HomeMy WebLinkAboutQPA Equipment Lease - AT&T Capital Services - iPads and Microsoft Surfaces for Various City Depts1316 COUNTY-Crry BuILUNG Ga
MACE MA
227 W, 11*1"FERSON BotiLEVARD
So� rrii BEND. INDIANA 46601,-1830
CITY OF Sourti BEND PETE BUTTIGIEG, MAYOR
BOARD OF PUBLIC WORKS
June 12, 2018
Dick Martin
AT&I'Capital Services, Inc.
36 S. Fairview Avenue, Floor I
Park Ridge, IL 60�068-4016
RE: QPA Equipment Lease
Dear Mr. Martin:
PHOW, 574/235-9251
FAX 574/ 235-9171
The Board of Public Works, at its meeting held on June 12, 2018, approved the above
referenced lease for iPads and Microsoft Surfaces for various City departments in the
amount of $513.25 per month for thirty-six (36) months, for a total of $18,477.
Enclosed please find the original of the lease for your signature. Please sign and return the
original agreement to our office and retain a copy for your records.
If you have any further questions regarding this matter, please call this office at (574) 235-
925L
Sincerely,
Linda M. Martin, Clerk
Enclosure
c: Shawn Delahanty, Innovation and Technology
GARY A. GILOT SUZANNA M, FizITZBER(i EiAZABE-ni A. MARADIK JAMFs A. MuEi,t,L,*iz THERLSE T. DORAU
11491% L� �
IIV �
10 114 A
0
City of South Bend 227 W Jefferson Blvd
TO: Board of Public Works, Linda Martin
CC Dan O'Connor, Jennifer Hockenhull, Michael Schmidt, Sandi Kennedy, Benjamin
Dougherty
FROM: Shawn Delahanty
SUBJECT: QPA Lease of iPads and Surfaces
DATE., 5/22/2018
Linda and Members of the Board
We are submitting for review and approval the QPA lease of 16 iPads with accessories and 10
Microsoft Surfaces. The total cost over 36 months will be $17,217.34.
The iPads will be used by the below departmients:
• Code Enforcement (2 iPads) — additional inspectors, used for Accela in the field
• 'SPA (3) — used for taking square payments and for field surveys at locations including
the East Race
• Water Works (5) — For use with upgraded mobile Maximo apip
• Traffic & Lighting (6) — for field use
The Surfaces will be used by the below departments:
• Building Department (9) — replace obsolete Surfaces for field inspectors
® Police Department (1) — expanding the pilot use for desktop replacement to 2 total
users in the Detective Bureau
Thank you.
n1
yv--eav
Shawn Delahianty
A T& T Capital Services, lilt.
Dick Martin Direct: 1-847-720-0631
a
36S, Fairview Avenue, Floor 1 E-mail W432@ottcam w Park Ridge, IL 60068-4016
May 18, 2018
The City of South Bend, Indiana
227 West Jefferson Blvd.
South Bend, IN 46601
Opportunity#: 1-74747915
AT&T Capital Services, Inc. is pleased to provide a proposal for the lease of the equipment and/or services as submitted to us.
The proposed lease terms are as follows:
NOTE: AT&T EQUIPMENT/SERVICES CONTRACT IS REQUIRED BEFORE ORDER CAN BE PROCESSED.
Amount Requested: $17,217.34
Pricing proslurnes Qty 16 ea. Apple iPad 32 GB @ $10.73/nionth, 16 Qty Native Union Belt CaNe @
Comments: $38/nionth, 16 Qty Ventev Car Charger (q) $38/month, 10 Qty Microsoft Surface Pro Tablet 256 GB
@ $31.65/month
Rates quoted are for commercial leases only.
Subject to execution of Mutually Acceptable Documentation.
Quoted Lease Payments Exclude Any Applicable Taxes.
Payments may be indexed up until lease commencement.
Customer agrees to allow AT&T Capital Services, Inc. to file UCC Financing Statements,
Credit Approval will be withdrawn, 120 days following the date of this letter if the lease has not commenced.
Approval is pending verification of corporate name and final verification of credit information,
Shipping Charges are not included in Data Equipment.
$250.00 processing fee for lease cancellation prior to commencement if P0 is issued.
Lessee's failure to execute mutually acceptable documentation relative to this lease within ninety (90) days of the lessee's first functional
use of the system will result in this lease converting to cash.
For quoted maintenance — lease term and payment amount are subject to change after installs Is completed.
End of Lease Options
$1 Purchase Option
Customer purchases the equipment for $1 at the end of the lease term.,
Thank you for this leasing opportunity. I am looking forward to working with you.
Sincerely, APP40VUlD
Dick;'AllartIn AGREED TO AND ACCEPTED BY: ftRIA ftf p
Inside Sales Manager The City of South Bend, Indiana
Name: 41
Title:
Date:
AT&T Capital Services, Inc.
