSIDE E N D
2575'i W WARREN
0 R DEARBORN HEIGHTS Ml
!Qi.!antitv Unit !Description
48127
1 EACH TO COVER THE COST OF FRONT END ADJUSTMENTS AND OTHER SERVICES
POLICE DEPARTMENT USE ONLY
101-300-932.000
LEE GAVIN DIRECT INQUIRIES TO
PURCHASE ORDER
NO. 13-00128
Date: 0.7101112 *+*+*+*+*+*+*+*+*+*+
BLANKET PURCHASE ORDERS JULY 1, 2012 THROUGH JUNE 30, 2013 TO BE PAID MONTHLY
Unit Cost Total Cost $0.00 $0.00
Total PO Amount o oo]
PURCHASE ORDER NUMBER MUST APPEAR ON INVOICE. OR INVOICE WILL NOT BE PAID!
M.S.D.S. REQUIRED ON HAZARDOUS MATERIAL NOTE: ANY DEVIATION IN PRICE ON THIS ORDER MUST BE APPROVED BY THE CITY PURCHASING DIVISION PRIOR TO DELIVERY
__ ORIGINAl, INVOICES TO: COMPU'iROLLER 1 S OFFICE 6045 FENTO, DBN. HTS., M! 48127
2. EX.EMJ?T FROM STATE/LOCAL AND F£DERiiL 'TAXES: 38-1"112300
3 PURCHASE ORDER NUMBER NUST APPEAR ON ALL INVOICES, SHIPPERS, AND CORRESPONDENCES.
4. SUBSTITUTIONS NOT ACCEPTED WI'THOUT P?IOR APPROVAL.
5. PARTIAL SHIPMENT WILL BE ACCEPTE:D IF INVOICED SEPARATELY. PAYMENT MADE UPON COMPLETION OF PURCHASE ORDER.
6. ACKNOWLEDGMENT COPY MUST BE RETURNED BEFCPE ORDER IS BINDING.
Fund:
Payee:
Description:
Account
Agenda: 10/23/12
Current Claims City of Dearborn Height!
Voucher Approval
Library Fund
US Bank
Library Bond Payment Invoice Dated 11/1112
Number:
Amount Budget Account Title Amount Before Payment
738-738-998-500 Interest $98,948.52 $381,785.00
Requested By: Library Fund
Comptroller Authorized Official
Concurrence
Daniel S. Paletko
bank, All Of Us Serving You Debt Service Invoice
I Maturity
Corporate Trust Services
DEARBORN HEIGHTS BUILDING AUTHORITY
ATTN: TREASURER
6045 FENTON STREET
DEARBORN HEIGHTS Ml 48127
Rate Principal Accrual Outstanding Start Date
Accrual End Date
Name of Issue:
CITY OF DEARBRON HEIGHTS BUILDING
AUTHORITY, BUILDING AUTHORITY BONDS
(LIBRARY PROJECT) DTD 12-1-2003
Account Number: 4597 _5
Debt Service Date: 11/01/2012
Payment Due Date: 11/01/2012
Page: 1 of 2
Interest Due Principal Due Call Premium I Date -- ----·~---· -------·-·--··-··-- -~-----
05/01/2013 3.75% 210,000.00 05/01/2012 10/31/2012 3,937.50
05/01/2014 3.75°/o 225,000.00 05/01/2012 10/31/2012 4,218.75
05/01/2015 3.75% 240,000.00 05/01/2012 10/31/2012 4,500.00
05/01/2016 3.80% 260,000.00 05/01/2012 10/31/2012 4,940.00
05/01/2017 3.90% 270,000.00 05/01/2012 10/31/2012 5,265.00
05/01/2018 4.00% 285,000.00 05/01/2012 10/31/2012 5,700.00
05/01/2019 4.10% 300,000.00 05/01/2012 10/31/2012 6,150.00
05/01/2020 420% 315,000.00 05/01/2012 10/31/2012 6,615.00
05/01/2021 4.30% 330,000.00 05/01/2012 10/31/2012 7,095.00
05/01/2022 4.40% 345,000.00 05/01/2012 10/31/2012 7,590.00
05/01/2023 4.45% 360,000.00 05/01/2012 10/31/2012 8,010.00
05/01/2024 4.50% 375,000.00 05/01/2012 10/31/2012 8,437.50
05/01/2027 4.625% 1 ,245,000.00 05/01/2012 10/31/2012 28,790.63
05/01/2030 4.70% 1 ,430, 000.00 05/01/2012 10/31/2012 33,605.00
b I:? L, {'~11'_ "'i)
- c~ 8 ""c) '-) f3'"~ , RECEIVE
'- I "·
SEP 1 I 20\2 Pfease Remit with Payment
Name of Issue: DBN.HTS.COMP.OF!:.
