HomeMy WebLinkAbout1st Escrow Disbursement Request ESCROlW AGFtEEMEhlT—ExhlbFtA
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DESq MPTION OF Ie`0UjPM t4Fr. G C r^�;S y�
INVOICE at `r is A t r •�°d�
IndIrale Method toe payment Disbursement.
Ovamigfrl'Chock Wks _RogularMailChock
tNMro Funds
LfalltndAddtsss:
w_ V+ltre Instructions:
Ttas r,Wl and a frog the 4ti l before � not Its msdo,
Lessee.btonroa Co4nty,Florlds
By. --� Digitally Signed by
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TMfMa: 17:2131-04*00°
Assignee Santa r ,fCA.
AuahatzeeiSlgr� - --�-
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A uC C E P TA EC E C E ATI F ICA TE
Lmsasa hereby ocknuwledgea reraipl In goad Condition of at1 the 044MOAl dew1bed above and'Vgoludad an tha attached,vendnrfa,rrola etrp,kreretly
a pta each equipment,and weby ogntras that Lessor or Its essaaAm has tulkyr and aatlslaol Inch Performed all ached, en and rn IcO(), to bs
a and
by&a vender rtra LssIKU warn reran#90 oA,O the Egnarat that ouch equipment k fatly artsurs�d In accorttarece r 4Ih Section&03 of the Least
end rhataucte aquapnvent eaonslllsrWae all or a pcnlon Of kart Equlpmarpt as that team as defined In the Leaae
leaeeet Monied Ce7rrrtity.Florida
By Digitally Signed by
: w, Date
p r a Tle: t7":74:jI3*t7r{'tta"
l'dgsrt Maadok,Clerk PA "'d rr&a leFPt rums anwavui
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Are�sYemrC�paryH,rsomey
South Florida Emergency Vehicles, LLC Invoice
4655 CUMMINS CT.
FT. MYER , FL. 33905 Date
FH;239-267-5300 202� 5-' 20934
F"AX:2.39-590-5246 6✓16/2025
Bill To: Strip To:
MONROE COUNTY, FLORIDA MI'I NROE COUNTY FIRE RESCUE
1100 SIM NTON STREET CHERI TAM BORSKI
KEY WEST, FL. 3'3040 7280 OVERSEAS HIGHWAY
MARATHON, FL., 33050
S.O. No P.O. Number Terms Rep Via HS #
72265 Net 30 LL
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I F4?U TS CHASSIS INC O 2024 FOU S 3000(,Af.LON TANKER 532,643.75 p 532,64175
F'FCEIGI FFLANL;R VIN UAC 140F F,3RDW35020
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I n nk wtydk for your buskiessTotal $532,643.75 '
Payments/Credits $0.00
Balance Due $532,643.75
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South Florida Em�ergency Vehicles,, LLC Invoice
4655 CL MMINa CT
FT. MYER , FL, 3 905 Date
PH:2 9- 67-5 0 2025-120 35
FAX:239-590-5246 6/16/2025
B111 To,: Ship To:
MONROE COUNTY, FL MONROE COUNTY FIRE RESCUE
1100 SIMONTON STREET CH RI T;p MBO� RSKI
Et" WEST, FL. 33040 7280 OVERSEAS HIGHWAY
P►I!AitATl-1ON, FL. 33050
S.O. No. P.O. Number Terms Rep Via HS
73773 Net 30 LL
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l 1'CIUTS CHASSIS INC O 2025 1'OUTS 3000 C`YALLON"T"AT KER 541,1,43.00 541,143.00
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I hank,you for your busim:s. Tot,al $541,143.00
Payments/Credit Payments/Credits $0.00
Balance Due $541,143.00
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DATE INVOICE NO
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NtlAI "H 3 , 2024 A[�I I 1 7f 't l R C qFt N/
b kIC E 10. NYtTI I ATt d tY7 M YEAR ,MAKE ?r; r, A
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SECOND-STAGE
MANUFACTURERS STATEMENT OFORIGIN , ,
The 'undersigned (company,_firm or corporation) hereby certifles'1h6t the now
rrlctor vehicle iescried below,the property the said(bemarlr;firm or t:orperatirrrr „
has been transferred on the date and invoice number below�to:
South Florida Emergency Vehicles LLC
4668 Cummins Court
Ft Dyers, FL 33905
SECOND-SSA E BODYDE cRiIPrlON ,
BODY IDENTIFICATION NO, YEAR � TRADE NAME OF BODY BODY STYLE SERIES OR MODEL NO,
32956 202 Fou Ccmr¢ercial Vehicles L'C Tanker 0BC� GaIlt�rt
INtitoICE bA7E INVOICE NO. Bobo°°WEIGHT
4122l26 73773 7„880lbs
FIASTSTAGEVEHICLI;CPESCRIPTION
VEHICLE IDENTIFICATION NO, ' YEAR _ MAKE,of CHASSIS AND POWSRTTRAIN
2NK5U9X3 IVl1a7203 2025 Kenworth'Ti'43,0A, ro
FINS -STAGE V ICI E AG t� E CHASSIS WEIGHT
�;0rgIav nwrz,0 L HC -Atlanta" I�,43g Ib "
COMPLETED VEHICLE
COMBINED CHASSIS AND BODY WEIGHT
22,319 lbs �11 Ir
le
- -•+,It is further certified that this is,the first transfer of th�ls second,�
ordiMr de and c Mmerce. ,. » , ;•
TitleClef
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ALT 1 $6 l�T MILL ROAD, SUITE 110, MffgMe � A iil0
3FFICE AbbRESS:OF SIGNATORY ✓�� CAMP �!��
IMPORTANT NOTICE,
Both this Statement of Origin and-the first-stage Statement of'Origin must accompany the application for Title.,
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IMPORTANT NOTICE
Both this Statement of Origin and the first-stage tatergenfof Origin must adcompany�`ft applicatdpn"forTitle, ..
=FIRST'A Sr �rr��ENT;
R VALUE 4VP ,the:unders' nod rob fr Wafers thv �i�" and"the motor vetiidio(Iascrlbsd"h4 in to:
fl�C „
"Address"
and cartifles that the vehicle Is new and has not been registered"fn this or,any other state,individual also warrariI thin tltle,of
motor vehicle at aims of delivery,subject to the'llens and,eincumbrances,"if any,easel out balew;
,Arno'untofLisa Gate ToWhom,Due Ad, roam
sv
AOIFY
ed Y Transferor(I IfmMarne) . SMg nums paaftMin
1/au0 certify,under Penalty of Law,that the statements set forth ebova are true and"correek to I e bast of,my/our �
InfcjrmaGcrn"aeud baliefw " „" `""� ,
Wlthess my 'r tw4and(a)and$sells)
This day of: .� 20 i
�
Lb1'wIC�J�SSM�iIVI�E�9�' � c�
�F'OR V,ALUS RECEIVED,the undersigned hereby lrarisfers this Staterri6hi ofCidgiri and,the motor veblde,dekell od theieln
_
Address ,
and cesdifies that the vehicle is new and has Trot been registered in this orany other state;Individual also warrants-the titie�of aald+ ;
motor vahi6le at kime of delivery,subject to liens and encumbianoes if any;os set out krekiw:;
Amount of Lien Date To Whop Due. Aairlrress
;Gated 20 " at _
]3
transferor(FMrm;F#ame) Slosture " posltlon�
IVavecar*,wrider,Penalty of Lawn,that the statements set forlh shove aro,triuo and,correct"to the beat"of rrtykyr`,kriowrle�e�
infdrmation.'An i belief.
Witness myrourhtand(s)and Seal(s) „ "
This day of
20,
THIRD ASSltahl l;�17� ,
FQFt VALUE RECEIVED,the undersigned hereby translate this$tatehant of pri in,and the motor vghicl .dear ribed,theretrn to,
address
and cartlfpse,tttaYthe vehicle is n and p not been:registered Mrs this or.any other state;i idivid6al al warrants"the,�tte
rncitor v�hicis of time of Dal syry subject to"d Tolle Gdn dmbrances,"If any,as set out taelouu „
e 9
itiuiit rif�Ltan' ,kddreas
Dated _ 20"� :a at ,
By,
Transf argot(Elkh Name) "po's"lon
tC rft egrt(fy;'under Penally,of'Law,-that the statements set forth above are tree and corrects to the brat of rriylour knowrledge,, "
informat]on and belief. '
'fitness myltrur Handle)and Seal(s)
This
- day of 20" „ i
Printed f Ihlck 0e cation 5ervic"
71,
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