36 S. lrairview Ave.
Park Ridge, IL 6068-4016
Office: 8001.323-7312
Fax: 847/326-0573
11-u-sces-
SM
AT&T M:uni Mobility 0
Financing Agreement
Number: 1-2340900-003
Dated: May 18, 2018
Customer fufJ legal name
THE CITY OF SOUTH BEND, INDIANA
Telephone number
Fax number
J
Fe. ;ra1 Employer Id Number (Required)
Federal
_(5� 24_1_56205
7e_
Contact Name
"all Address
SHAM N DELAHANTY
I sdefahan@southbendjn.q)v
HeadquarterAddiess
coy
state zip
County
227 WESTJEFFERSON BILVD,
SOUTH SEND
46601
LocatloM If different from above
--IN
CRY
state zip
County
227 WEST JEFFERSON BLVD.
SOUTHBEND
IN 46601
Equipment Detail
Equipment Description
Mobility- Microsoft Surface Pro Tablet with accessories, !Pad 32613 & accessotles
EquipmentSupplier AT&T Mobility Corporation
bGnCUUIC CITUCIrIlTal r-aymenIts
Purchase option
One Dollar
Down Payment fit applicable)* I Term finmanths] Total number of paymentsi 36 in Arrears
*Payable
Monthly
36
Servicex, Inc. and doe upon execution oflids Agreement.
Payments". 36 at $513.25
Remaining at $_ (plus applicable taxes]
Acknowledgement
Accepted By
Customer hereby certifies that he/she has read and age to all ofthe terms and
THIS AGREEMENT IS NOT SINDINUNTILACCEPTED BY LENDER.
conditions set forth an pages 1-3 of this AT&T Mobility Financing mement.
Customer imameTHE CITY OF SOUTH BEND, INDIANA
DBA:
AT&T CAPITAL SERVICES, INC.
A PTW V U p
Name and Title (please mad Pahlors
of ic wk
Name and Title (please Print)
Signature PIN I
slanature
kA�
Forni. Rev. 2-16-2017 Page 1 of 3
Terms and Conditions
1. AGREEMENT - Subject to the terms and conditions of this AT4,T Muni
Mobility Financing Agreement (the "Agreement"), Customer agrees to finance
from Lender the equipment (the "Equipment") described on page 1 of this
Agreement. The Agreement shall commence an the date the Equipment Is
delivered to the customer ('Commencement Date") and shall continue for the
number of months specified in the Agreement ( Term").
Customer's failure to execute this Agreement within ninety (90) days of the
delivery of the Equipment will result in this Agreement converting to a cash
sale, with payment due and payable immediately.
2. PAYMENTS - During the Term of the Agreement, Customer agrees to
pay Lender the total number of payments multiplied by the amount of each
payment (plus taxes) specified on page 1 of the Agreement. The due date of
the first payment is the date upon which the Equipment is delivered to
Customer or any later date designated by Lender. Restrictive endorsements
on checks sent to Lender will not reduce Customer's obligations to Lender.
The payment amount specified Is indexed to lute -term US Treasury Bills, and
any Increase or decrease in the corresponding US Treasury Bills will cause the
payment to be adjusted point for point at the time of the Commencement Date.
The payments do not include any additional Interest expense for progress
payments which are required by Lender on all transactions with installations
exceeding 60 days. Progress payments will be financed through Lender at
Prime Rate plus 2% at time of funding.
3. NON -CANCELABLE AGREEMENT - Customer's obligation to make
payments and to pay any other amounts due hereunder shall be ABSOLUTE
AND UNCONDITIONAL and shall not be subject to any delay, cancellation,
termination, reduction, set-off, defense, counterclaim or reeoupment for any
reason whatsoever. This Is an irrevocable Agreement for the full Term and
cannot be cancelled, other than for Non -Appropriation, as hereinafter defined.
4. NOWAPPROPRIATION: This Section is appltcable only if the inclusion
of such a non -appropriation provision is legally required. Cuslomaeu
obligations to pay Payments and any other amounts due for each fiscal period
is contingent upon approval of the appropriation of funds by its governing
body. In the event funds are not appropriated for any fiscal period equal to
amounts due under the Agreement, Customer may terminate the Agreement
effective on the first day of such fiscal period ("Termination Date'), if, (a)
Customer has used due diligence to exhaust all funds legally available; and (b)
Lender has received written notice from Customer at least thirty (30) days
before the Termination Date, Upon the occurrence of such non -appropriation,
Customer shalt not be obligated for Payments for any fiscal perlod for which
funds have not been so appropriated, and Customer shall deliver the
Equipment to Lender on the Termination Date, packed for shipment in
accordance with the manufacturer's specifications, freight prepaid and Insured
to any location in the continental United States designated by Lender. If
Customer ferminates an Agreement pursuant to this Section, unless the
following would affect the validity of a Agreement, Customer will not purchase,
lease, rent, seek appropriations for, or otherwise obtain equipment serving the
same function as the Equipment for the fiscal period in which such termination
occurs or the next succeeding fiscal period and such an obligation will survive
termination of this Agreement
5. DELIVERY AND ACCEPTANCE - Customer understands that Lender
Is not responsible for delivery of Equipment. Customer holds Lender harmless
from specific performance of this Agreement and from any damages if for any
reason the manufacturer, supplier, vendor or distributor (collectively referred to
in this Agreement as 'Vendor") delays in delivery, or if the Equipment is
unsatisfactory.