CITY OF DEARBRON HEIGHTS BUILDING
AUTHORITY, BUILDING AUTHORITY BONOS
(LIBRARY PROJECT) DTD 12-1-2003
Remrt: check to: (must be received 5 business days prior to due date}
US Bank
CM-9705
PO Box 70870
St. Paul, MN 55170-9705
FTC OM 10220 09111112·031
~Account# Debt Service Date:
!Payment Due On:
INet Amount Due:
~mount Enclosed:
Change of Address:
DEAHGTBDG03 JSR
0.00 0.00
0.00 0.00
0.00 0.00
0.00 0.00
0.00 0.00
0.00 0.00
0.00 0.00
0.00 0.00
0.00 0.00
0.00 0.00
0.00 0.00
0.00 0.00
0.00 0.00
0.00 0.00
Tl Ff.l
75\) ?!3
11/01/2012
11/01/2012
$171,785.63
bank, Ail Of Us Serving You Debt Service Invoice
I
L Maturity
Date
Corporate Trust Services
DEARBORN HEIGHTS BUILDING AUTHORITY
ATTN: TREASURER
6045 FENTON STREET
DEARBORN HEIGHTS Ml 48127
Rate Principal Outstanding
Accrual Start rJate
Accrual End Date
Name of !ssue:
CITY OF DEARBRON HEIGHTS BUILDING
AUTHORITY, BUILDING AUTHORITY BONDS
(LIBRARY PROJECT) DTD 12-1-2003
Account Number: 4597 _5
Debt Service Date: 11/01/2012
Payment Due Date: 11/01/2012
Page: 2 of 2
Interest Due Principal Due Call Premium
·~~~~~--c-==c-~--~~~cc- -----05/01/2033 4. 75% 1 ,555,000.00 05/01/2012 10/31/2012 36,931.25 0.00 0.00
Totals 7,745,000.00
!Total Amount Due: $171,785.631
171,785.63 0.00
Wire Instruction:
(must be received by 11 :30am central time on due date) BBK: U.S. Bank N.A. (091000022)
BNF: U.S. Bank Trust N.A.
AC: 170225065979
OBI: TFM
REF: 4597_5
0.00
For questions contact JOSEPH ROBERTS 651-466-6109
Pfease Remit with Payment
Name of Issue:
CITY OF DEARBRON HEIGHTS BUILDING
AUTHORITY, BUILDING AUTHORITY BONDS
(LIBRARY PROJECT) DTD 12-1-2003
Remit check to: (must be received 5 business days prior to due date)
US Bank
CM-9705
PO Box 70870
St. Paul, MN 55170-9705
FTC OM 10220 09/11/12-031
Account# I 4597 5
Debt Service Date: I 11/01/2012
Payment Due On: I 11/01/2012 '
Net Amount Due: I $171,785.63
Amount Enclosed: I
Change of Address:
DEAHGTBDG03 JSR
Fund:
Payee:
Description:
Account 202-202-880.500
Comptroller
Agenda: 10/23/12 Number:
Current Claims
City of Dearborn Heights Voucher Approval
Major Streets
Wade Trim & Assoc.
