Loading...
HomeMy WebLinkAboutBack-Up DocumentsCustomer Invoice 58 8755 S.W. 129th Street, Miami, FI 33176 Phone: 305-251-4067 Fax: 305-251-4588 www.ericsoutboard.com Eric's Outboard Marine Service 8755 SW 129th Street Miami„ FL 33176 305-251-4067 1-888-832-1426 Buyer Information City of Miami Accounts Payable 444 SW 2nd Avenue, 6th Floor Miami, FL 33130 NJU Year Make New 2021 YAMAHA New 2021 YAMAHA Salesperson Details Name: Cesar Gomez Phone: (305) 798-3357 Email: ceser@ericsoutboard.com PO# 1707985P 305-329-4763 561-351-0077 payables©miamigov.com Model Stock # VIN/1-1IN LF300XCB LF300XCB F300XCB F300XCB Manufacturer ()chops, Parts and Labar Repower-Twin DEC 6YC(L) TVVIN MAIN DEC REM, CNTRL(P) CL5 DISPLAY UNIT KIT - DEC ENG(P) SVIS2W/SDS (3 x 15-1/4 x 19)(P) SVVS2W/SDS (3 x 15-1/4 x 19-L)(P) Main ENG Harness, 10M(P) STARTSW KIT,TVVIN EN(P) CL7JCL5 INSTALL KIT DEC(P) 10FT MAIN BUS(P) 20W40 Yamalube Oil Gallon(P) --20W404amalube-Oil-Quart(P)----------- 6FT Pigtail Bus(P) 10M FUEL FLTR ELEMEN(P) Pricing, Details Manufacturer Base Price Price as Equipped Discount Unit Subtotal Net Selling Price Amount Financed $57,940.00 $66,150.20 ($12,151.00) $53,999 20 $53,999.20 553,999.20 Customer Date Dealer Representative Date Printed 0405/2021 RECIPIENT 1 GRANTEE Financial History Report Shaded cells are calculated for you. You do n DIVISION OF EMERGENCY MANAGEMENT Financial History and Performance Tracking PORN IA AGREEMENT# FY19 ()PSG- R0078 QUARTERLY REPORTING DUE DATES (Drop box list below select the quarter of activity being reported along with year) Period: ' January 1 - March 31 Due no later than April 30. need to enter anvthina into them. Category' Total Allocated Quarterly Fund Expended I Total Funds Expended Expenditure(s) Completion Percent Remaining Balance Planning Costs - Training Costs ( $ Exercise Costs I $ - Organization Costs $ - Equipment Costs $54,137.63 0% $ 54,137.63 M&A Costs {limited up toy%ofTotal Award) Total Expenditures $ - $ 54,137.63 i $ $ - 54,137.63 $ ? _ - Performance Tracking Project Title Category Start Date Projected End Date Percentage Completed Funds Allocated Budget) Project Status Operation Stonegarden Organization Costs € $ - ( Other Operation Stonegarden Equipment Costs 7/13/2020 I 3/31/2021 0% $ 54,137.63 Other Operation Stonegarden M&A Costs S - { Other $ - - _$ - TOTAL orAvera a Percenfa e7 in -In.:, N 54,137.63 ...' Cumulative Amount Previously Submitted for Reimbursement Total Received I hereby certify that the above cost are true and valid cost incurred in accordance vpith the project agreement. Signed: Date: Grant Manager I hereby certify that the above costs are true and valid costs incurred in accordance with the project agreement. Signed: Financial Officer By signing this report, I certify to the best of my knowledge and belief that the report is true, complete, and accurate, and the expenditures, disbursements and cash receipts are for the purposes and objectives set forth in the terms and conditions of the Federal award. I am aware that any false, fictitious, or fraudulent inform*ion, or the omission of any material fact, may subject me to criminal, civil or administrative penalties for fraud, false statements, false claims or otherwise. (U.S. Code Title 18, Section 1001 and Title 31, Sections 3729-3130 and 3801-3812). Date: Recipient I DIVISION OF EMERGENCY MANAGEMENT Quarte ;Iy Status Report FORM 1 B AGREEMENT# I FY19 OPSG- R0078 PROJECT STATUS (Equipment Training Exercise, Organization, Planning) TIMELINE OF EVENTS FOR REPORTING PERIOD OTHER (Optional) - Can report internal expenditures not yet claimed and/or any projected{ balance and reason (i.e. cost savings or cancelled projects). TECHNICAL ASSISTANCE Is technical assistance needed: If "yes', ere you requesting, onsite visit or phone call I hereby certify that the above information provided are true and the cost(s) are valid cos(s) incurred in accordance with the project agreement. Signed: Date: Grant Manager By signing this report, I certify to the best of my knowledge and belief that the report is true, complete, and', accurate, and the expenditures, disbursements and cash receipts are for the purposes and objectives set forth in the terms and conditions of the Federal award. I am aware that any false, fictitious, ar fraudulent nform4l©n, or the omission of any material fact, may subject me to criminal, civil ar administrative penalties for fraud. false statements, false claims or otherwise. (U.S. Code Title 18, Section 1001 and Title 31, Sections 3729-3730 and 3801-3812). DIVISION OF EMERGENCY MANAGEMENT REIMBURSEMENT REQUEST Form 2 RECIPIENT t GRANTEE AGREEMENT# FY19 OPSG• R0078 POC'Phone 'COSTS INCURRED DURING THE PERIOD OF: Agreement Amount Submission Date Payment # Payment Amount Shaded cells are calculated for you. You do not need to enter anything into shaded cells. 