6. WARRANTY DISCLAIMER - CUSTOMER AGREES THAT IT HAS
SELECTED THE VENDOR AND PRODUCT BASED UPON ITS OWN
JUDGEMENT AND DISCLAIMS ANY RELIANCE UPON ANY
STATEMENTS OR REPRESENTATIONS MADE BY LENDER. LENDER
MAKES NO WARRANTY WITH RESPECT TO THE PRODUCT. EXPRESS
OR IMPLIED, AND LENDER SPECIFICALLY DISCLAIMS ANY WARRANTY
OF MERCHANTABILITY AND OF FITNESS FOR A PARTICULAR
PURPOSE AND ANY LIABILITY FOR CONSEQUENTIAL DAMAGES
ARISING OUT OF THE USE OF OR THE INABILITY TO USE THE
PRODUCT. WARRANTIES MADE BY THE VENDOR TO THE LENDER
SHALL INURE TO THE BENEFIT OF THE CUSTOMER, TO THE EXTENT
ASSIGNABLE. IF THE EQUIPMENT DOES NOT OPERATE AS
REPRESENTED, WARRANTED OR GUARANTEED BY VENDOR, OR ARE
UNSATISFACTORY FOR ANY REASON, CUSTOMER SHALL MAKE ITS
CLAIM AND ANY COMPLAINT THEREFOR AGAINST VENDOR, AND NOT
AGAINST LENDER AND SHALL CONTINUE TO MAKE ALL PAYMENTS
REQUIRED HEREUNDER. CUSTOMER ACKNOWLEDGES THAT VENDOR
IS NOT AN AGENT OF LENDER AND STATEMENTS OR
REPRESENTATIONS OF THE VENDOR SHALL NOT BIND OR. AFFECT
LENDER, AND SHALL NOT AFFECT THE CUSTOMER'S OBLIGATIONS
UNDER THIS AGREEMENT.
7. NO AGENCY - Customer acknowledges that (1) there is no agency or
joint venture between Lender and the Vendor, (2) neither the Vendor nor any
other person is authorized to act on Lender's behalf, and (3) ONLY AN
INDIVIDUAL AUTHORIZED BY LENDER IS PERMITTED TO WAIVE OR
ALTER ANY TERM OR CONDITION OF THIS AGREEMENT.
8. ASSIGNMENT - LENDER MAY ASSIGN ITS INTEREST IN THIS
AGREEMENT WITHOUT CUSTOMER`S CONSENT. CUSTOMER AGREES
THAT IN ANY ACTION BROUGHT BY AN ASSIGNEE AGAINST
CUSTOMER TO ENFORCE LENDER'S RIGHTS HEREUNDER, CUSTOMER
WILL NOT ASSERT AGAINST SUCH ASSIGNEE, AND EXPRESSLY
WAIVES AS AGAINST ANY ASSIGNEE, ANY BREACH OR DEFAULT ON
THE PART OF LENDER HEREUNDER OR ANY OTHER DEFENSE, CLAIM
OR SET-OFF WHICH CUSTOMER MAY HAVE AGAINST LENDER EITHER
HEREUNDER OR OTHERWISE. NO SUCH ASSIGNEE SHALL BE
OBLIGATED TO PERFORM ANY OBLIGATION, TERM OR CONDITION
REQUIRED TO BE PERFORMED BY LENDER HEREUNDER.
8. QUIET ENJOYMENT - Provided that no Event of Default (as defined in
Section 12 herein) has occurred or is continuing hereunder, Lender shall not
interfere with Customer's right of quiet enjoyment and use of the Equipment.
10. TAXES AND FEES - Customer shall pay when due and shall Indemnify
Lender for, and hold Lender harmless from and against all federal, state, and
local Fling fees, assessments, taxes including without limitation, sales, lease,
use, excise and personal property taxes (excluding only taxes payable with
respect to Lender's net income) whfoh may be imposed on the Lender arising
in any way out of the use or leasing of the Equipment. Such amounts shall be
considered additional rent and shall be payable by Customer upon demand by
Lender.
The obligations under this section shall survive the expiration or termination of
this Agreement.