Certificate for Payment No.1, Dated 10/04/12 Project: Pardee Road Paving. Job No: DHT-2554-03T
Account Title Street Rep
Amount $135,463.42
Requested By: DPW
Amount Budget Before Payment $1,018,267.77
Authorized Official
Concurrence
Daniel S. Paletko
WADE TRIM 'Gtl!I;)T:fi~ll~\li~l!,t ~l\Mmtlllt~!\,
Owner: City of Dearborn Heights 6045 Fenton Avenue Dearborn Heights, MI 48127
Contractor: Tiseo Brothers, Inc. 68660 Hillside Washington, MI 48095
Job No. DHT-2554-03T
Project: Pardee Road Paving
CERTIFICATE FOR PAYMENT
In accordance with the Contract Documents, based on the data comprising the above application, the ENGINEER to the best of his knowledge, information and belief and subject to the limitations stated in the Contract Documents certifies to the OWNER that; (1) Work has progressed to the point indicated, (2) the quality ofthe Work is in accordance with the Contract Documents, and (3) the CONTRACTOR is entitled to payment of the Total Balanace Due This Certificate.
Prepared By: \JOV(JN~h"i1~ JL{:;bo!Z. /: Johnny everette/JeiT Smither Date
Reviewed By:~~ Mr. Dan Brooks, PE
JO/sj;z_ Date
Certified By: k\"-" ¥~\..&'? ~ l'-'1 Off t--. iir:. / · · ~ ' r Date
Engineer's Certi:l:1cate for Payment
Substantial Completion Date: Extended To:
Final Completion Date: Extended To:
I>criod Start Date:
Original Contract Price: Total Change Order Amount: S
Current Contract Price: S
Total Earned To Date: $
Less Previous Certificates: S Less Retention Amount:
Owner Approval
A1 Rcviewe~ '
~:,~~
Oct. 15 2012
Oct. 31 2012
Aug. I, 2012
~
Date
ro-lo~l~ Date
Owner: City ofDearbom Heights 6045 Fenlon Avenue Dearborn Heights, MI 48127
Contractor: Tiseo Brothers, Inc. 68660 Hillside Washington, J\11!48095
Job No. DHT-2554-03T
Project: Pardee Road Paving
CONTRACTOR'S CERTIFICATION ______ _::_
The undersigned CONTRACTOR certifies that to the best of his knowledge, information and belief, the work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by him for Work for which previous Ce1iificates for Payment were issued and payments received from the Ow-NER, and that current payment shown herein is now due.
CONTRACTOR'S DECLARATION
l hereby declare that l have not, during the period covered by this Application, performed any work, furnished any material, sustained any loss, damage or delay for any reason, including soil conditions encountered or crealed, or otherwise done anything for which I shall ask, demand, sue for, or claim compensation from the OWNER, or its agents, and the owner's ENGINEER, or its agents, in addition to the regular items set forth in the Contract as dated above executed between myself and the OWNER, and in the Change Orders for Work issued by the OWNER in writting as provided thereunder, except as I hereby make claim for additional compensation and/or extention of time, as set forth on the itemized statement attached hereto.
