HomeMy WebLinkAboutCORRESPONDENCE - GENERAL CORRESPONDENCE - BLANKET EXEMPTION CERTIFICATEAdministrative Services
Finance Administration
City of Fort Collins BLANKET EXEMPTION CERTIFICATE
(For use by States, Territories, or political subdivision thereof)
Date: Tuesday, October 10, 2006
The undersigned hereby certifies that she is Nancy Watkins, Administrative
Clerk I of City of Fort Collins to execute this certificate and that the article or articles
specified in the accompanying orders, or on the reverse side hereof, are purchased from
RESEARCH IN MOTION for the exclusive use of the City of Fort Collins of the
State of Colorado.
It is understood that the exemption from tax in the case of sales of articles under this
exemption certificate to a State, etc., is limited to the sale of articles 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 manufacturer of the article or articles covered by this certificate. It
is also understood that the fraudulent use of this certificate to secure exemption will
subject the undersigned and all guilty parties to a fine of not more than $10,000.00 or to
imprisonment for not more than five years, or both, together with costs of prosecution.
State of Colorado Department of Revenue, Certificate of Exemption
Identification Number 98-04502.
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Nancy Watkins — Accounting Dept.
(Title of Officer)
215 North Mason Street • 2nd Floor • P.O. Box 580 • Fort Collins, CO 80522-0580 • (970) 221-6788 • FAX (970) 221-6782
TRANSACTION REPORT P,01
t OCT-10-06 TUE 03:11 PM
SEND(M)
DATE START RECEIVER TX TIME PAGES TYPE NOTE M# DP
�K OCT-10 03:10 PM 915197465793 44" 2 SEND ( M) OK 186
TOTAL 44S PAGES: 2
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CUSTOMER INF RIYIATION
You may pay for your order either by credit card or by completing this Customer Information Sheet.
Please fax the completed application to 1-877-746-3296
Customer Information.:
Full Legal Name & Address of Company: City of Fort Collins, Colorado, USA
Billing Address: p0 Box 580, Fort Collins Colorado, b5A
Bill -to contact name (attention line on invoice): A l 'i c j a M i o do ns k i
Payment T erms
Years in Business:
Business Currency S$ GBP, Euro, Cdn $):
Net 30 from date of invoice
over 100 years
Name of Customer Payinglnvoices: Alicja Mi.odonski
. -
P, 01
TRANSACTION REPORT
t
OCT-10-06
TUE 03:18 PM
>K
SEND(M)
>K DATE START RECEIVER
TX TIME PAGES TYPE
NOTE
Mi«
DP
OCT-10 03:17 PM 918777463296
Of 2 SEND
(-M) OK
188
TOTAL
49S PAGES;
2
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CUSTOMER INFORMATION SHEET
You may pay for your order either by credit Cana or by Completing this Customer Information Sheet.
Please fax the completed application to 1-877-746-3296
Customer Information:
Pull Legal Narne & Address of Company:
City of Fort Collins, Colorado. USA
Billing Address:
PO Box 580, Fort Collins Colorado. bSA
Bill -to contact name (attention line on invoice); Alicia Mi odo ns k i
Payment Terms Net 30 from date of invoice
Years in Business; over 100 years
Business Currency S$ GBP, Euro, Cdn S):
Name of Customer Paying Invoices: Alicja Modonski
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