11, INDEMNITY - Customer hereby inderrrnfffes Lender and holds Lender
harmless from any and all claims, actions, suits, proceedings, costs,
expenses, damages and liabilities, including attorney's fees, arising out of or
connected with the Equipment or the use thereof, including without limiting the
generality of the foregoing, Its manufacture, selection, delivery, possession,
use, leasing, fitness operation, return, or latent or otherdefects, whether or not
discoverable, or arising out of any failure by Customer to perform or comply
with any of the terms and conditions of this Agreement. The indemnities
contained herein shall continue In full force and effect notwithstanding the
termination of this Agreement, whether by expiration of time, by operation of
taw, or otherwise,
12. DEFAULT AND REMEDIES - If Customer (a) does not pay rent within
ten (10) days after the same becomes due, (b) breaches any of its
representations, warranties or other obligations under the Agreement, (c) is in
default under any other agreement between Customer and Lender (d)
becomes insolvent or assigns its assets for the benefit of its creditors, or (e)
enters (voluntarily or involuntarily) a bankruptcy proceeding ("Event(s) of
Default"), Customer will be in default. Upon the occurrence of an Event of
Default, Lender may require that Customer pay the remaining balance of all of
the rental payments due underthis Agreement, present valued using a 3% per
year discount rate. Customer also represents to Lender that interest on all
sums due Lender from the date of default until paid will he at the rate of one
and one-half percent (1-1129/6) per month, but only to the extent permitted by
law. In addition, Lender shall be entitled to recover from Customer any of the
remedies available under the Uniform Commercial Code ("UCC") or any other
law. It Lender refers this Agreement to an attorney or collection agency for
enforcement or collection, Customer agrees to pay the cost of recovery
including, but not limited to, legal fees and expenses,
Customer Initials
Page 2 of3
Form. Rev, 2 162017
13. OTHER RIGHTS -Customer agrees that any delay or failure to
enforce Lender's rights under this Agreement does not prevent Lender from
enforcing any rights at a later time. Customer and Lender intend this
Agreement to be a valid and legal document, and agree that If any part is
determined to be unenforceable, all other parts will remain in full force and
effect.
14. ENTIRE AGREEMENT; CHANGES - This Agreement contains the
entire agreement between Customer and Lender and supersedes ail
previous discussions and the terms and conditions of any purchase orders
issued to andlor by Customer and it may not be altered, amended, modified,
terminated or Otherwise changed except in writing and signed by Customer
and Lender. The descriptive headings hereof do not constitute a part of the
Agreement and no inferences shalt be drawn there from. Whenever the
context of the Agreement requires, the masculine gender Includes the
feminine or neuter, and the singular number includes the plural, and
whenever the word Lender its used herein, it shall include ail assignees of
Lender. If there is more than one Customer names[ In ft Agreement, the
liability of each shall be joint and several.
15, NOTICES. r All of Customer's notices to Lender must be sent by
certified mail or recognized Overnight delivery service, postage prepaid, to
Lender's address stated in this Agreement, or by facsimile transmission to
our facsimile telephone number, with oral confirmation of receipt. Lenders
notices to Customer may be sent first class mail, postage prepaid, to
Customers address stated in this Agreement.
OPINION OF COUNSEL
16. MISCELLANEOUS - Customer and Lender Intend and agree that a
photocopy or facsimile of this Agreement and all related documents, with
their signatures thereon shall be treated as originals, and shall be deemed
to be as binding, valid, genuine and authentic as an original signature
document for all purposes. This Agreement Is a "Finance Agreement' as
defined in Article 2A of the UCC.
17. JURISDICTION - This Agreement shall be governed by the laws of
the state in which the Customer is located.
18. CUSTOMER REPRESENTATIONS - customer represents and
warrants that (1) It has complete and unreslricted power to enter into this
Agreement, (ii) the persons executing thin Agreement have been duly
authorized to execute this Agreement on Customers behalf, (ill) all
information supplied to Lender Is true and correct, including all credit and
financial information and (iv) it is able to meet all its financial obligations,
Including the rent payments hereunder.
THE LOGO APPEARING ON THIS DOCUMENT IS A FEDERALLY REGISTERED TRADEMARK
AND MAY NOT BE USED IN ANY WAY NOR MAY THIS DOCUMENT BE ALTERED OR
MANIPULATED VOTHOUT THE PRIOR EXPRESS WRITTEN CONSENT OF AT&T CAPITAL
SERVICES, INC. CUSTOMER MAY TRANSFER THIS DOCUMENT FROM ELECTRONIC FORMAT
TO A TANGIBLE ONE BY PRINITNp IT IN ITS UNALTERED STATE.
Customer initials �
With respect to that certain AT&T Muni Mobility Financing Agreement (the Agreement') dated by and between AT&T Capital Services, Inc. and the Customer,
am of the opinion that. (i) the Customer is, within the meaning of Section 103 of the internal Revenue Code of 1986, as amended, a State or a fully constituted
politioal subdiv"Ision or agency of the State of the l=qulpment location described herein; (It) the exeeutlon, delivery and performance by the Customer of 1he
Agreement have been duly authorized by all necessary action on the part of the Customer, and, (iii) the Agreement canstilutes a legal, valid and binding
obligation of the Customer enforceable In accordance with Its terms.
Attorney for Customer
Page 3 of 3
Fam3. Rev. 2-16 2017
Fan, 8038-0
(Rev. January 2012)
Department of the Treasury
Internal Revenue Service
Information Return for Small Tax -Exempt
Governmental Bond Issues, Leases, and installment Sales
* Under Internal Revenue Code section 149(e)
Caution: if the issue price of the issue is $100, 000 or more, use Foma 8038-G.
