HomeMy WebLinkAboutOpening of Proposals - Police Vehicle Decal Design and Application - LNR GraphicsLNR Graphics
Ronald Hoaks Phone: 574-298-2419
26174 Lakeview Dr. Fax:
AL
South Bend, IN 46619 E-mail:rhoaks@hotmail.com B'
Invoice#
Date 12-4-18
Bill To: Comments: Attn: Service Department
South Bend Police Dept.
701 W. Sample St.
South Bend, IN. 46601
574-235-9201
DATE �escriltion NUnit T"cltai
__ ... .......... _................. f
12 418 1'rR:te 1r r krr on SBPD cars 365.00
..........
12-4-18 Price to install graphics on SBPD gra p cars 150.00
MAIL CHECKS TO Subtotal
Ronald Hoaks Tax
............................
26174 Lakeview Dr. Shipping
South Bend, IN 46619 Miscellane-
Balance 1515.00
REMITTANCE
Statement#
Date 12.4-18
Amount Due
When the prospective Contractor is unable to certify to any of the statements below, it shall attach an explanation to this Affidavit.
CONTRACTOR'S NON -COLLUSION AND NON -DEBARMENT AFFIDAVIT,
CERTIFICATION REGARDING INVESTMENT WITH IRAN, EMPLOYMENT ELIGIBILITY
VERIFICATION, NON-DISCRIMINATION COMMITMENT AND CERTIFICATION OF USE
OF UNITED STATES STEEL PRODUCTS OR FOUNDRY PRODUCTS
(Must be completed for all quotes and bids. Please type or print)
STATE OF a F:
SS:
h COUNTY
The undersigned Contractor, being duly sworn upon his/her/its oath, affirms under the penalties of perjury that:
1. Contractor has not, nor has any other member, representative, or agent of the firm,
company, corporation or partnership represented by him, entered into any combination, collusion
or agreement with any person relative to the price to be bid by anyone at such letting nor to
prevent any person from bidding nor to induce anyone to refrain from bidding, and that this bid
is made without reference to any other bid and without any agreement, understanding or
combination with any other person in reference to such bidding. Contractor further says that no
person or persons, firms, or corporation has, have or will receive directly or indirectly, any
rebate, fee, gift, commission or thing of value on account of such sale; and
2. Contractor certifies by submission of this proposal that neither contractor nor any of its
principals are presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from participation in this transaction by any Federal department or agency;
and
3. Contractor has not, nor has any successor to, nor an affiliate of, Contractor, engaged in
investment activities in Iran.
a. For purposes of this Certification, "Iran' means the government of Iran and any agency or
instrumentality of Iran, or as otherwise defined at Ind. Code § 5-22-16.5-5, as amended from
time -to -time.
b. As provided by Ind. Code § 5-22-16.5-8, as amended from time -to -time, a Contractor is
engaged in investment activities in Iran if either:
i. Contractor, its successor or its affiliate, provides goods or services of twenty million
dollars ($20,000,000) or more in value in the energy sector of Iran; or
ii. Contractor, its successor or its affiliate, is a financial institution that extends twenty
million dollars ($20,000,000) or more in credit to another person for forty-five (45)
days or more, if that person will (i) use the credit to provides goods and services in
Non -Collusion Non -Debarment Affidavit Non Iran Fonn
the energy sector in Iran; and (ii) at the time the financial institution extends credit, is
a person identified on list published by the Indiana Department of Administration.
4. Contractor does not knowingly employ or contract with an unauthorized alien, nor retain
any employee or contract with a person that the Contractor subsequently learns is an
unauthorized alien. Contractor agrees that he/she/it shall enroll in and verify the work eligibility
status of all of Contractor's newly hired employees through the E-Verify Program as defined by
I.C. 22-5-1.7-3. Contractor's documentation of enrollment and participation in the E-Verify
Program is included and attached as part of this bid/quote; and
5. Contractor shall require his/her/its subcontractors performing work under this public
contract to certify that the subcontractors do not knowingly employ or contract with an
unauthorized alien, nor retain any employee or contract with a person that the subcontractor
subsequently learns is an unauthorized alien, and that the subcontractor has enrolled in and is
participating in the E-Verify Program. The Contractor agrees to maintain this certification
throughout the term of the contract with the City of South Bend, and understands that the City
may terminate the contract for default if the Contractor fails to cure a breach of this provision no
later than thirty (30) days after being notified by the City.
