ORDER NO. 29495 DISCUSS LEASE PURCHASE AGREEMENT FOR ASPHALT ZIPPER MILLING MACHINE Came to be heard this the 12th day of December, 2005, with a motion made by Commissioner Letz, seconded by Commissioner Williams. The Court unanimously approved by vote of 4-0-0 to: Approve and accept Lease Purchase Agreement for Asphalt Zipper Milling machine for Road and Bridge including approval of payment of $500 for document processing fee and an additional $15 for UCC filing and authorize County Judge to sign same. a~~9S I ' ~ COMMISSIONERS' COURT AGENDA REOUEST PLEASE FURNISH ONE ORIGINAL AND TEN COPIES OF THIS REOUEST AND DOCUMENTS TO BE REVIEWED BY THE COURT. MADE BY: Pat Tinley OFFICE: County Jud MEETING DATE: December 12, 2005 TIME PREFERRED: SUBJECT: Consider, discuss and take appropriate action on Lease Purchase Agreement for Asphalt Zipper Milling machine for Road and Bridge including approval of payment of $500 for document processing fee and an additional $15 for UCC filing and authorize County Judge to sign same. EXECUTIVE SESSION REQUESTED: (PLEASE STATE REASON) NAME OF PERSON ADDRESSING THE COURT: County Judge ESTIMATED LENGTH OF PRESENTATION: IF PERSONNEL MATTER -NAME OF EMPLOYEE: Time for submitting this request for Court to assure that the matter is posted in accordance with Title 5, Chapter 551 and 552, Government Code, is as follows: Meeting scheduled for Mondays: 5:00 P.M. previous Tuesday. THIS REQUEST RECEIVED BY: THIS REQUEST RECEIVED ON: All Agenda Requests will be screened by the County Judge's Office to determine if adequate information has been prepared for the Court's formal consideration and action at time of Court Meetings. Your cooperation will be appreciated and contribute towards your request being addressed at the earliest opportunity. See Agenda Request Rules Adopted by Commissioners' Court. '. r KERR COUNTY ATTORNEY REX EMERSON COUNTY COURTHOUSE, SUITE BA-103 700 MAIN STREET November 30, 2005 Leonard Odom Department Supervisor Road and Bridge RE: Asphalt Zipper Milling Machine Contract- Security State Bank Deaz Leonard: KERRVILLE, TEXAS 78028 The enclosed contract contains "standard" language for a this type of lease. Please review the highlighted paragraphs of the contract to determine their feasibility relative to your budget, operation etc. Should you have any questions or concems please contact me. If the there are no concerns, please give Judge Tinley your blessing to proceed. ex Emerson MAIN NUMBER (830) 792-2220 ~ HOT CHECKS (830) 792-2221 FAX (830) 792-2228 Sent Yia Email: ssbtketr(nyktc.com November 22, 2005 David Derry Security State Bank & Trust Re: Financing for One (1) Asphalt Zipper Milling Machine, Kerr County Deaz Mr. Derry: Please bad the enclosed documentation for your review and completion An instruction sheet has been included as a guide to assist you with the process. The documentation has been filled out according to the terms and amount shown on the formal proposal. If you have questions or comments please call. For your convenience, we have listed the documentation that is required before funding: - ^ The Lease I77Y t.L .XHIBIT'S ITFD ORRFCTT Y - ^ d03d IRS Form -File Form with the Internal Revemte Service Center, Philadelphia, PA 19255 - ~ Insurance CerfiJ'cicate listing Security State Bank & Trust as Loss Payee & Additionallnsured - ^ Copy ojlnvatce for Exact Amount to Finance (indicating trade & down payment) - (~ Front & Back Capy ajMSO~tIe lisHttg Security State Bank & Trust as first lienholder (if applicable) - ^ UCC-1 Forms Please note that an invoice for SSOOAO is enclosed for the preparation of the documents. Please remit payment to Baystone Financial Group, 2312 Anderson Ave., M,nhattan, KS 66502. If you have any questions regarding the above documentation, please