Contractor's Application for Payment
Substantial Completion Date: Extended To:
.Final Completion Date: Extended To:
Period Start Date:
Total Change Order Amount: $
Current Contract Price: $
Total Earned To Date: $
Less Previous Certificates: $
Less Retention Amount: $
Less
Oct. 15,2012
Qct2.L29J2
_.}_O.SEf'!-1 lt . .:n;o lb/t!ffaZt~IZ Printed N arne ate
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/ / -;?"" ( ~ ~~- ·~ .. ,. ,~~-.~---·~,.~
,,;;> ' ,~/ · // Signature ·
/
I P /11.1' / 2-t? /':1--7
'Date
'V\TADETRil\..:I , , ' - CeJ·tificalc for:V;~ymcnt No,··. - 1 '
PROJECT NAME: P11rdee Ro"d Paving
JOB NO. OHT·l554--0JT CLIENT: City of Ot:.nd>(Jrn l!ei;:hu
DATE: Octolm ii,:ZOJ:2
Contract Date: July 30, :Wll Cons:truriion Sturt Date: August 8, 20i2
DESCRH'TJON P!nn Qty ! U1-) Q!y I Rtv. Qty I Unil
DESCIUPT!O.N (+/-)Qty
Printed On i01412012 9:57AM
Uni! Prite Original C<mtr~cl
Tutal l'<'ril<:lll Current Ctlntr:;sc(
Totllf Per Item %, ofWt>rk Campfde
Su&~!nnlial Cmnpk!i!,n o~tec
E<t,m1ed Toe
Fllu! Comp!ctinn Datt:
E.ttcmkd To:
Period Start Olltc:
Peri!ld End l)a!e:
Total Amouni
Qs1.12.JQll
lli.hl_l 1lH 2
Aug.l, 2012
s.,rL Jo.1on
Am<Hmt Earned
Thi~ Period
Page 1 of l
Fund:
Payee:
Description:
Account
Agenda: 10/23/12
Current Claims City of Dearborn Heights
Voucher Approval
Community & Eco. Dev Fund.
Wade Trim & Assoc.
Number: U -~;(
Professional Services rendered from 7/29/2012 through 9/1/2012 Invoice Number 104674, Dated 09/25/12
Amount Budget Account Title Amount Before Payment
103-960-918.211 Administration $1,955.00 $62,559.41
Requested By: CDBG
Comptroller Authorized Official
Concurrence
Wade Trim 25251 Northline Road • Taylor, Ml48180 734.947.9700 • FAX: 734.947.1380 • www.wadetrim.com
FederaiiD 38-1802386
City of Dearborn Heights 26155 Richardson Dearborn Heights, Ml 48127
Attention: Mr. Ron Amen, Director
Re: As Needed-Community Develop Assist
Invoice Date : Invoice#: Project#:
INVOICE
Terms: Net 30 Days 1.5% Per Month After 30 Days
18% Annual Rate
September 25, 2012 104674 DHT625901D
Remit payment to : Wade Trim P.O. Box 10 Taylor, Ml 48180
For Professional Services rendered from 7/29/2012 through 9/1/2012
Prior Invoices
This Invoice
Total Invoiced
Paid to Date
Total Salaries
Total Expenses
Professional Services Rendered
Amount Due This Invoice
Statement
Amount Outstanding
$10,334.66
S1 ,955.00
$12,289.66
$9,654.66
$2,635.00
$1,955.00
$0.00
$1,955.00
$1,955.00
Fe·e Summary
Authorized Fee
Total Invoiced
Amount Remaining
$12,289.66
$12,289.66
$0.00
Wade Trim 25251 Northline Road • Taylor, Ml48180 734.947.9700 • FAX 734.947.1380 • www.wadetrim.com
FederaiiD 38-1802386
Phase: 1 -- NSP Assistance
Task: 18 -- General Planning & Administration
Rate Schedule Labor
Class Name Date Hours
Professional Planner I
08/02/2012 2.00 08/09/2012 4.00 08/10/2012 2.00 08/13/2012 2.00 08/14/2012 1.00 08/20/2012 6.00 08/21/2012 1.00 08/27/2012 1.00 08/28/2012 1.00 08/29/2012 1.00 08/30/2012 1.00 08/31/2012 1.00
23.00
Total Rate Schedule Labor
Total Task: 18 General Planning & Administration
Total Phase : 1 -- NSP Assistance
Invoice Date : Invoice#: Project#:
PBte
$85.00 $85.00 $85.00 $85.00 $85.00 $85.00 $85.00 $85.00 $85.00 $85.00 $85.00 $85.00
Labor Expense
Labor Expense
INVOICE
Terms: Net 30 Days 1.5% Per Month After 30 Days
18% Annual Rate
September 25, 2012 104674 DHT625901D
