HomeMy WebLinkAboutReso. 1987-077 - Approving installment payment agreement no. g720172 . :, . . • •
RESOLUTION NO, j���-z�
A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF REDDING
APPROVING INSTALLMENT PAYMENT AGREEMENT NO. G720172 ,
REFERENCE SUPPLEMENT DATED MARCH 3 , 1987 , BETWEEN THE CITY
OF REDDING AND INTERNATIONAL BUSINESS MACHINES CORPORATION
FOR THF PURCHASE OF COMPUTER EQUIPMENT, AND AUTHORIZING THE
MAYOR TO SIGN ALL NECESSARY DOCUMENTATION.
BE IT RESOLVED by the City Council of the City of Redding as
follows ;
1 . That the City Council of the City of Redding hereby
approves Installment Payment Agreement No. G720172 , Reference
Supplement dated March 3, 1987 , between the City of Redding and
International Business Machines Corporation for the purchase of
computer equipment, a true copy of which is attached hereto and
incorporated herein; and
2 . That the Mayor of the City of Reddinq is hereby
authorized and directed to sign all necessary documents on behalf
of the City of Redding in connection therewith, and the City
Clerk is hereby authorized and directed to attest the signature
of the Mayor and to impress the official seal of the City of
Redding on the aforesaid documents, when appropriate.
I HEREBY CERTIFY that �he foregoing Resolution was
introduced and read at a regular meeting of the City Council of
the City of Redding on the 7th day of Apri 1 , 1987, and was
duly adopted at said meeting by the following vote:
AYES: COUNCIL MEMBERS: Carter, Dahl , Gard, Johannessen, & Fulton
NOES: COUNCIL MEMBERS: None
ABSENT: COUNCIL MEMBERS: None
ABSTAIN: COUNCIL MEMBERSa None
��4�,l�l�l.��, ��
LEE D. FULTON, M.D. , Mayor
City of Redding
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ATTEST: FORM PROVED: �
��C/. � - � �
ETHEL A. NICHOLS, City Clerk RAN ALL A. HAYS, City Attorney �
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! : ir��rna�+�r��l Bu�aness �achines ��ra#ion • Armo�;k, New York �0504
� 1�x4.o�o�. 10/1 I��ta1l�ne�� P�,►rrr�e�� Ae��eerrtent
(�iat� and Loca! Governm�nt)
i'vame and Address of Custorner: Reference Agreement No.: G720172
� Citv of Redding
� i o0 ParkvieG; Ave Reference Supplemeni Dated: 03/03/£37
, t:wddir�g, CA 96001
Agrcement No.:
IBM Branch Office Address �BM Branch.Office No.: I��.14
i .:��J C�_�.iLi�l �'Ic..`� .
Sac�a?aento, CA 9�814 Customer No.: ��gg'o02
' lnternational Business Machines Corporation (IS�1)a�d the Customer agree that this Installment Payment Ayreement
supplements and amends the referenced Agreement for Purchas�of IBM Machinss and its referenced Supplement with
respect to the fioliowing IBM machines, features, model upgrades, machine elements and/or accc�ssori�s (hereinafter
� calied �`��lachines" unless the context requires individual reference).
IBM Piant
Order or Purchase
Price�
Machine Serial Model or Ne±Unit Price Amount$
Qty. Type Number(') Feature Description � )
i 1 5170 53XBNN 319 PC AT (Std Kybd) 4,384. /�+,384.00
1 5153 53XBNP 001 Color Display 476. 476.00
� 1 4202 53XBNQ 001 Proprinter 616. 616.00
2 5170 53XD�IV,Y 319 PC AT (Std Kybd) 4,808. 9,616.00
2 5154 53X.UVW,Z 001 Enhanced Color Display 594. 1,188.00
4 5201 53XCBF,J 002 Quietwriter Printer 1,481. 5,924.0�
: 53XDVX,
53XDW3
2 5170 53XCBC,G 319 PC AT �Std Kybd) 3,881. 7,762.OU
2 51.51 53XCBD,H 001 Monochron�e Display 192. 384a00
(•)An ""'indicates Machine Serial Number. TOl�AL; $ _ 30,350,00
Stater:ient o�l`ransac#ion -
30,350.00
1. Cash Price (if this vvere a cash sale) . . . . . . . .. . . . . . . . . . . .. . . . . ... . .. .. .. . . . . . . . . . . . . . . �--_
.00
� 2. Trade-in Aliowance Credit (from IB�Yi trade-in agreement) . . . .. . .. . . . . .� .. ... . . . • • . • • . • • • � —
� 3. Cash Down Payment. . . . . . .. . . . . . . . . . . . . . . .. . . .. . . . . . . .. . . . .. . . . . . ... . . . . . . . . .. .. .