6. Persons, partnerships, corporations, associations, or joint venturers awarded a contract by
the City of South Bend through its agencies, boards, or commissions shall not discriminate
against any employee or applicant for employment in the performance of a City contract with
respect to hire, tenure, terms, conditions, or privileges of employment, or any matter directly or
indirectly related to employment because of race, sex, religion, color, national origin, ancestry,
age, gender expression, gender identity, sexual orientation or disability that does not affect that
person's ability to perform the work.
In awarding contracts for the purchase of work, labor, services, supplies, equipment, materials,
or any combination of the foregoing including, but not limited to, public works contracts
awarded under public bidding laws or other contracts in which public bids are not required by
law, the City, its agencies, boards, or commissions may consider the Contractor's good faith
efforts to obtain participation by those Contractors certified by the State of Indiana as a Minority
Business ("MBE") or as a Women's Business Enterprise ("WBE") as a factor in determining
the lowest, responsible, responsive bidder.
In no event shall persons or entities seeking the award of a City contract be required to award a
subcontract to an MBE/WBE; however, it may not unlawfully discriminate against said
WBE/MBE. A finding of a discriminatory practice by the City's MBE/WBE Utilization Board
shall prohibit that person or entity from being awarded a City contract for a period of one (1)
year from the date of such determination, and such determination may also be grounds for
terminating the contact for which the discriminatory practice or noncompliance pertains.
7. The undersigned contractor agrees that the following nondiscrimination commitment
shall be made a part of any contract which it may henceforth enter into with the City of South
Bend, Indiana or any of its agencies, boards or commissions.
Non -Collusion Non -Debarment Affidavit Non Iran Form
Contractor agrees not to discriminate against or intimidate any employee or applicant for
employment in the performance of this contract with privileges of employment, or any matter
directly or indirectly related to employment, because of race, religion, color, sex, gender
expression, gender identity, sexual orientation, handicap, national origin or ancestry. Breach of
this provision may be regarded as material breach of contract.
I, the undersigned bidder or agent as contractor on a public works project, understand my
statutory obligations to the use of steel products or foundry products made in the United States
(I.C. 5-16-8-1). I hereby certify that I and all subcontractors employed by me for this project will
use steel products or foundry products made in the United States on this project if awarded. I
understand I have an affirmative duty to notify the City in my bid that my proposal does not
include the use of steel products or foundry products made in the United States. I understand it is
my sole obligation and responsibility to provide a justification to the City, subject to review and
approval, why the cost of United States made steel or foundry products is unreasonable. Prior to
award and upon submission of bid which does not use steel products or foundry products made
in the United States, the City, through its director of public works, shall make a determination if
the price of United States made steel or foundry is unreasonable. 1 understand that violations
hereunder may result in forfeiture of contractual payments.
I hereby affirm under the penalties of perjury that the facts and information contained in the foregoing bid for
public works are true and correct.
�l
Dated this
........_ day of ° .., 21r._..
C ontracto /rddpr (Firm)
Sit, r Iturc of Con��/Bidder or Its Agent
2 ,4
Printed Name and Title
Subscribed and sworn to before me this —
My Commission Expires
County of Residence ,
Non -Collusion Non -Debarment Affidavit Non Iran Form
f . �, 201
Public
EEAL
NOTARt PUBLIC�
Commission
Number
694088 -
Ivry Com miisalon —
Jan 2T„ 205 �
VI,
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SCHEDULE C
(Forth 1040)
Department of the Treasury
Internal Revenue Service (09)
Name of proprietor
RONALD L HOAKS
Profit or Loss From Business
(Sole Proprietorship)
► Go to wwwJrs.gov/ScheduleC for instructions and the latest information.
► Attach to Form 1040, 1040NR, or 1041; partnerships generally must file Form 1065.
A Principal business or profession, including product or service (see instructions)
DESIGN APPLICATION
C Business name. If no separate business name, leave blank.