Amount
$170.00 $340.00 $170.00 $170.00
$85.00 $510.00
$85.00 $85.00 $85.00 $85.00 $85.00 $85.00
$1,955.00
$1,955.00
$1,955.00 $0.00
$1,955.00 $0.00
Fund:
Payee:
Description:
Agenda: 010/23/12
Current Claims
City of Dearborn Heights Voucher Approval
General Fund
Wayne County
Number:
Traffic Signal Maintenance- July, 2012 Invoice 1006193, Dated 10/03/12
Account Account Title Amount $5,014.01
Amount Budget Before Payment $54,743.59 101-440-925-000 Signals
Requested By: DPW-Highway
Comptroller Authorized Official
Concurrence
Daniel S. Paletko
Invoice Number
1006193 COUNTY OF WAYNE --'----1
Invoice Date
10/03/12 Robert A. Ficano · County Executive 500 Griswold, 20th Floor, Detroit, Ml 48226
Send Remillance to: Wayne County Accounts Receivable 500 Griswold, 20th Floor Detroit, Ml 48226 Customer:
Dearborn Heights, City of 6045 Fenton
lnvoi
Customer Number I Direct Inquiries to:
500005
Dearborn Heights Ml 48127 Mr. Amiel Baldwin Telephone (313) 224-6286
line No. Due Dale i Description of Item, Material, Services or Work
001 11/03/12 Traffic Signals - Jul of 2012
Invoice Number
1006193
o 15 oLJ /D(-'i"(o ·' lo< "
Plecrse Pay This Amount=> $
Return Remittance Copy of Invoice with Payment
Invoice Date
10/03!12
Amount
5,014.01
5,014.01
Wednesday, October 3, 2012 Wayne County Department of Public Services - Roads Traffic Signal Billing- Community Billing Records- Historical Data- Jul-2012
!CITY OF DEARBORN HEiGHTs - JD. Edwards No.- s()ll()()5 ~
Signal Street
5601 Ann Arbor Trail 5600 Ann Arbor Trail 544 Ann Arbor Trai! 258 Ann Arbor Trail 433 Ann Arbor Trail
5617 Annapolis 1425 Beech~Daly
5597 Beech-Daly 5596 Beech-Daly 653 Beech-Daly
5624 Beech-Daly 5389 Beech-Daly
243 Beech-Daly 5647 Beech-Daly
362 Cherry Hill 5595 Cherry Hill 656 Ford WB 488 Ford 391 Ford
1377 Ford 1002 Ford 929 Ford 558 Inkster 974 Inkster
1061 Inkster 923 Inkster 917 Joy 924 Joy 422 Michigan 601 Michigan 67 4 Outer Drive-W
5598 Pelham 14 Pelham
440 Telegraph 890 Telegraph
1 007 Telegraph 1 005 Van Born 812 Van Born ,916 Van Born
1068 Van Bam 542 Van Born 649 Van Bam
5662 Warren
C:\Prograrn Files\Signals\Traffic01_rpt
Street
Garling Drive Glengary Inkster Outer Drive-W Warren Monroe *Fire Station, Dearborn Heights Annapolis Cherry Hill
Hass Kennedy Penn Van Bam Wllson Inkster John Daly
MOOT Number
Rouge Circle 8208101024
Beech-Daly 8208101018
Gulley 8208101016
Heights Dr 8208101062
John Daly 8208101045
Silvery Lane 8208101025
Annapolis Hass/Maplewood Powers Wilson/Marquett Fenton Hemingway Beech-Daly 8206101012
Gulley 8206101022
Midway Annapolis Van Born Ann Arbor Trail 8205301013
Annapolis 8205201027
Hass 8205301021
*Library Drive, Dearborn Heights DPW Campbell Gulley John Daly Monroe Pardee/Heathrln Berwyn
Effective Date
Jan-90 Dec-93 Feb-02 Mar-01 May-86 Dec~72
Jul-99 Jan-90 Jan-96 Feb-96 Feb-96 Feb-96 Jul-97 Feb-96 Jan-98 Jun-93 May-05 May-12 May~12
May-05 Apr-12 May-12 Aug-94 Feb-98 Mar-01 Feb-98 Jan-90 Mar-04 Jul-09 Jun-93 Feb-01 Dec-72 Ju!-95 Jun-·03 Aug-97 Dec-88 Mar-06 Oct-91 Sep-96 Sep-96 Oct-91 Nov-91 Jul-98
Bill Payer
500005 500005 999999 999999 999999 500005 999999 500005 500005 999999 500005 500016 999999 500005 999999 500005 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 500005 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 500005
Page i of 2
Maint.