� .00
i .00
4. Total t�own Payment (Sum of Items 2 and 3) . . . . . . . .. . . . . . . .. . .. . . . .. . . .... . . . . . . . . . . $ —
30,350.(>0
5. Unpaid Eialance of Cash Price (Item 1 minus I;ern 4) . . . . . . . . . . . . .. .. . . .. .. . . . . . . . . . . . . . . �
1,821,00
6. Statz and Local Taxes, if applicable . . . . . . . . . .. .. . . . . . . .. .. .. . .. . . . .. .... .. . . . . . ... .. . .$
30,350.00
7. Amount to be Financed {Sum of Items 5 and 6) . . . . . . .. .. . . . .... . . . . . .. .... . . . .. . . . . . . . $
i 8. FINANCE CHARGE (Time Price Differential on Item�)��inanr..e Chargz consists 7, 169.80
of iriterest at an ANNUAL PEftCENTAGE RATE of % . . . .. ....... . . . .. .... . . . �
� .00
� 9. Tax on Finance Charge, if applicable, (payable in first instailment) . .. . .. .. ... ... . .. .. .. . . �
' 30,350.00
10. Total Amount of Remaining Payments {Sum of Items 7, 8 and 9). . . . . .. . . ... . . . . . .. . . . . .. $
11. Total Time Sale �'rice (Sum of Items 4 and 10} . . . . . . . . . . .. . . .. .. . . . . .. ..... . . . . . . . . . .. .
� 39,340>80
'�
Z120-2791-03(Rev.47/84) »� Paye 1 OI A
' U/M 025
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p�yr;���'�;; • The Customer may�ny tim4ti, pay i� advance the fuli
' � T"�e Cu�,tomet� z�r�,�e�s ta pay tt�e Cash Down I��-�yrr�ent, ��mou��t du� ��ereunder anr� the r�ina�ce �;��rqe Luill k�e
� r , adju5��d by iE3Nl to refiect th� shor�.e� p=iyrr,�r�t �eric>d.
if any, (a) upon the i7ate e� Installation of .he iVlachinEs or All remittances are to be made to the !�M Brancn Office
�, (b) �;,rith respect to installed Machines, on the Effec#ive
, Date of �'urchase, and agrees to pay tl�e Total Amount of �ddress listed herein unless othenr�i�e �er�9,�este:� by 1Bfv1.
� Rernaining Payments in consecutive Periodic Payments,
in;;ludinc� �inance Charge, forthe Fiscal Periods as setfortl�, ,�ssi�nments
beio�� in either Payment �ian I or Payment �lan II. This Ins}t liment Payn�entArreerr�Eert is natassigna�lE by
� the C�.�stomer, nor may the Customer seil, transfer, sub-
�'�Y�'�=�T �'�-�'��� � stantially modify, relocate or disposs of any or ail of the
Periodic Paymer.t F��ance cndr9e Machines without prior �vri�ter; pe�miss��n of fB�Ji. in no
Fiscai (Annual) (inciuded in event may the PAachin�s b2 relocated outside the Uniied
, �er:�3d (s;enniai} Paym2nt) States. Any attempted assignment or transfer by the
-- -- -- --- ---- — Cus�ome; of any o; t�.� righ:;:,, tiuti2s or ;;�liga+.ions o� t'r�;s
, � Inst�Ument Paym�r;t P.gr��mant is voi�.