LNR GRAPHICS
2017
Attachment 09
S(aldw�arvare No
Social security number (SSN)
309-68-6998
B Enter code from Instructions
► 999999
D Employer ID number (EIN), (see instr )
E Business address (including suite or room no.) 26174 LAKEVI EW DR
it , town or post ZIP 2 UTH BEND ( 661� _..._
F Accounting method: office, state, � Cash d O �µAccOrual (3) Other specify) � _
_ IN 4
G Did you "materially participate" in the operation of this business during 2017�f "No," see instructions for m _ _...w.
limit on losses ;" Yes J No
H If you started or acquired this business during 2017, check here , . . . • . . . . . . , , , I , . , ►
hat
did YForms
NX
No
I If I "Yes," make
you or will payments
file 2017 t or would require you to file Forms 1.099? see instructions Yes No
income
1 Gross receipts or sales. See instructions for line 1 and check the box if this income was reported to you on
Form W-2 and the "Statutory employee" box on that form was checked ►
2 Returns and allowances . « . . » . I I . , < , • • . . , ... .
3 Subtract line 2 from line 1 • . . « . . « « . , . , , . . . . .
4 Cost of goods sold (from line 42)
5 Gross profit. Subtract line 4 from line 3 • • • • • • . • • • . • • • • • • . . . . . . .
6 Other income, including federal and state gasoline or fuel tax credit or refund (see instructions)
7 Gross Income. Add lines 5 and 6 « ►
M rt ii Ex en ee Enter expen come oni r on lire 30,
8 Advertising • • • • • . • • 8 )ffice expense (see instructions)
9 Car and truck expenses (see 'ension and profit-sharing plans
instructions) 9 tent or lease (see instructions):
10 Commissions and fees • • . �10 rehicles, machinery, and equipment
11 Contract labor (see instructions) 11 )ther business property
12 Depletion . . . . . • . • . . . W 12 Repairs and maintenance • • • •
13 Depreciation and section 179 Supplies (not included in Part III)
expense deduction (not faxes and licenses
included in Part III) (see •
instructions) • • • • • • • • 13 fravel, meals, and entertainment:
14 Employee benefit programs travel . . . . . . . . . . . . .
(other than on line 19) • . • 14 Deductible meals and
15 Insurance (other than health) 15 entertainment (see instructions)
16 Interest: Utilities . • • • • • • . . . . . .
a Mortgage (paid to banks, etc.) 16a Wages (less employment credits)
b Other • • • • • . . . . . . . . 16b Other expenses (from line 48) .
17 Legal and professional services �17 Reserved for future use • . •
28 Total expenses before expenses for business use of home. Add lines 8 tnr _
ough 27a ►
29 Tentative profit or (loss). Subtract line 28 from line 7 • • • • • • • • • • . . . . . . . . . . . . . . .
30 Expenses for business use of your home. Do not report these expenses elsewhere. Attach Form 8829
unless using the simplified method (see instructions)„
Simplified method filers only: enter the total square footage of: (a) your home:
and (b) the part of your home used for business: mmmmUse the Simplified
Method Worksheet in the instructions to figure the amount to enter on line 3W
_.._._._ _ ....__ ... 0
31 Net profit or (loss). Subtract line 30 from line 29.
a If a profit, enter on both Form 1040, line 12 (or Form 1040111 line 13) and on Schedule SE, line 2.
(If you checked the box on line 1, see instructions). Estates and trusts, enter on Form 1041, line 3.
• If a loss, you must go to line 32.
32 If you have a loss, check the box that describes your investment in this activity (see instructions).
• If you checked 32a, enter the loss on both Form 1040, line 12, (or Form 1040NR, line 13) and
on Schedule SE, line 2. (If you checked the box on line 1, see the line 31 instructions). Estates and
trusts, enter on Form 1041, line 3.
• If Lou checked 32b, you must attach Form 6198. Your loss ma be limited
Ished t....—......,.,...
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SCHEDULE C Profit or Loss From Business 9M8No 1545-0074
(Form 1040) (Sole Proprietorship) 2017
Daparlment of the Treasury
Internal Revenue Service (99)
Name of proprietor
RONALD L HOAKS
► Go to www.Jrs.gov/ScheduleC for instructions and the latest information.
A,ua4,kviwnT
► Attach to Form 1040, 1040NR, or 1041; partnerships generally must file For 1065. Soquencs No.
