HomeMy WebLinkAbout2554 Midpoint Dr - Miscellaneous - 04/09/1997NOV-15-99 MON 10:11 AM ADVANCED RFGTECH 9704951814
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City of Fol't Collins _ 1
D L A N R E T E 8 E M Y T I D N C$ R T I F I C A T E
(For use by States, Territories, or political subdivision thereof)
Date April 9 - 1997
The undersigned hereby certifies that she is Ana hoernicke
�un
Senio�potant of the city of Fort
(Title of officer) (State, Territory or political
subdivision)
authorized to execute this certificate and that the article or articlea
specified in the accompanying orders, or on the reverse side hereof, are
purchased from Advanced $oofiag for the exclusive use
of the _.._s ty of Fort Col 1 incz __ of the State of CQ orado _
(Governmental Unit) (State, Territory or political
subdivision)
I_ is understood that the exemption from tax in the case of sales of articles
under this exemption certificate to a state, ste., is limited to the sale of
arl�icles purchased for its exclusive use, and it is agreed that if articles
purchased tax free under this exemption certificate are used otherwise or are
sold to employees or others, such fact will be reported by me to the
lanufacturer of the article or articles covered by this certificate. It is
also understood that the fraudulent use of this certificate to secure
ex�mpticr. *.dill subject the unde-r�iglred and -ail guilty parties to a fine of
no: more that $10,000.00 or to imprisonment for not more than five years, or
both, together with costs of prosecution.
C'tate of Colorado Department of Revenue, Certificate of Exemption
Tdentification Number 98-04502.
(Signature)
--- ��—S-aII] 1?Lg no try nt _,__
(Title of officer)