MEARS LEASE PURCHASE SCHEDULE 09-C'N CLEARWAT -.41TY OF Posy' OFFICE Box 4748. CLEAR XYD , 'Ll 33758-47 48
MUNICIPAL SERVICES Bi ILDING, 100 SOI Tx MYR I I` k.1.EA-RwvrER, FLORIDA 33756
F ;RVIUF S
TO: Mears Motor Leasing
3905 El Rey Road
Orlando, FL 32808
407-298-2982
AT'T'N: Joanne Corneir
FROM: City of Clearwater
RE: Lease Purchase Draw Request
1. Request No.: 09-C
July 14, 2009
2. Please Pay: $476,536.39 dollars (see lease term schedules)
We hereby request this disbursement from the line of credit under the Master Lease
Agreement and, in connection therewith, certify and agree as follows:
A. The undersigned has not previously drawn down any amount of the line of credit
for the current expenditures;
B. The items covered by this request have been or are being purchased in accordance
with the terms of the Master Lease Agreement.
PAYMENT INSTRUCTIONS
Banking Information
Bank Name
Bank ABA Number
Account Number
Account Name
Dated: -1/1/6
Bank of America
026009593
001260030758
City of Clearwater Consolidated Cash
Signed by:
Margaret Simmons, Finance Director
Em u
DISBURSEMENT DETAILS
5-Year Lease Term
Invoice No. Vendor Description Amount
W64724 Bobcat of Tampa Bay 2009 Bobcat T250 Track Loader 43,137.53
124829 Maroone Dodge 2009 Dodge Nitro 19,022.00
9FBO3519 Duval Ford 2009 Ford F150 Pick Up Truck 20,659.00
9EA97920 Duval Ford 2009 Ford F250 Pick Up Truck 18,102.00
81916 Pat's Pump & Blower 2009 Sterling ST7501 Cab & Chassis 248,577.00
W64753 Bobcat of Tampa Bay 2008 Bobcat 5250 Skid Steer Loader 27,21 1.18
f9EB08503
9 KC 51951
9KC 51952
9EA97921
61000129136
XD5W396M6C
Alan Jay Automotive
Duval Ford
Duval Ford
Duval Ford
TrueData Technology, Inc
Dell Marketing LP
3-Year Lease Term
2009 Ford F250 Pick Up Truck 22,325.00
2009 Ford F150 Pick Up Truck 15,153.00
2009 Ford F150 Pick Up Truck 14,355.00
2009 Ford F250 Pick Up Truck 23,105.00
Voice Processing Board 699.00
Network Servers 23,642.08
Total 5-Year Term $475,987.79
Invoice No. Vendor Description Amount
XD4P621R3C Dell Marketing LP Computer Monitors 318.62
1100077567 Insight Public Sector, Inc Computer Monitors 229.98
Total 3-Year Term $ 548.60
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Form Information turn for Tax-Exempt Governmental Obligations
Under Internal Revenue code section 149(e)
(Rev. November 2000) ? See separate Instructions.
Department or the Treasury
Internal Revenue Service Caution: If the issue price is under $100,000, use Form 8038-GC.
OMB No. 1545-0720
Ftennirtina Authority If Amended Return. check here ? n
1 Issuer's name 2 Issuer's employer identification number
City of Clearwater 59 : 6000289
3 Number and street (or P.O. box if mail is not delivered to street address) Room/suite 4 Report number
PO Box 4748 3 09-06
5
-.-
-............ _-.-........
City, town, or post office, state, and ZIP code
6 Date of issue
Clearwater, FL 33758-4748 07/1512009
7 Name of issue 8 CUSIP number
Master Lease Agreement No. 09-C NIA
9 Name and title of officer or legal representative whom the IRS may call for more information 10 Telephone number of officer or legal representative
Clement Vericker, Debt Specialized Accounting Manager ( 727 ) 562-4520
Type of Issue (check applicable box(es) and enter the issue price) See instructions and attach schedule
11 ? Education 11 ._
12 ? Health and hospital 12
13 . . . . . . . . .
? Transportation . . . . . . . . . . 13
14 ? Public safety. . . . .
. .
.
. .
. .
. 14
15 .
.
.
.
.
? Environment (including sewage bonds) . . . . . . . 15
16 ? Housing .
. .
. .
. .
. 16
17 . . . . . . . . .
.
.
. .
.
? Utilities 17
18 . .
? Other. Describe ? Various Equipment for City Use 18 475,988
19
20 If obligations are TANS or RANs, check box ? ? If obligations are BANS, check box ? El
If obligations are in the form of a lease or installment sale, check box ? ? p
Description of Obligations. Completeor the entire issue for which this form is bein filed.
(a) Final maturity date (b) Issue price (c) Stated redemption
price at maturity (d) weighted
average maturity (e) Yield
21 07101/2014 $ 475,988 $ 475,988 5 ears 3.11 %
Uses of Proceeds of Bond Issue (including underwriters' discount
22 Proceeds used for accrued interest
. 22
23 . . .
.
Issue price of entire issue (enter amount from line 21, column (b)) . . . . . 23 475'988
24
Proceeds used for bond issuance costs (including underwriters' discount)
24 _
25
26 Proceeds used for credit enhancement _ .
Proceeds allocated to reasonably required reserve or replacement fund 25
26
27 Proceeds used to currently refund prior issues . . . . . . . 27 _-
28 Proceeds used to advance refund prior issues . . . . . . 28
29 Total (add lines 24 through 28) . . . . . . . 29
30 Nonrefundin roceeds of the issue (subtract line 29 from line 23 and enter amount here) . 30
® Description of Refunded Bonds (Complete this part only for refunding bonds.)