1. Planning Expenditures 2. Training Expenditures 3. Exercise Expenditures 4. Organizational Expenditures 5. Equipment Expenditures THROUGH THIS MUST BE ACCOMPANIED BY THE DETAIL OF CLAIMS FORM 6. Management and Administration Expenditures (limited up to 5% of the total award) TOTAL EXPENDITURES I hereby certify that the above costs are true and valid costs incurred In accordance with the project agreement. Signed: D I hereby certify that the above costs are true and valid costs Incurred In accordance with the protect agreement. Signed: Financial Officer Ey signing This repel, I certify to the best of my knowledge and belief that the report Is True, complete, and accurate, and the expenditures, disbursemenls and cash receipts are for the purposes and objectives set forth in the terms and conditions of the Federal award. I am aware that any false, fictitious, or fraudulent information, or the omission of any material fact, may subject me to criminal, civil or administrative penalties for fraud, false statements, false claims or otherwise. Dale: TO BE COMPLETED BY DEM STAFF AGREEMENT AMOUNT PREVIOUS PAYMENT(S) THIS PAYMENT REMAINING BALANCE TOTAL AMOUNT TO BE PAID ON THIS INVOICE DEM FORM OPB - 6 9114 DATE SUBMITTED TO FDEM DIVISION OF EMERGENCY MANAGE DETAIL OF CLAIMS FORM 3 SCROLL DOWN TO THE APPROPRIATE CATEGORY AND C SHORTCUT LINK TO EACH CATEGORY 1. Planning Expenditures 2. Training Expenditures 3. Exercise Expenditures 4. Organizational Expenditures 5. Equipment Expenditures 6. Management and Administration Expenditures (limited up to 5% of the total award if passing through funds, sub - awards} GRANTEE: COST INCURRED DURING THE PERIOD OF: MPLETE A FORM FOR EACH BEING CLAIMED AGAINST CATEGORY EQUIPMENT AGREEMENT # FY19 OPSG- R0078 THROUGH VENDOR DATE PAID CHECK # DESCRIPTION AMOUNT (Requested for reimbursement) Issue Number S0.00 TOTAL EXPENDITURES $0.00 FORM MUST ACCOMPANY THE REIMBURSEMENT REQUEST DIVISION OF EMERGENCY MANAGEMENT REIMBURSEMENT BUDGET BREAKDOWN FORM 4 FORM 1S BACKUP AND MUST ACCOMPANY THE 'REIMBURSEMENT REQUE FORM 2) AND TAIL OF CLAIMS' (FORM 3). BUDGET Total Allocated Current Claim Amours Previous Claims) Total Remaining Li no Item Allowable Planning Costs Quantityl lJn)t Cost Balance Issue # iglbal Eq A lA qsi lb C.bl . .,^ .r>s G grqu P a. ...% for N-a rn.-.0 q .n a 1 a M. .qa{+ 11.1 .Nq04 d, 0,,,, r a,c, Are la e.a eve an. t.. • �us^r w l ♦.. £ c e,k.',EL) o+t-a l.wrc-r Lr..-nade.lar.fr an s,0E, a�..77 ar•�t v.... ra at.Rp u¢ aa:a (szry tea KvzMaaa•. „ $ PwuruJProtece;. Er/Awned $0.00 $ - $ - $0.00 $ - - - Eapbak v Carelca R' f..; n LYd RaYlda:en Eqa' raM $0,00 $ 5 $ $0.00 5 $ CRRHE °IEr ued Search ami Rassw Edip-curt $0.00 $ - $ - $ $0.00 $ ' $. .... $ - In e+mn cn TccF.-e.`cur $0.00 5 - $ - 5 - $0.00 $ 5 _ Ca bur6a.erxyEre-uncured Equ pr-•1 $0.00 $ - $ - $ - $0.00 $ - $ - 5 - 4&usraraeoCurran cs, 1E94manC $0.00 $ - $ _. _. _ ..... .... ,.... .,.. ......... ............50.00 5 _ - --_$_ -.. $ ......._....-. [Vector, Eqa; Prr t ' $0,00 5 - $ - 5' 50.00 $ $ $ - G:ecrt^.;la:<n Eqipn-tcl 50.00 $ $ - $ - $0.00 $ - 5 - $ s'cd<al $0,00 $ ..t_5....._ - $ $0.00 $ $ $ - Pa., $0,00 $ 5 $ _. $0.00 5 $ - $ CUE RE E,, rare . s ,.. $0.00 $ - 5... - $0.00 $ - $ - $ - CeRlaE n ie 4 HasTonaa vane s $0.00 S 5 5 $0.00 $ - 5 - 5 Tula Arn lnc'6a,el. Pr c cn Egtor/rent $0.00 $ - 5 - $ - $0.00 $ $ - $ PnlnCal 6nc.4 ErEqucmara $0,00 $ - $ - 5- $0.00 $ - $ - $ - hue et on del suEenbg 5laims $0,00 $ u. $ $ $0.00 $ AgnClit ra TerreiST Pue.sn.ivr, Resperse, l.:y a:<n Egvprnerk $0.00 $ - $ - $ - $0.00 $ $ 3 - C9RllEIPaa.cn!' ,..1Res pmseWa'..eras 1 S 54,13/.63 $54,137.03 $ - $ - $ 54,137.63 $0.00 $ - $ - $ - BRIM A,'rcnE9JFruent $0.00 $ $0.00 $ $ -..5- $ - C6RNElag' t<almrlEpv{menl $0.00 $ $ - $0.00 $ - 5 - $ - In'kn<r,:cn EgWcer<nl $0.00 $, - $ - $ - $0.00 $ - $ 5 Stu Aafihv"ead Equ'vr. 1tme-K3a al/ esnseu1.c.