Social security number (SSN)
309--,68-6998
09
A Principal business or profession, including product or service (see instructions) B Enter code from instructions
TATTOO.. SHbp IN _. .... _.. _ - w ....._. ... ...._. _,. _. - . ►7 1 1 5:'110
C Business name. If no separate business name, leave blank. D Employer ID number (EIN), (see insir )
NADWE ZIµBE TATFOOS ETCmLLC _ 35-2035374
E Business address (including suite or room no.) ► 5 6 9 7 7_... Y F L w....... _ ..... ea--�f--- - ... W. m —
( 9 MAYFLOWER RD
........
City,town or post office, state, and ZIP code SOUTH BEND IN 46628
F Accounting method: (1) OCash 2 Accru. ..._ OT (specify) _
_ _ p
(► al � Other specify) ►
G Did you "materially participate" in the operation of this business during 2017? If "No," see instructions for limit on losses Yes No
H If you started or acquired this business during 2017, check here , „ . . . . ►
I Did you make any payments in 2017 that would require you to file Form(s) 'f099? (see instructions) Ix Yes _ No
I "Yes," did
F" t.. Forms 1099? �—�
_.. m.�• - - �•_.�.__.��_a..�.,.�� ..... .•_.� � Yes No
income
III ou file required ..._ _..
1 Gross receipts or sales. See instructions for line 1 and check the box if this income was reported to you on
Form W-2 and the "Statutory employee" box on that form was checked • . • • • • • . • • . . . . ►
2 Returns and allowances • • • • • • • • • • • • • . • . . • • . . . . . . . . . . . . . . . . . . . „
3 Subtract line 2 from line 1 . . . . • . . . . . . . . , . . . ,
4 Cost of goods sold (from line 42) • • • . • • . . . . . . . . . . . . . . . . . . . . .
5 Gross profit. Subtract line 4 from line 3 • • • • • • • . . • • . . . . . . • . . . . ,
6 Other income, including federal and state gasoline or fuel tax credit or refund (see instructions)
7 Gross income. Add lines 5 and 6 • • • • • • . • . • . . . . . . . . . . . . . . ►
ar �� ..Expenses. Enter exph_��.�_. ,. l.r bowie only on line 30..
8 Advertising . • • • • • . . • Office expense (see instructions)
9 Car and truck expenses (see Pension and profit-sharing plans
instructions) • • • • . • . • Rent or lease (see instructions):
10 Commissions and fees I Vehicles, machinery, and equipment
11 Contract labor (see instructions) i Other business property • • • •
12 Depletion • • • • • • • . . . . Repairs and maintenance • • •
13 Depreciation and section 179 Supplies (not included in Part III)
expense deduction (not d licenses
included in Part III) (see Taxes an . . . .
instructions) • • • • • • • • Travel, meals, and entertainment:
14 Employee benefit programs I Travel • • . • • . . . • • . . .
(other than on line 19) I Deductible meals and
15 Insurance (other than health) entertainment (see instructions)
16 Interest: Utilities • • • • • • . . . . . . .
a Mortgage (paid to banks, etc.) 1l Wages (less employment credits)
b Other • • • . . • . • . . . 1f I Other expenses (from line 48)
17 Legal and professional services 11 1 Reserved for -future use
28 Total expenses before expenses for I hrough 27a • . . . • • ►
29 Tentative profit or (loss). Subtract line 28 from line 7 • . • • . . • . . . . . . . . . . . . . . . .. ,
30 Expenses for business use of your home. Do not report these expenses elsewhere. Attach Form 8829
unless using the simplified method (see instructions).
Simplified method filers only: enter the total square footage of: (a) your home:
and (b) the part of your home used for business: U..•
•• —_-__ _ ......._� see the the Simplified
Method Worksheet in the instructions to figure the amount to enter on line 30 • • • • • • • • . . . . . .
31 Net profit or (loss). Subtract line 30 from line 29.
• If a profit, enter on both Form 1040, line 12 (or Form 1040NR, line 13) and on Schedule SE, line 2.
(If you checked the box on line 1, see instructions). Estates and trusts, enter on Form 1041, line 3.
• If a loss, you must go to line 32.