ONIS No, 1545-0720
1 Issuer's name
2 Issuer's employer Identification number (EIN)
THE CITY OF SOUTH BEND, INDIANA
3 Number and street (or R0, box it mail Is not delivered to street address)
Hoorwsuite
227 WEST JEFFERSON BLVD
4 City, town, or post office, state, and 2tP code
5 Report number (For IRS Use Only)
SOUTH BENDr IN 46601
07 I
B Name and title of officer w other employee of issue(or designated conlact person whom the IRS may call for more InfomratIon
7 Tolephone number of officer at legal representatrva
574 245.6205
Lleacnptlon of Mligalions unecK one: a single Issue IJ or a consonclatea return
❑ .
Sa
Issue price of obltgation(s) (see Instructions) . . . . . . . . . . . . . . . . . .
8a
b
Issue date (single Issue) or calendar date (consolidated). Enter date In mm/dd/yyyy format (fora,
r
example, 01/01/2009) (see instructions) 0-
9
Amount of the reported obligation(s) on fine Ba that is;
a
For leases for vehicles . . . . . . . . . . . . . . . . . . . . . . . . .
9a
b
For leases for office equipment . . . . . . . . . . . . . . . . . . . . . . .
9b
c
For leases for real property . . . . . . . . . . . , . . .
90
d
For leases for other (see instructions) . . . . . . . . . . . . . . . . .
9d
e
For bank loans for vehicles . . . . . . . . . . . . . . . . . . . . . . . .
9e
f
For -bank loans for office equipment . . . . . . . . . . . . . . . . . . . . .
of
9
For bank loans for real property. . . . . . . .
9
h
For bank loans for other (see instructions) . . . , , . . . . . . . . . . . . .
9h
1
Used to refund prior Issues) . . . . . . . . . . . . . . . . . . . . . . .
9i
I
Representing a loan from the proceeds of another tax-exempt obligation (for example, bond bank)
91
kOther
. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
9k
10
If the issuer has designated any issue under section 265(b)(3)(B)(i)(I11) (small issuer exception), check
this box . . . . ► ❑
11
If the issuer has elected to pay a penalty in lieu of arbitrage rebate, check this box (see instructions)
. . . . . ► ❑
12
Vendor's or banks name;
13
'Vpndnr'�, nr hank'Q P.m nrnunr lelpntjfir•afinn nr,mkm-,
Signature
and
Consent
Paid
Preparer
Use Only
hder perraltles of penury, I declare that I have examined this retum and awAxnpanyfing schedules and statements, and to the best of my knowledge and berief, they are
ue, correct, and complete. I further declare that f consent to the IRS's discbsure of the issuer's return information, as necessary to process this return, (o the person(s)
at I have auguired above,
-7 4-
Signature of issuer's authorized representative Date Type or print name and Attie
;UTYpe praparer's name Preparers signature Date check 0 if ""
Pinn's name i► Firm's EIN ■
Firm's address I► Phone no.
General Instructions
Section references are to the Internal Revenue
Code unless otherwise noted.
What's New
The IRS has created a page on IR8,gov for
Information about the Fotm 803B series and
Its instructions, at wwwJrs.gov/fonnW38.
Information about any future developments
affect#ng the Form 8038 series (such as
legislation enacted after we release €t) will be
posted on that page.
Purpose of Form
Form 8039-G0 is used by the Issuers of tax-
exempt governmental obligations to provide
the IRS with the information required by
section 14g(e) and to monitor the
requirements of sections 141 through 150.
Who Must File
Issuers of tax-exempt governmental
obligations with Issue prices of less than
$100,000 must file Form 808-G0.
Issuers of a tax-exempt govemmental
obligation with an issue price of $100,000 or
more must file Form 8038-G, Information
Return forTex-Exempt Governmental
Obligations.
Filing a separate return for a single issue.
Issuers have the option to file a separate
Form 8038-GC for any tax-exempt
governmental obligation with an Issue price
of less than $100.000.
An issuer of a tax-exempt band used to
finance construction expenditures must file a
separate Form 8038-GC for each issue to give
notice to the IRS that an election was made to
pay a penalty in lieu of arbitrage rebate (see
the line 11 instructions).
Filing a consolidated return for multiple
issues. For all lax -exempt governmental
obligations with issue prices of less than
$100,000 that are not reported on a separate
Form 8038-CC, an issuer must V@ a
consolidated information return inotuding all
such issues issued within the calendar year.
Thus, an issuer may fife a separate Form
8038-GC for each of a number of small issues
and report the remainder of small Issues
issued during the calendar year on one
consolidated Form 8038-GG, However, if the
Issue is a construction issue, a separate Form
8038-GC must be filed to give the IRS notice
of the election to pay a penalty In lieu of
arbitrage rebate.
Cat.No.64103B Form SOM-112110 (Rev, 1-2012)
Fort 6038-GG (Rev. 1-2012)
When To File
To file a separate return for a single issue, file
Form 8(138-GC on or before the 15th day of
the second calendar month after the close of
the calendar quarter in which the issue is
Issued.
To file a consolidated return for multiple
issues, file Form 8038-GC on or before
February 15th of the calendar year following
the year in which the issue Is Issued.