2 Cusfomer's Covenants
� The Customer covenan�s and agrees that (a) it ���ili not
3 c+�eate, assume, or voluniarily s��ffier to exist,withoui giving
IBM at least 15 calendar days' prior written notice, any
� mortg�ge, p':edge, encumbrance, security inYsrQ�t, lien or
� charc��of any ki�d upon any o;ali of tha�vt�chines;(b; it�r�i;i
5 I<eep the Machines in ga�d rep�ir a.r,c, ope;ating condition;
� (c) it wiil promptly pay all tax2s, inter�st and other charges
I when levied or assesssd upon th� Machines or their
i 6 operation or use, or upon IBM,exclusive of taxes based on
IBM's net income, in cennection with this Installment
� PAYt�9E9VT PLAN II Payment Agreement; (d) it wi11 proi�iptiy satisfy al! liens
against the Machinss; a��d (e) the�°� are no mortgages,
Total Finance pledges,encumbrances,security interests, lier�sorcharges
Periodic Payment Charge for of any kind by any party other than i8M or assigns upon the
1 (Total of Monthly Fiscal Period machines on which features, mo;ei upgrades, machine
Fiscal Payments for Monthly (Included in
' Period Fiscal Period) Payment Payments) elemen#s cr accessories wili be instailed subject to this
- instaliment Payment Agreement.
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1 Insu�an��
' 1,250.66 625.33 222094
�. 2 The Custamer further agr�e�to pra�ure ancP rrrair�t�i�i fir�
' 7,503.96 625.33 2,433.23 insurance �vith extended coverag� againsT fas�, th�ft,
3 damage to or destruction of the Machines for the fuil
� � insurable value thereof for the dura:fion of this fnstallmert
7,503.96 62�.33 1,957.55 Payment Agreement, thE policy for such insurance being
I 4 endors�d to show loss payable to IBM and assigns as
7,503.96 625.33 1,437.26 respective interests may a�pear. Upon requsst,a�ertificat�
� 5 of siach insurance will be furnish2d to IBM or assi�ns.Rrni
� 7,503.96 625.33 868.16 proceeds received clirer,t!y by 18�Vi und�r such insurance
6 shall be credited to the �ayment required from the Custcr .
6,253.30 625.33 250.66 mer pursuant to the Section entitl�d "Casualry Occur-
rences."
The Periodic Payment for Period 1, which inciudes the
� Tax on �inan;� Charge, if applicable, is due on the first Cas�r�3t ����srrPr�c�s
� business day o� the month fo�lowing the Date of Installation Y
or ths Effective Da2e of Purchase, and the Periodic Pay- A Casua!ty Occurrenc�s�aii b�d6em�d to exist i�any of
men�s for Periods 2 throuc�h__.�—are du�o�the first the Machines shali be lo�t, 5tolari, iz�r:�par�+bly damar��d c�r
; bu�ir�ass day of each succeeding Fisca! Peried. lf Paymunt desiroyea or othen,vise rendered pQr�ma��entiy un�it�ti>r 3�se
Pian i ���as b�;en chosen, payment: must be made in ful! on from any cause �vhatsoev�r prior to the p�ym�nt in �u'.! of
' tha due dates. li Payment Plan 11 has be2n chosen, the Total Time SaIA PCiC�. To the ext8+tt p2rmitteG by lativ,
payments must be made in equal consecutive montnly the Customer shall promp,ly pay to 1Bi�t a sum equal to the
; instailments,except tnat thefir�t instaUmentwill includethe aggregate Casuaity Value ofi such Nlachines.
Tax on Finance Charge, if appiicable, begirning on the due The Casualty Value ot eact� Macnine sufferir,g a Casuaity
dates and continuing on the corresponding :iay of each Occu�:ence shali be t��e sum of the unpaid balances of the
month ofi each Fiscal Period until fully paid. Payments State and Loca! Taxes, Unpaid Balance of Cash �'rice and
include Finance Charge in the appropriate amount in- Finance Charge at tne time of such Casual,y Occurrence
dicat2d abov�. and attributa�ie to such Machine.The�inance ChargQ shali
The Custorner having been offer�d the choice of pur- be adjusted by ISM to reflect ths shorter payment p2riod.
chasing ai tne foregoing Cash Price (plus applicable State Any money so paid sha'I i;� appli2d by iB�^, to red�c�
and Locaf Taxes) or at the Total Time Sale Price has elected insta!lments thereafter falling due so t�at si�ch instaflments
, to purchase at such Totai Tim2 Sale Price. repres2nt only the paymen#s due.for the remaining Ma-
I ��3 b���eYl���) � _. Page 2 of 4
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hines. An� excess insurance a� ment�eceived b� I?3M reason�ble att�:�rne 's�es a.nd le al ex ense�. IBM ti��ll�z�
� � 1 C � ,D 1� � y � � r �
�is"1cZ,I� t)�`', C.P�i'�;¢,:lC� iC) �f12 ��UStGiTIE,-'f. �O $'t'1� .�'..Li:ifC)�fle3't"cl1'1�% �>:1flRui`± �''if'!E IlE,'� �`lt'i7C�`�.^s^ia� III c.nC.E,.;;
ofi the ur�paid Total Time Sale Price.