31 Enter the remaining weighted average maturity of the bonds to be currently refunded ? _ N/A years
32 Enter the remaining weighted average maturity of the bonds to be advance refunded ? N/A years.
33 Enter the last date on which the refunded bonds will be called . . . . .
..........
34 Enter the date(s) the refunded bonds were issued ?
Miscellaneous
35 Enter the amount of the state volume cap allocated to the issue under section 141(b)(5) 35 -
36a Enter the amount of gross proceeds invested or to be invested in a guaranteed investment contract (see instructions) 36a
b Enter the final maturity date of the guaranteed investment contract ?
37 Pooled financings: a Proceeds of this issue that are to be used to make loans to other governmental units 37a
b If this issue is a loan made from the proceeds of another tax-exempt issue, check box ? ? and enter the name of the
issuer ? and the date of the issue ? _
38 If the issuer has designated the issue under section 265(b)(3)(B)(i)(111) (small issuer exception), check box . . . ? ?
39 If the issuer has elected to pay a penalty in lieu of arbitrage rebate, check box ? ?
40 If the issuer has identified a hedge, check box . . . . . . ? ?
Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge
and belief, they are true, correct, and complete.
1 rl
ere "7 Margaret L. Simmons, Finance Direr
Signature of issu is authorized representative Date `Type or print name and title
For Paperwork Reduction Act Notice, see page 2 of the Instructions. Cat. No. 63773S Form 8038-G (Rev. 11-2000)
Form 8038-G Information Return for Tax-Exempt Governmental Obligations
? Under Internal Revenue Code section 149(e) OMB No. 1545-0720
(Rev. November 2000) ? See separate Instructions.
nle--or the Treasury
lnte Caution: if the issue price is under $100,000, use Form 8038-GC.
'^'*I Rev evenue service
OFT3 , Renortino Authority If Amended Return. check here ? (-1
1 Issuer's name 2 Issuer's employer identification number
City of Clearwater 59 : 6000289
3 Number and street (or P.O. box if mail is not delivered to street address) Room/suite 4 Report number
P Box 4748 3 09-07
5 City, town, or post office, state, and ZIP code 6 Date of issue
Clearwater, Ft. 33758-4748 0711512009
7 Name of issue 8 CUSIP number
Master Lease Agreement No. 09-C N/A
9 Name and title of officer or legal representative whom the IRS may call for more information 10 Telephone number of officer or legal representative
Cl^ment Vericker, Debt Specialized Accounting Manager ( 727 ) 562-4520
_J_ Type of Issue (check applicable box(es) and enter the issue price) See instructions and attach schedule
11 ? Education . . . . . . . . . . . . . . . . . . . . 1
12 ? Health and hospital . . . . . . . . . . . . 12
13 ? Transportation . 13
14 ? Public safety. . . . . . . . . . 14
15 ? Environment (including sewage bonds) . . . . . . . . . . . . . . . . . . 15
16 ? Housing . . . . . . . . . . . . . . . . . . . . 16
17 ? Utilities 17
18 ? Other. Describe ? Various Equipment for City Use 18 549
E
19 If obligations are TANs or RANs, check box 1? [I If obligations are BANs check box Ill 20 If obligations are in the form of a lease or installment sale, check box ? ?
Oescrintion of bliantions. C;omnlete for the entire issue for which this form is beina filed.
21 (a) Final maturity date
07/01/2012 (b) Issue price
$ 549 (c) stated redemption
price at maturity
$ 549 (d) Weighted
average maturity
3 ears (e) Yield
3.02 %
Uses of Proceeds of Bond Issue (including underwriters' discount
22 Proceeds used for accrued interest 22
23 Issue price of entire issue (enter amount from line 21, column (b)) . . . . 23 549
24 Proceeds used for bond issuance costs (including underwriters' discount) 24
25 Proceeds used for credit enhancement . . . . . . . . . . . . 25
26 Proceeds allocated to reasonably required reserve or replacement fund . . 26
27 Proceeds used to currently refund prior issues .
. . 27
. . . .
.
28 Proceeds used to advance refund prior issues 28
2 Total (add lines 24 through 28) . . . . . . . . . . 29
30 Nonrefundin proceeds of the issue (subtract line 29 from line 23 and enter amount here) . 30
° - v Description of Refund Bonds (Complete this part only for refunding bonds.)
31 Enter the remaining weighted average maturity of the bonds to be currently refunded . . . r N/A years
32 Enter the remaining weighted average maturity of the bonds to be advance refunded . . . 1? N/A years
33 Enter the last date on which the refunded bonds will be called . . . ?
34 Enter the date(s) the refunded bonds were issued ?
Miscellaneous
35 Enter the amount of the state volume cap allocated to the issue under section 141(b)(5) 35
36a Enter the amount of gross proceeds invested or to be invested in a guaranteed investment contract (see instructions) 36a
b Enter the final maturity date of the guaranteed investment contract ?
37 Pooled financings: a Proceeds of this issue that are to be used to make loans to other governmental units 37a -
b If this issue is a loan made from the proceeds of another tax-exempt issue, check box I? ? and enter the name of the
issuer ? and the date of the issue ?
38 If the issuer has designated the issue under section 265(b)(3)(B)(i)(III) (small issuer exception), check box . . . ?
39 If the issuer has elected to pay a penalty in lieu of arbitrage rebate, check box . . . ? ?
40 If the issuer has identified a hedge, check box ? ?
. . . . . . . . . . . . . . . . . . . . . . .
Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge
and belief, they are true, correct, and complete.
'n
ere 1 tollo - Margaret L. Simmons, Finance c)irec
a ?m
Signature of issues authorized representative Date Type or print name and title
For Paperwork Reduction Act Notice, see page 2 of the Instructions. Cat. No. 637736 Form 8038- (Rev. 11-2000)