Late tiling. An issuer may be granted an
extension of time to file Form 8038-00 under
section 3 of Rev. Proc. 2002-48, 2002-87
I.R.B. 531, if it Is determined that the failure to
file on time Is not due to willful neglect. Type
or print at the top of the form, "Request for
Relief under section 3 of flev. Proc. 2002-48."
Attach to the Form 8038-GC a letter briefly
stating why the form was not submitted to the
IRS on time. Also indicate whether the
obligation in question is under examination by
the IRS. Do not submit copies of any bond
documents, leases, or installment sale
documents, See Where To Fife next.
Where To File
File Form 8038-GC, and any attachments,
with the Department of the Treasury, Internal
Revenue Service Center, Ogden, UT 84201.
Private delivery services. You can use
certain private delivery services designated by
the IRS to meet the "timely mailing as timely
filing/paying" rule for tax returns and
payments. These private delivery services
include. only the following:
• DHL Express (DHL): DHL Same Day Service,
• Federal Express (FedEx); Fed Ex Priority
Overnight, FedEx Standard Overnight, FeclEx
Way, FedEx International Priority, and FedEx
International First.
■ United Parcel Service (UPS): UPS Next Day
Air, UPS Next Day Air Salver, UPS 2nd Day
Air, UPS 2nd Day Air A.M., UPS Worldwide
Express Plus, and UPS Worldwide Express.
The private delivery service can tell you
how to get written proof of the mailing date.
Other Forms That May Be
Requires!
For rebating arbitrage (or paying a penalty in
lieu of arbitrage rebate) to the Federal
Government, use Form 6038-T, Arbitrage
Rebate, Yleid Reduction and Penalty in Lieu
of Arbitrage Rebate, For private activity
bands, use Form 8038, Information Return for
Tax -Exempt Private Activity Bond Issues.
For a tax-exempt governmental obligation
with an issue price of $100,000 or more, use
Fora 8038-G.
Founding to Whole Dollars
You may show the money items on this return
as whole -dollar amounts. To do so, drop any
amount less than 50 cents and increase any
amount from 50 to 99 cents to the next higher
dollar.
Definitions
Obligattons. This refers to a single tax-
exempt governmental obligation if Form
8038-GC is used for separate reporting or to
multiple fax -exempt governmental obligations
ii the form is used for consolidated reporting.
Tax-exempt obligation. This is any obllgagan
Ineiudtng a bond, installment purchase
agreement, or financial lease, on which the
interest Is excluded from incoma under
section 103.
Tax-exempt governmental obligation. A
tax-exempt obligation that is not a private
activity bond (see below) is a tax-exempt
governmental obligation. This Includes a bond
Issued by qualified volunteer fire department
under section 150(e).
Private activity bond. This Includes an
obligation issued as part of an Issue In which:
More than 10% of the proceeds are to be
used for any private activity business use, and
More than 10% of the payment of principal
or interest of the Issue Is either (a) secured by
an interest in property to be used for a private
business use (or payments for such property)
or (b) to be derived from payments for
property (or borrowed money) used for a
private business use.
It also includes a band, the proceeds of
which (a) are to be used to make or finance
loans (other than loans described in section
141(c)(2)) to persons other than governmental
units and (b) exceeds the lesser of 5% of the
proceeds or$5 mifl€on.
Issue. Generally, obligations are treated as
part of the same issue only if they are issued
by the same issuer, an the same date, and as
part of a single transaction, or a series of
related transactions. However, obligations
Issued during the same calendar year (a)
under a loan agreement under which amounts
are to be advanced periodically (a "draw -
down loan") or (b) with a term not exceeding
270 days, may be treated as part of the same
issue if the obligations are equally and ratably
secured under a single indenture or loan
agreement and are Issued under a common
financing arrangement (for example; underthe
same official statement periodically updated
to reflect changing factual circumstances),
Also, for obligations Issued under a draw -
down loan that meets the requirements of the
preceding sentence, obligations issued during
different calendar years maybe treated as
part of the same issue 9 all of the amounts to
be advanced under the draw -down roan are
reasonably expected to be advanced within 3
years of the date of Issue of the first
obligation. likewise, obligations (other than
private activity bonds) Issued under a single
agreement that is In the form of a lease or
installment sale may be treated as part of the
same Issue if all of the property covered by
that agreement is reasonably expected to be
delivered within 3 years of the date of issue of
the first obligation.
Arbitrage rebate. Generally, interest on a
state or local bond is not tax-exempt unless
the Issuer of the bond rebates to the United
States arbitrage profits earned from Investing
proceeds of the bond in higher yielding
nonpurpose investments. See section 148(f).
Construction issue. This Is an issue of tax-
exempt bonds that meets both of the
following conditions,.
Page 2
1. At least 75% of the available construction
proceeds of the Issue are to be used for
construction expenditures with respect to
property to be owned by a governmental unit
or a 501(c)(3) organization, and
2. All of the bonds that are part of the Issue
are qualified 601(o)(3) bonds, bonds that are
not private activity bonds, or private activity
bonds issued to Finance property to be owned
by a governmental unit or a 501(c)(3)
organization.