E�enPs ��L?�f��Jt In th� event I[3M reposs�sses ancf remo�rEs a ���aturE>,
� Any one or r,�or�of th�fiollo�✓ing are Events cf Defauit: ;a) �odel ungracie, mac'r�irie element or accessory, it sh�li �e
the Custorn�r fai�s to pay vvhen du�any amount r2quir2d io ti�e Customer's responsibility to restore any remaining
� !;e paicl by t�� C�astc�mer hereunder and such ¢�^iiure shall �nformat;on pr�cessing equipment to �o��d workinq orci�;r.
i contir;ue irr a �erfod of sev�n days aiier th� ciu� uata, �he Cu-;tomer aqre�-�s that IBtva sh�ali r��ve ��o liability ;oY
except as provid�d in the Section entit{�d"�untiing"; (o)the d�mag�s caused by the repossession of s�ch a fLature,
Cus2omer faiis to procure and rnaintair: ins+arance as model upc�rare, machine efement or accessory or by the
requi��d ir� t�iis instaliment Paymt;rt Agreement; (c) th� Custom�r's fa:iure to fulfi�i such res�onsibi�!tses. FGrth�,r,
Cus?on�er faiis to perform any other provisions t�ere���n�er iBM sh:�ll have no obligation to reimburse the Customer,
� or viofates any o'the covenants or agreemen+s made by the uszr or any other secured party for th� cost of r�pair
� '^! `._^,��;�' '"�''f?..t�'��t", aT'(7 S.:Ci� ' �!Ll(�' O� �,` �C(1 S(1?1� I'F�Siliiii'� fi'^T SUC�? �'�'Rl0`I?�.
� � f,�; � i ci � �� � l3��. �-;�y p��rsue��ny oti�ar r��ee!y avai;a3lz at l���v or in
C�Ji�i'tflu.-; C.� a �:-,lCC7 � 7�7 G..y� ���ik.'i' aVtiiii�tl fl0'fIC2 I5
' receiv�d by the Customer from IBVi; c�r(d) any �r�solvency ����ty; includir,g, but not limited to, seeking c�amat�es,
� proce�dings of any character, voiuntary or involuntary, sp�cific performance and an injunction. No nghtor remedy
� shall bQ instituted by or �rainst the Customer. is exciusive o# any other provided hArein or permitted by
r�n, iail+a;e� ci i��'�9 Yo require strict p�rformance oy i�2 I_iw or equity. All suc;h righ,s and remedi�s s�all b2
� Customer or any waiver by IBM of any provision of this. cumuiative and may be enforced concurrently or individ-
Instaliment Payment Agreem�nt shall not b�construed as a ualiy frorr� time ta tim�.
; consent cr�.v�iv�r of any other breaci� of tf��sam�or ofi any `
' other �rovision. �c�n�'in�
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, Since�i��e Cu�Yflmer intend� ft�rec�utsi the a�?�irc�{�riatic,r�
����f�� of funds pericdically to be paid fc�r the Machines, ii func�s
� If an �vent of Defaulf shali have occurred and be are not appropriated for the Custamer for such Periodic
� continuing, IBM or assigns may,to the sxtent permitted by Payment for any fut�re Fiscal Period,the Customer wiil not
' iaw, (a) rAcov€�r from t�e Customer any and ali amounts be obli��ted to pay th� remainder of tt�e.i o.tal 7ir��e Saie
then due and to be t�ecom�due; {b)take possession of any Price due beyond the e;nc� c�f th�then curr�nt�iscai �'eria�.