32 If you have a loss, check the box that describes your investment in this activity (see instructions).
• If you checked 32a, enter the loss on both Form 1040, line 12, (or Form 1040NR, line 13) and
on Schedule SE, line 2. (If you checked the box on line 1, see the line 31 instructions), Estates and
trusts, enter on Form 1041, line 3.
If you checked 32b,'you must attach Form 6198. Your loss maybe limited. -
State of Indiana
Office of the Secretary of State
CERTIFICATE OF ORGANIZATION
Me
NADWE ZIBE TATTOOS AND PIERCINGS STUDIO, LLC
I, TODD ROKITA, Secretary of State of Indiana, hereby certify that Articles of Organization
of the above Domestic Limited Liability Company (LLC) have been presented to me at my
office, accompanied by the fees prescribed by law and that the documentation presented
conforms to law as prescribed by the provisions of the Indiana Business Flexibility Act.
NOW, THEREFORE, with this document I certify that said transaction will become effective
Monday, October 03, 2005.
0 11 § SOro-- -��
�'
w
U.
In Witness Whereof, I have caused to be
affixed my signature and the seal of the
State of Indiana, at the City of Indianapolis,
October 3, 2005.
TODD ROKITA,
SECRETARY OF STATE,
2005100700612/2005100709727
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TAX In NUMBER DUPI ICArL NUMBER µR(}µERTY IYPF RILLIiD MC7R7C AC'r GUM['ANY
M -00 13886125 2017 Payable 2018 Personal
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9fi 00 Warren Townslu 2 L1'7 ®8 8410 , � R WP4 ^n
_.�. cI. —LI$007
PROPERrY NU BCR
TAXING UNIT NAME 1 OI AI�CAX RATE Tm A A'U V 9 RC 6
Net Property Tax Sprint
Delinquent Ta
Delinquent Penalt
Owner of Record for payable 2018 is Ronald L Honks Penalty & Fee
81400*199**G50**0.574**1/2*********AUT05-DIGIT46619 ,Other ASsessmenl
LNR GRAPHICS Current Ta
26174 LAKEVIEW DR Delinquent Ta
SOUTH BEND IN 46619-4587
Delinquent Penalt
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PROPERTY NUMBER TAXING UNIT NAME
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LNR GRAPHICS
26174 LAKEVIEW DR
SOUTH BEND IN 46619-4587
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By 05/10/2018:
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PROPERTY
7 YPE BILLED MOR CGAGE COMPANY
2018 1psonal
TOTAL TAX RATE Tmr IAVIl RC'RI II,CI R
2.6217 _ 8 8410 .. m 84111
Net Property Tax Fall
Penalty & Fee:
Other Assessment
Current T-w
TAX ITT .... _
NUMBER DUPLICAT
71 021 07 �t"M(rddCl 13886125 2017 Pa able2018
PROPrRTYNUMBER TAXING UNIT NAME
Property Address: 26174 Lakeview Drive South Bend IN 46619
Property tax payments can be made in South Bend at
the { a%ty-("tty IJullding, 22.7 W. Jefferson Blvd.
Monday - Friday, 8J)0 AM to 4:30 PM.
LNR GRAPHICS
26174 LAKEVIEW DR
SOUTH BEND IN 46619-4587
PAY 1'H-11,'� AM W ; By 1/13/201. :
PROPERTY TYPE
101 AL TAX RATE Tmi AV PrRC R.W
2.6217 8.8410
G® Paperless
Sign up for e-billing at
w""y"1"'*Pall t�� 1t''t,"dl1"11111k�« �`t�'11"1
with this code:
STJ-Z35PBAD2
BIT. LED MORTGAGE COMPANY
L)'r I! Rale
Total Net Property Taa
Delinquent Tax
Delinquent Penalt)
Penalty & Fee
Other Assessment
Current Ta
Delinquent Tr
Delinquent Penal
Less Payments Recei\
Current Account Balance:
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'TAX TV) NUMBER DUPLICATE NUMBER I
71-017-05593-00 686394.7. 2017 PaLtle-
PROPERTY NUMBER �Tl�a UNIT NAME
71-125-05593-00
wner of Record for payable 2018 is Ronald L Hoaks
www
82198*20 V *G50**0.574** 1/2** ***AUTOS -DIGIT 46619
NA-DWE'ZIBE TATTOOS ETC LLC
56977 MAYFLOWER RD
SOUTH BEND IN 46619-2211
1111111111. 1-11-11 Ill. I.... Fill .... 111, 11-1.