In lieu of rebating any arbitrage that may be
awed to the United States, the issuer of a
construction Issue may make an Irrevocable
election to pay a penalty. The penalty is equal
to 1--112% of the amount of construction
proceeds that do not meet certain spending
requirements. See section 148(f)(4)(C) and the
Instructions for Form 8038-T.
Specific Instructions
In general, a Form 8038-GC must be
completed on the basis of available
Information and reasonable expectations as of
the date of Issue. However, forms that are
filed on a consolidated basis may be
completed on the basis of information readily
available to the issuer at the close of the
calendar year to which the form rotates,
supplemented by estimates made in good
faith.
Part I -Reporting Authority
Amended return. An Issuer may file an
amended return to change or add to the
information reported on a previously filed
return for the same date of Issue. if you are
filing to correct errors or ohange a previously
filed return, check the `Amended Return" box
in the heading of the form.
The amended return must provide all the
information reported on the original retumr in
addition to the new corrected information.
Attach an explanation of the reason for the
amended return and write across the top
'Amended Return Explanatlon."
Line 1. The issuer's name is the name of the
entity issuing the obligations, not the name of
the entity receiving the benefit of the
financing: In the case of a lease or installment
sale, the issuer is the lessee or purchaser.
tine 2. An Issuer that does not have an
employer Identificatfon number (EIN) should
apply for one on Form SS-4, Application for
Employer Idant€fication Number. You can get
this form on the IRS website at IRS.gov or by
calling 1-800 TAX -FORM (1-800-829-3676).
You may receive an EIN by telephone by
following the instructions for Form SS-4.
Lines 3 and 4. Enter the issuer's address or
the address of the designated contact person
listed on line 8. If the issuer wishes to use its
own address and the issuer receives its mail
in care of a third party authorized
representative (such as an accountant or
attorney), enter on the street address line
"C/O" followed by the third party's name and
street address or P.O. box. Include the suite,
room, or other unit number afterthe street
address. If the post office does not deliver
mall to the street address and the issuer has a
P.O. box. show the box number instead of the
Farm 6MR-GO (Rev. 1-2012)
street address. If a change in address occurs
after the return is filed, use Form 8822.
Change of Address, to notify the IRS of the
new address.
Note. The address entered on lines 3 and 4 is
the address the iRS will use for all written
communications regarding the processing of
this return, Including any notices. By
authorizing a person other than an authorized
officer or other employee of the Issuer to
communicate with the IRS and whom the iRS
may contact about this return, the issuer
authorizes the IRS to communicate directly
with the individual listed on fsne 6, whose
address is entered on lines 3 and 4 and
consents to disclose the issuer's return
information to that Individual, as necessary, to
process this return.
Line 5. This line is for IRS use only. Do not
make any entries In this box.
Part ii—Description of Obligations
Check the appropriate box designating this as
a return on a single issue basis or a
consolidated return basis.
Line Sa. The issue price of obligations is
generally determined under Regulations
section 1.148-1(b). Thus, when Issued for
cash, the Issue price is the price at which a
substantial amount of the obligations are sold
to the public. To determine the issue price of
an obligation issued for property, see sections
1273 and 1274 and the related regulations.
Line 9b. For a single Issue, enter the date of
issue (far example, 0311 5/2010 for a single
issue issued on March 16, 2010), generally
the date on which the issuer physically
exchanges the bonds that are part of the
Issue for the underwriter's (or other
purchaser's) funds; for a lease or installment
sale, enter the date Interest starts to accrue.
For issues reported on a consolidated basis,
enter the first day of the calendar year during
which the obligations were Issued (for
example, for calendar year 2010, enter
01/01/2010).
Lines 8a through 8h. Complete this section if
property other than cash is exchanged for the
obligation, for example, acquiring a police car,
afire truck, or telephone equipment through a
series of monthly payments. (Phis type of
obligation is sometimes referred to as a
"municipal lease.") Also complete this section
if real property is directly acquired In
exchange for an obligation to make periodic
payments of interest and principal.
Do not complete lines 9a through 9d H the
proceeds of an obligation are received in the
farm of cash even if the term "lease" is used
in the title of the issue. For lines ga through
9d, enter the amount on the appropriate line
that represents a lease or installment
purchase. For line 9d, enter the type of item
that Is leased_ For lines go through 9h, enter
the amount on the appropriate fine that
represents a bank loan. For line gh, enter the
type of bank loan.
Lines 91 and 9i. For line 91, enter the amount
of the proceeds that will be used to pay
principal, Interest, or call premium on any
other issue of bondsr including proceeds that
will be used to fund an escrow account for
We purpose. Several lines may apply to a
particular obligation. For example, report on
lines 9i and 9j obligations used to refund prior
issues which represent loans from the
proceeds of another tax-exempt obligation.
Line 9k. Enter on line 9k the amount on line
Ba that does not represent an obligation
described on lines gathrough 9J.
Line 10. Check this box if the Issuer has
designated any issue as a "small Issuer
exception" under section 265(b)(3)(B)(i)GII).