«r0-''..-'ceo costs fn tivs crx rr: Wea :f rural rrersI ka prn.'dad by FEM.. rear In Cu torn cJ any Ands ka consquaria cc acrsva:mt $0.00 - $ - $ - $0.00 $ - $ $ - Equlpruent -SUB TOTAL $54,137.63 $0.00 $ - $ 54,137.63 TOTAL EXPENDITURES $54,137,63 $ - $0.00 $ 54,137.63 DIVISION OF EMERGENCY MANAGEMENT Procurement. Method Report Form 5 Vendor Name: Agreement ff; Invoice k: invoice Amount; FY19 OPSG- R0076 Attach to Applicable Invoice This report must be used to summarize methodology for all procurements. All forms mentioned are available at: hrfo/Awvv.11oridadisasterord/FinanceendAdmin/Procurement/7ndex.h rn Sub -grantee must check the federally debarred/suspended vendors of System for Award Management (previously called Excluded Parties List System) at twnv.sam-gov prior to execution of any procurement or contract. Check appropriate boxes below lJ Checked System for Award Management (SAM) for debarrtlenlfsuspension (Print page and attach) Sole Source and Single Vendor Response to a Competitive Bid Alt sole source procurements and single vendor response to a competitive bid require pre -approval by the Florida Division of Emergency Management Domestic Security Unit and use of the Sole Source Form (PUR 7776). FDEM's sole source approval documentation will be maintained In both the Jurisdictional and FDEM grant files. State Term Contract Stale Term Contract is available for commodity and service purchases, Discretionary Purchases Purchases up to $2,499: shall be carried out using good purchasing practices which may Include written quotations or written record of telephone quotes. $0 - $2,499 - Self-assurance and adequate competition must be documented for jurisdiction's grant files. Purchases greater than $2,500 but less than $35,000: Requires at feast three (3) written quotations or written record of telephone quotes that must be documented. 0 S2,500 - S34,090 - Certification Statement required for reimbursement (for each procurement). Written quotes from al feast three vendors. Written documentation attached. 1. Vendor Name 2. Vendor Name 3. Vendor Name 5etecttota..Meih. oil_&.. tus.tl Formal Solicitations Scope of Work (SOW) must be provided, Amount: Amount: Amount: Attach Additional Pagafa) as Needed for explanation. of Sal Don Process UUIlan d and JuS ttniadon. for Selection S35,000 - Greater - Written solicitation required and pre -approval from FDEM. FDEM Pre -Approval recelved date Invitation to Bid or Request for Proposal documents Published advertisement andlor solicitations. List all submitted proposalslvendor and the bid amounts Vendor award/selection criteria, Justification statement as to why vendor was chosen Contract award/Change Orders/Revisions/Amendments/etc. Alternative Contract Source Commodities or Services available to the State via outside contract vehicle. Only GSA Schedules 70 & 84 are available to the state. Sourcing from a General Services Adminlsrallon approved vendor lists ($0450,000) 1. Applicable Government Contract 2, Vendor Name Local form demonstrating procurement isacceptable in lieu of this report. I certify the above Information Is true and accurate and documentation related to this procurement Is on file and available upon request. Grant Manager Signature Gate Print Nance and Tnte By signing this report, I certify to the best of my knowledge and belief that the report Is true, complete, and accurate, and the expenditures, disbursements and cash receipts are for the purposes and oblectives set forth In the terms and conditions of the Fedora) award, I am aware that any false, fictitious, or fraudulent Information, or the omission of any material fact, may subject me to Criminal, civil or administrative penalties for fraud, false statements, false claims or otherwise, (U.S, Code Title 18, Section 1001 and Tiile 31, Sections 3729.3730 and 3801.3812), This report must be used to summarize the methodology for all procurements FedoraliStale Procurement References 80-A 1.002 Florida Administrative Code 287-057 F.S. Slates of Florida Statute 44 CFR 13,36 Code of Federal Regulations