� or all ofi the�v1aci�ines,wherever located,without demand or Such event rvill not constitute an Event of Defauit. The
� natice and withoi�t any court order or other proc�ss of la+,v, Custom�r agrees to natify IBM in vrriting of such nor�appro-
or render th2m unusabie, and retain ali prior payments as priation at the earliest possible time. :
partiai cor�pensation for their use and depreciation; (c) �n the �:vent that funds are nok appropriazed as provided
require the Cus±omer to assembl�the Machines and make ubove a�d the Customer is unable to make further pay-
' t�em availab!e to ISM, freight prepaid, at any place in the ments due under this instaliment �ayment AgreAment
continental U�ited States speciT;2d by ISM;and/or(d}incur beyond the end o`t�;e ihen current FiYcai P�riod, i�i�9�vill,
reasnnai�le att�rney's fe�s ant! i�ga9 exper�ses in ex�vrcising witti?r� a r�asonabi�tii��e after ii��end of such Psrit�d, ent�r
� �r7y of i�s rig3�is and�rerne�ies upon de��aii �,��hich the anr� fa�� tl-�e �,%l�chin�;� �frar7i t�� Custoir�er'c r,rer-�ises ar��� �
Custor��er I�er�by agrees to pay. Upon r��L�SJ�:JSIO�I of wii! reta;n all sums pr�;viousiy paid by the Custorrrar to i�3;�,�
such ��lachines, iBaU1 may seil, fease or otherwise dispose of as partiai compensation for m=�chine use and depr�ciation;
' any or ai! ofi th� Machin�s in a commsrcially reasonable provideci, }�oeveaer fhat u�can ��� Custorrrer's r2quest, the
' manner, �,vith or �r�itho�� notice and by public or privdte Customer may, prior t� suuh repossessien, retain t�e
� p,ocze�in�s, and a�p;y ti��a ��t proceeds tnereof tov°�ar�s I�9ac�in��during a r�asonat�9�period a�reecJ io by ��3�V1 ata
the arnoun#s Cu2 undar this lnst�i;ment Payment Agree- monthly chargs ds�igna+�d by IdM, beginrirg on ���e#irst
, m�r.t afi�r deducting thz reasona�le expenses of retaking, day folicwing the last Fiscal Period tor tivhicn payment has
hol�"sr�c� and ;,r2�aring for such dis�osition anu d�ductin� been mads h�reun�vr.
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'� � ` • unenforceabie,,the pa�s agree that the P�lachines shall be
• •:�scurlty Int$resf ansi,toc�fron of l�lach��s
cieerned to;�a"ve:d:����� inc5tal;ed under€EiP�'3 State anc:Lt�ra'
To secure t'r�e payrnent ofi fi��e Totai;�ii-r�e Sale I'rice, IBiiil Government Lease Plan pursuant to the terms and condi-
reserves a purchase money security interest in each of the tions of IBM's applicable agreement and/or amendment at
tiiachines, and th2 Custorner hereoy grants a security 18�1's app(icable Lease Plan Monthly Charg2s, comr��enc-
interest in any substitutions,replac2ments,accessions,and ing with the Date of Installation or the Effective [7ate of
additions th2reto and the proceeds thereof. Such interest purchase of the Machines. For the period prior to such
shall be satisfied by payment in fuil ot fhe Total Time Sale hoiding, fBM shall credit to the applicable Lease Plan
Price. A, copy of this �nstaliment Payment Agreem2nt may Monthly Charges the amounts paid by the Customer to IBM
be filed with appropriate state and local authorities, at any under this Installment P�:yment Agreement and amounts
time aiter .:signaiure by the Customer, as a financing paid by the Customer for maintenance, property tax2s and
statement in order to perfiect IBM's secur�ty interesf. Such insu�ance. Any excess credits will be refund2d to the
�fiiing does not c��nstitute acceptance of this instailment Customer,and any deficiency shall be dueto 18M;butin no
Payment Agreement by IBM. The Customer also shali even; sh�li any ?mount be due to IBM in excess oE iurds
' B:C�;CUC� li Oi�l t!!"il?t0 tlil�:3, c�.�Cfl@ O(`J`/i'i1 �5;��, �i'�y fi�,c`�.f?Cli?� r r r;;,�; r' th .� �I-� +- 1 r' -�
a�prc-,� ��. In �2 event t��at �, e a��ect�c t�;la.,ni��-s :lr..,
=:��a�e����,��s or oiner docu�nents and do su�h o�n�r act or notavailable frorn t8N1 underaleaseorrentalagreernent,a;
, acts considered •by IBrUI to bs necessary or desirable to the time of such holding, the Customer and !BM wili agree
perfect or protect the security interests hereby created.The �,pon a fair and equitable Lease Plan Monthly Charge for
Machines shall remain personal property, not become the period orior #o and foilowing such hoiding and, ot�er-
lixtures to rea� �roperty, Ur�d be kept at: N�ise, the Frovisions o� this Section shail apply.