Line 11. Check this box If the issue Is a
construction issue and an irrevocable election
to pay a penalty in lieu of arbitrage rebate has
Wen made on or before the date the bonds
were issued. The penalty is payable with a
Form 8038-T for each 6-mont h period after
the date the bonds are issued. Do not make
any payment of penalty in lieu of rebate with
Form 8038-GC. See Rev. Proc. 92-22,
1992-1 G.B. 736, for rules regarding the
"election document."
Line f 2 Enter the name of the vendor or bank
who is a party to the installment purchase
agreement, loan, or financial lease. If there
are multiple vendors or banks, the Issuer
should attach a schedule.
Line 13. Enter the employer identification
number of the vendor or bank who is a party
to the installment purchase agreement, loan,
or financial Tease. If there are multiple vendors
or banks, the issuer should attach a schedule
Signature and Consent
An authorized representative of the issuer
must sign Form 8038-GC and any applicable
certiftoatlon. Also print the name and title of
the person signing Form 5038-CC. The
authorized representative of the Issuer slgning
this form must have the authority to consent
to the disclosure of the issuer's return
information, as neoessary to process this
return, to the person(s) that has been
designated in this form.
Note. tf the issuer authorizes In line 6 the IRS
to communicate with a person other than an
officer or other employee of the issuer, (such
authorization shall include contact both in
writing regardless of the address entered in
lines 3 and 4, and by telephone) by signing
this fort, the Issuer's authorized
representative consents to the disclosure of
the Issuer's return information, as necessary
to process this return, to such person.
Page S
Paid Preparer
it an authorized representative of the issuer
filled in its return, the paid preparer's space
should remain blank, Anyone who prepares
the return but does not charge the
organization should not sign the return.
Cedaln others who prepare the return should
not sign. For example, a regular, full-time
employee of the Issuer, such as a clerk,
secretary, etc., should not sign.
Generally, anyone who is paid to prepare a
return must sign it and fill In the other blanks
in the Paid Preparer Use Only area of the
return. A paid preparer cannot use a social
security number In the Paid Pmparer Use Onfy
box. The paid preparer must use a preparer
tax identification number (PTIN). If the paid
preparer Is self-employed, the preparer
should enter his or her address in the box.
The paid preparer must:
• Sign the return in the space provided for the
preparer's slg nature, and
• Give a Copy of the return to the issuer.
Paperwork Reduction Act Notice
We ask for the information on this form to
carry out the Internal Revenue laws of the
United States, You are required to give us the
information. We need it to ensure that you are
complying with these laws,
You are not required to provide the
information requested on a form that is
subject to the Paperwork Reduction Act
unless the fora displays a valid OMB control
number. Books or records relating to a form
or its instructions must be retained as long as
their contents may become material in the
administration of any Internal Revenue law.
Generally, tax returns and return information
are confidential, as required by section 6103.
The time needed to complete and file this
form will vary depending on individual
circumstances. The estimated average time is:
Leamfng about the
law or the form . . . . 4 hr., 46 min.
Preparing the form . . , 2 hr., 22 min.
Copying, assembling, and
sending the form to the IRS 2 hr., 34 min.
If you have comments concerning the
accuracy of these time estimates or
suggestions for making this form simpler, we
would be happy to hear from you. You can
write to the Internal Revenue Service, Tax
products Coordinating Committee,
SE:W:CAR:MP:T:M:S,1111 Constitution Ave.
NW, IR-6526, Washington, QC 20224. Do not
send the form to this address, instead, see
Where 7b file.
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BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW RE, QUEST FORM
5/22,/2018
Shawn Delahantv
Department Innovation & Tech
BPW Date 6/12/2018 Phone Extension 6205
E=== Required Prior to Submittal to Board
Legal Attorney Name Kennedy
Controller review is required for all Contracts $5,000.00 or more
Controller Z and greater than one year in length per the City Purchasing
Policy
Check the Appropriate Item Type - Required for All Submissions _J
R Agreement El Contract El Proposal El Addendum
El Professional Services R Amendment
EJ Bid Opening El Bid Award El Req. to Advertise El Title Sheet
El Quote Opening ❑ Quote Award
F-1 Chg Order No. ❑ C/O & PCA No. ❑ PCA
❑ Ease./Encroach. Traffic Control El Resolution
Other: Hardware Lease D Claim
Company or Vendor Name
New Vendor
Project Name
Project Number
Funding Source
Account No.
Amount
Terms of Contract
AT&T Mobility
0 Yes El If Yes, Approved by Purchasing
E] No
El MBE Completed E-Verify Form Attached
F] WBE
Mobile Tablet Lease
IT Lease Account
279-0672-415-37-11 (principal)_and 37-12 (interest)
$513.25 per month for 36 months ($143r-,477 total)
36 months
F-1 Yes
F-1 No
Purpose/Description 16 ipads for SBWW, Traffic & Lighting, VPA, Code; Surfaces for
Building Dept and Police
For Change Orders OnI
Amount of❑ increase $
El Decrease $
Previous Amount $
Current Percent of Change: %
New Amount $
Total Percent of Change: %
Time Extension: Dispersal After Approval
Copy Original
M ❑ Shawn Delahanty
❑ F-1