3006863047 000000000000
L `lif'R 11.:
TAX IDNUMBER DUPLICATE NUMBER
71 _017 -05,593-00 6863047:_L2017
PROPERTY NUMBER TAXING UNIFNAME
71-125-05593-00Ponta e1 ovdnsh
,III 111 11111111 1111111111
weer of Record for payable 2018 is Ronald L Hoaks;
NADWE'ZIBE TATTOOS ETC LLC
56977 MAYFLOWER RD
SOUTH BEND IN 46619-2211
0006863047 000000000000
TAX ID NUMBER DUPLICA rr NUMBER
71-017-05593-00 6863047 2017
PROPERTY NUMBER ' TAXING UNIT NAME
71-125-05593-00 Porta'gq:El
Iroperty Address: 56977 Mayflower Rd South Bend IN 46628
rolVerty tax payments can be made in South Bend at
ie County -City Building, 227 W, Jefferson Blvd.
londay - Friday, 8:00 AM to 4:30 PM.
PROPERTY TYPE BILLED MORTGAGE COMPANY
TOITL� VtKIE lowl8AV8 PI PC It—, LIT 7846 , 8 (') j
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Net Property Tax Spri
Delinquent
Delinquent Pen
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Delinquent Pena
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PAY THIS, A M 0 U N'T By 05/10/2018:
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PROPERTY
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TOTAL TAX RATE 1,12,1 AV PTRCR2,I,
27946 9.8410
BILLED MORTGAGE COMPANY
WMER=
Net Property Tax Fall
Penalty & Fees Other Assessments
Current Tax:
PAY 'THIS AMOUNT By 11/13/2018:
PR0PERTY1YPL
Personal
roTALTAX RATE
2.7846
Go Paperless
Sign up for e-billing at
www.enoticesoiiline.com
with this code:
BILLED MORTGAGE COMPANY
1.1.1 At PTRC R.W LIT 1% Ral007
e
Total Net Property Tax
Delinquent Tax:
Delinquent Penalty:
Penalty & Fees:
Other Assessments
Current Tax:
Delinquent Tax:
Delinquent Penalty:
NADWE'ZIBE TATTOOS ETC LLC STI-WK61.112RF
56977 MAYFLOWER RD
SOUTH BEND IN 46619-2211 Less Payments Received:
C -ent Account Balailee:
Barre
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LNR Graphics
26174 Lakeview dr.
South Bend, IN 46619
PH: 574-298-2419
To Whom:
Enclosed are copies of tax papers showing that LNR does business in
the state of IN. and St. Joseph County. Where work is conducted on the
South Bend police vehicles, my home owners ins. covers any and all
liabilities for all vehicles. Federal tax ID 35-2035374 which is Nadwe
Zibe Tattoo, LLC and doing business as LNR Graphics.
I have worked with several of the city chiefs and many others on SBPD
for the last 16yrs on your designs and installations for the cars and many
other departments in the SBPD city.
I also have the contract for St. Joseph County police department LNR
works with Major Chandler. LNR Graphics also has the contract for
Norte Dame PD and other departments related to the PD.
I already have all art work and designs for SBPD so there forth there is
no cost for art work or design. For the most of cars and SUV's the price
for graphics kit is 365.00 for graphics and for most vehicles to install
complete car is 150.00. This is for whole vehicles, it gets broken down
per what they need if wrecked. If parts are needed they get ran that day
or the next so vehicle can be put back into service as fast that it can be
and there is no shipping cost or waiting on parts because LNR delivers
to body shop, or we install them the next day after body shops
deliveries the vehicle to us.
LNR Graphics only provides SBPD graphics to the city of SBPD and not
to anyone else.
LNR graphics provides a 1 yr warranty on all installed graphics for any
reason that went wrong on our part. We provide a 5yr warranty on any
fading that is a part of material issues.
LNR Graphics has ADT and Xfinity for security with surveillance.
LNR is located less then 10 mins from City Garage and has in side
storage with year round climate control. Storage and shop is located at
26174 Lakeview Dr; South Bend, IN 46619
Any question please call Ron Hoaks at 574-298-2419.
Owner Ronald Hoaks
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