Perfrmr
999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999 999999
Agency Steady % Watts
100.00 737 100.00 1.172 25.00 2,900 50.00 3,400 25.00 1,545
100.00 804 100.00 2.440 75.00 1,604 75.00 2,840 50 00 2,600 33.30 1,750 50.00 2,600 25 00 3,050
100.00 2,800 12.50 50.00 33.30 25.00 3700 5000 5000 25.00 25.00 25.00 25.00 25.00 2500 25.00 50.00 25.00 50.00 25.00 25.00 50.00 50.00 5000 33.30 25.00 2500 2500 25.00 25.00 3330
3,107 1,203 1,340
324 2,188 2.275 2.578 2,188 2.840 2,840 2,840 2.840 1,604 2,040
294 4,500 2,440
804 3,770 3,700 4,500 3,504 2,040 1,468
2,640 2,915 1,668 1,868 2,640
Energy Cost
$30.12 $70.62 $16.04
$101 .36 f)Qj
49!
$54.00 :'S4::J 49\
$54.00 $31.67
$16.13 GO\ '"'''
$18.54 $3.36
$33.63 $47.25 $53.55 $22.72 $2949 $29.49 $29.49 $29.49 $16.66 $21.19
$6.11 $46.73 $50 68
;;'j;/: f)t:c
$39.15 $76.85 $93.47 $7278 $28.22 $15.25 $27.42 $3027 $17.32 $19.40
Maint.
Cost
$46.58 $74.07 $45.82
$107.44 $24.41 $50.81
$154.21 $7603
$134.62 $82.16 $36.83 $82.16 $48.19
$176.96 $24.55 $38.01 $28.20
$5.12 $5116 $71.89 $81.46 $3457 $44.87 $44.87 $44.87 $44.87 $25.34 $32.23
$9.29 $7UO $77.10 $1270 $59.57
$116.92 $142.20 $11073
$42.93 $23.19 $41.71 $46.06 $26.35 $29.51 $55.56
Rental
Cost
Total
Billing
46.58 74.07 75.94
178.06 4045 5081
255.57 59.37
105.13 136.16
"';.66
136.16 79.86
176.96 40.68 13.02 46.74
8.48 84 79
1 19 14 135 01 57.29 74.36 74.36 74.36 74.36 42.00 53.42 15.40
1 17.83 127.78
98 72 193.77 23567 183.51 71.15 38.44 69 13 76.33 43.67 48.91
')~.J
Wednesday, October3, 2012 Wayne County Department of Public Services - Roads Traffic Signal Billing- Community Billing Records- Historical Data- Jul-2012 I
I CITY OF DEARBORN HEIGHTS : JD. Edwards No-::500005 I
MOOT Effective Bill Maint. Agency Steady Energy Maint. Rental Signal Street Street Number Date Payer Perfrmr % Watts Cost Cost Cost
5661 Warren Fairwood Ju!-98 500005 999999 50.00 3.880 i$80 59! $122.61 614 Warren Fenton Jul-98 999999 999999 50.00 2,840 $58.99 $89.74 625 Warren Garllng/Fieldg Jul-92 999999 999999 25.00 1,835 $19.06 $28.99 701 Warren Gulley Jul-98 999999 999999 50.00 2,840 $58.99 $89.74
Overhead@ 0.26000
Total for CITY OF DEARBORN HEIGHTS~ JO. Edwards No.~ 500005
C:\Program Files\Signals\T raffic01_rpt Page 2 of 2
Total Billing
4202 148.73 48.05
148.73
$3,979.37
$1,034.64
$5,014.01
Fund:
Payee:
Description:
Agenda: 1 0/23/12
Current Claims City of Dearborn Heights
Voucher Approval
General Fund
Winder Police Equipment
Equipment Installation
r1 APPRr,:JVEDFOR)
AGENDA OF I
1--·-~--~i i J 0-:;1,3- J ;;ti ~,,,_;:::~
Various Invoices for September 2012
Account Account Title 101-300-932-000 Repair/Maint Eqpt
Amount $17,079.40
Amount Budget Before Payment
$149,233.32
Requested By: Police Dept.
