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ONESOURCELABORATORY <br />SERVICES <br />Perkin <br />For the Befler <br />PerkinElmer Health Sciences, inc. <br />710 Bridgeport Avenue <br />SHELTON CT 06484-4794 <br />USA <br />TEL: (800) 762-4000 FAK (203) 944-4983 <br />Quotation Number <br />Quotation Date <br />40610817 <br />1112012017 <br />LYour Prior Agreement <br />Quote Expiration Date <br />35425014 <br />05122/2018 <br />Customer Contact <br />Your Prior PO Number <br />MICHELLE SMITH <br />234185 <br />Telephone Number <br />574-235-5994 <br />QUOTATION - SEE COVERAGE PLANS <br />Site Address: <br />MICHELLE SMITH <br />CITY OF SOUTH BEND <br />WASTEWATER TREATMENT PLANT <br />3113 RIVERSIDE DR <br />SOUTH BEND IN 46628 <br />USA <br />Site Number <br />1 00021642 <br />Payment Terms <br />Net 30 days <br />Coverage Period <br />05/10/2018 to 11/0912018 <br />Fax Number <br />BELOW <br />Invoicing Address (if different) <br />CITY OF SOUTH BEND <br />ACCOUNTS PAYABLE <br />227 W JEFFERSON BLVD <br />SOUTH BEND IN 46601 <br />USA <br />Customer Number <br />4013875 <br />Billing Plan <br />Yearly <br />Additional Notes- <br />1, This quotation is subject to the, terms and conditions attached and is valid until the expiration date shown above. <br />2. Customer is responsible for applicable taxes, including sale, use andlor excise tax unless otherwise noted above. <br />1 If Preventative Maintenance is covered under your agreement, please indicate any special date requirements below. <br />PM#1 <br />P M#2 <br />If any infornnafion presented on the document is incorrect e.9 Biffing address, serial numbers, please indicate the required changes below: <br />Page Number <br />4 of 4 <br />PLEASE SIGN THIS MAINTENANCE AGREEMENT QUOTATION AND RETURN ORIGINAL COPY ALONG WITHI YOUR PURCHASE <br />ORDER TO: <br />By Mail: By Fax, 203-944-4,983 <br />PerkinElmer Health Sciences, Inc. OR <br />710 (Bridgeport Avenue By E-mail: <br />Mail Stop 75 <br />Nelton, CT 06484-4794 <br />YOUR SIGNATURE BELOW CONFIRMS THAT YOU HAVE READ AND UNDERSTAND THE ABOVE STATEMENTS AND THAT THE <br />INFORMATION INCLUDED THEREIN IS CORRECT TO THE BEST OF YOUR KNOWLEDGE. <br />IN ORDER TO AVOID A LAPSE IN SERVICE COVERAGE,, PLEASE FORWARD A PURCHASE ORDER PRIOR TO THE EFFECTIVE <br />START DATE OF THE CONTRACT, <br />Accepted By: <br />Customer Purchase Order N77,7 <br />ql',) 7/ram <br />