760 Parkview A�enue If any provision or provisions of this Instaliment Payment
� Agre�ment shalf be h�id ta be invalid, iflegal or unenforce-
� ts.reet addras;� able, and the preceding paragraph does no} aonly, ft�e
R�ddi.ng Ca validity, le�ality and enforceability of thc r��maining protii-
� �c�cy> � �co���iy` �� (State) sions shal{ not in any way b2 af�e�tetl or impaired ther�b��.
TH�CUSTO�rTER�C�i�°OWLEDGES TF��T THE�l3��'O�
; where IBArI may inspect them at any reasonabie time. {��� y�S READ TH1S AG�E��EVT, U�1aERST,A�3D5
' Ger��ral IT, AGREES TO 8� 80�!9�1D BY I�S TER�JIS AP�ID C09N-
DITIONS, �i�Q �Y TH� CU51'd9��f�'� Sl�GN�.filll9�
� ff the Net Unit Price for any Machine is adjustera as ��L�Nd, ACKNti+l�`LEC?G�, TH�,T "C�� C�STOiVi�� !�
provided in the referenced Agreement, or the trade-in LEGALl.Y AUTHORIZED TO E�lTER i�VTO TH1S AG��CE-
ailowance for any trade-in equipment is adjusted as pro- N1��1T. FU�iT�i�R, T!-!E CUST�ii�ER A�REES Tt�A�
� vided in an applicable IBM trade-in agreement, Items No. 1 THtS Ii�STALtiVIEyT P�Y���V7 AG�i��A��6��', ?'r��' .
i through 11 in the Statement of Transaction and the F��FE�t�I�°�ED AGRc�fW��lT J1t�lD SUPPL�PIlF�T A���
Payments herein agreed to be paid shall be adjusted, and �'+�dY A?PLICABi.E fS�il TRAD�-I�I AG�d��it�E�1T C�JJN-
this Instaliment Payment Agreement shall be deemed to be S7'ITUTE A Sl�1GLE AG1���A.1EPdT A�i3 TN� CU�iI-
amended accordingly. PLE7� At�D EXC���IV� STA'fEi�lE�? O�TH��G���-
The terms and conditiors of this instaliment Payment P���vlll` 6�T'�V���! TH� CU���0�5�R AND 1BiV1, b�tNiC�i
Ayreement shall prevail notv✓ithstanding any variance with SID���iS��ES AL� E��C���ti�LS G�� ��?i�� A�s=r���
t�e terns ar;d condiiions o# the referericed Agreement. P�i��lT�, G�,a�l. O�; 1�.'�it"TT��1, �e�kD �,L� O"�i��r� Cv��,`3-
Sho�ld this Insta!Iment Payment Agreement and/or the �lUN1C��i0AIS i3�Tb�J��� Ti-�E P�R�SES REL6�1�`l7��G
referenced Agreement be held by th�courts to be invalid or TO -i`1-IE SLI�JEC� ��tATT�s� H��EOF.
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Sacramento/DH4
Received by ISNt at ------------- �------......__----- --------------- ------
Branch Office Nare/Number
�'� -- ------ ----�--�- ------�-----....----- --------- ------- --- ------- -------------
Manager's Signature
-�---- ----- ----- --- ----------- --------------- -- — -------------------- --- - --------- '
Name(Typ?vr Prin±) . D3te
Accepted by: C�ty of P.�dding
!n#��na�i�r��f �usir��ss fi�9aci�ines �or�ora#ic+n --------------------------------------�------------- -----------------...----------------------------
Customer
By -------------�------------------ ---- ---�----�-------------------�---------- -------- BY =---- -- -�------------------ - - ----•- ------9---------...-------------------------'----
Authorize�Si nature Authorized Si nature
---------- ---- - --- ---- ---------------�-- ------------�-------------------- -- ----�------- ----- --------�--- ------�--------- -----•- ------�--�-----•-------------------------••--�----�
Name (Type or Print) Date Name(Type or Pri�t) Date •
' 1DH4.0707. 10/3
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