Comptroller Authorized Official
Concurrence
Daniel S. Paletko
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Fax: (734) 281-9255
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INVOICE
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Fax: (734) 281-9255
INI/OICE
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13200 REECK I~OAD • SOUTHGATE, Ml48195 Phone: (7'34) 28.1-6800
Fax: (734) 281·9255
7
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PLEASE DE'.TACH AND SEND THIS STUB WITH YOUR REMITTANCE TO:
A Serv~ce ""'~"'" 2:4°/o Oil £1!
mum ol .50 cenls is added lo all accounts afh?r 30
13200 REECK !'lOAD" SOUTHGATE, Ml48195 Phone: (734) 281-6800
Fax: (734) 281 ·9255
A iun~e "f'har~i< Y<n' from Ali of '"' iE!!i'it W~nder Po~mll:e folf your $UPJ~il'JHl'"il duwffng 'lli:he past ~4 V~@JTS~
CITY OF DEARBORN HEIGHTS 6045 FENTON • DEARBORN HEIGHTS, MICHIGAl'\J 48127 TELEPHONE (313) 791-3443 e FAX (313) 791-3441
Shiip To: ~~-
POLICE DEPARTMENT CITY OF DEARBORN HEIGHTS
25637 MICHIGAN AVENUE
DEARBORN HEIGHTS Ml 48125
VENDOR NO. 58030
v WINDER POLICE EQUIPMENT INC. ~ "13200 REECK ROAD 0 0 R SOUTHGATE
1 Quantity I Unit !Description
Ml 48195
PURCHASE ORDER
NO. 13-00138
Date: 0-7/01/12 *+*+*+*+*+*+*+*+*+*+
BLANKET PURCHASE ORDERS JULY 1, 2012 THROUGH JUNE 30, 2013 TO BE PAID MONTHLY
1 EACH TO COVER THE COST OF MISCELLANEOUS Unit Cost
$0.00 Total Cost J
$0.00 REPAIRS AND SUPPLIES FOR THE POLICE DEPARTMENT USE ONLY
101-300-932.000
LEE GAVIN DIRECT INQUIRIES TO
Total PO Amount .-----1
0 001 L__ ___ .J
PURCHASE ORDER NUMBER MUST APPEAR ON INVOICE. OR INVOICE WILL NOT BE PAID!
M.S.D.S. REQUIRED ON HAZARDOUS MATERIAL NOTE: ANY DEVIATION IN PRICE ON THIS ORDER MUST BE APPROVED BY THE CITY PURCHASING DIVISION PRIOR TO DELIVERY
OHIGINAL INVOICES TO: COMPUTROLLER'S OFFICE 60~-5 FENTO, DBN. HTS., MI 48127
2. EXEMPT FROM STATE/LOCAL AND FEDERAL TAXES: 38-1712300
> PURCHASE ORDER NUMBER MUST APPEAR ON ALL INVOICES, SHIPPERS, AND CORRESPONDENCES.
4. SUBSTITUTIONS NOT ACCEPTED VJITHOUT PRIOR APPROVAL.
5. PARTIAl, SHIPMENT WILL BE ACCEPTED IF INVOICED SEPARATELY. PAYMENT MADE UPON C0l'1PLETION OF PURCHASE ORDER.
6. ACKNOWLEDGMENT COPY MUST BE RETURNED BEFORE ORDER IS BINDING.