feel free to contact me. Sincerely, Amy Miller Documentation Associate Documentation Instructions The instnudions listed below should be foNowed when completing the enclosed documentation, t)ocumentation completed improperly wip delay funding. B you have arty questions regarcting the instructions or the documentation, please call us. I. LEASE WITH OPTION TO PURCHASE AGREEMENT EXCEPT AS NOTED, ALL S/GNATURES MUST BE BY THE PERSON OR PERSONS AUTHORIZED MI EXHIBIT E 1. The Agreement • Sign artd type name and title 2. Exhibit A -DESCRIPTION OF E4UIPMENT • Type in complete equipment description • Type the location where the equipment wit be boated alter delivery/i~tatlation. 3. Exhibit B -PAYMENT SCHEDULE • Sign and type name and title 4. Exhibit C -CERTIFICATE OF ACCEPTANCE • Type in essential use of equipment • Sign and type name and title 5. Exhibit D -OPINION OF COUNSEL • Request that your legal counsN oomplete the opinion of counsel section by retyping the example given on his/her letterhead with their signature. • Leaal counsel shat not alter the oainbn. B. Exhibit E -LESSEE RESOLUTION • Type in the date of the meeting in which the purchase was approved. • Print or type the name and title of the individual(s) who is authorized to execute the Agreement • The secretary, chairman or other authorized !ward manlxr of the Lessee moat sign the resolution where Indicated. • A third individual must attest the Resolution where indicated. T. Exhibit F, BANK QUALIFIED CERTIFICATE • Sign and type name and title II. 8038 -IRS Fonn ^ In Box 2, type employer ides ^ Sign and type name and title III. CERTIFICATE OF INSURANCE ^ Attach a written certificate (binder) of proof of insurance with S .,,rrty crate Bank & T ~ +as loss payee"and "additional insured' ^ SEEATTACHED INSURANCE REQUIREMENTS IV. ADDITIONAL DOCUMENTATION THAT MUST BE SENT TO Security State Bank & Trust: 0 Vendor invoice '- ^ Copy ofWe/W1S0listing Security State Bank 6 Trust as 1si lienhokler (If applicable) ^ First payment check (d applicable) All documentation should be returned to: Security State Bank & Trust, 1130 Junction Highway, Kerrville, Texas 78028 ~_ ~~ ~~ ~aR ~~ ~4 ~a B6 16 ~ ~ ~~ ~a ~~~~~ ~n~~~ ~~~ ~~~~ ~a~ '~ ~ ~ ~a ~~ ~~ ~~ ~~ a~ ~~ ~. ~~ ~~a ~9 555 .F ~nR$g~g @& N A 3 $ qa ~~~~~^ "m S n g~a~~~~ ~~ ~°~yyg~~p ~~Z 4II g ~~~ ~~~ ~~ s ~ ~ B4 ~~ ~~ ~q ~~ s ~~ m~ ~~ ~~ ~ ~qq~y R l6Q ~- ~n~ a ~~ ~~ ~~ ~#~ ~~ a~ ~a~ ~~~ °3 $ ~~~ g~ Q ~~ 3~ 6~ ~~ ~~ ~~ ~~~ ~~ s .~ a ~~ ~~ ~~ ~~ ~~ ~~ 3R m ~ V ~ ~~~ a 3 ~ ~ x ~~ d 3 °V° N °° J 0 J m c ~7 :` m~~' q=~ ~~ ~~~ Q ~~~~~ ~$ ~~~~ ~~~~ n ~~~ ~~ ~~ss ~~~r~~ ~s ~, ~g~~ s~~~ ~~~~ ~ ~~~ ~~~ ~~ ~ ~~s~ y~~~ $~~~~~ ~~~ ~ ~~ ~~ ~~~ ~ ~$ £~ 159~~.t0 ~~~~~~ ~~ g~~ W ~$~ ~g~ ~~ CP a ~~ ._~ ~8 4 g a ~~ o~ ~~ L h s ~~ ~~ ~~~ e~ ~~ ~~ ~~ ~~ ~~ Sb~ ~~~ ~~~ ~g$$gW ~ 8~ ~s~ ~~6 a ~ ~~ ~ ~; ~~ ~~ 98 ~~ ~~ ~~ $~~ ~E~ ~ ~ ~ ° ~~ ~~~ ~~ ~~~ ~$5~ ~~~t~ .~~~~ ~~ ~~ ~~ r~~ ~~ ~~~~~~s ~~s~ ~£~~ E~~~~~ °~ ~~~~~ ~~ ~~ ~b~ . s~~g ~~9~~ ~$ ~~ ~~ ~~g. ~ ~ a ~~~~ ~~~~~ e~ ~~ m~ $~ ~ ~~ ~ .= ~8~~ ~~~E ~~ ~~~~ ~~~~ s ~~~ ~ ~~~~ ~ ~ ~ ~~ ~ ~g ~8 ~~ ~~'~ ~~~ ~g ~~~ ~ ~~ ~ a ~~9 ~ ~~ ~ d ~ ~~ '~&~ ~~~~ ~~; ~ ~a;~~~~ ~~~ ~~~s ~~ ~~~ ~m g~ ~~~ ~'~~~~ ~~~~~~ ~~~ ~~ ~ ~ ~ 9~ ~~ ~~_~. ~~~~~~~ tiW~~ Ale ~~~~~ ~~~ ~b~ ~~~ ~~~ ~~~ ~~ ~9 g ~o s ~ ~ ~~~~ ~~ s 8~ p~ ~ ~ ~~ ¢~~ ~~~ ~~ ~~~ ~~~~ ~~ £~ ~ ~ ~8 ~ ~Q ~; ~ s~ ~, ~~ ~~ ~~ ~~~ ~; a m ~ ~~ ~~ a~ ~~ ~~ m ~~~~ ~a ~ ~' ~~ ~~ ~ ~ a ~ ~' ~~ B ~ g ~ ~ $5 ~~ ~~mBBg ~~ ~~~~~~ ~~~~ ~~$ g m soh ~~~ ~~~~ ~~as~e s ~~~~~~ s~ ~=~g ~~ g$~~ ~°a ~~ ~w _ ~~~ . ~~ ~~~ Ems ~ ~E~~ ~ ~$ ~~~~~~~ ~~ ~ ~ ~~ ~~ ~~~~ _~~~~ s $~ a~~ W s ~ ~~~~ ~~~ p ~~~ ~~$~~~~ ~~~~ ~~ b4 ~~ s ~~ ~8~ ~~~~ ~~~ s~~~~ ~~~ ~~~ g .~ a a~~ ~~ ~~ ~~ Q~ ~~ a~~ nag ~W~ ~~ ~~~ ~~ ~~ ~~ 'e ~ ~ at ~ ~ P~ ~ ~~ S ~ ~~~ ~~ ~8 8~~ ~g ~~9b ~~ B~ ~~ ~~~€ ~~~ ~ ~ ~~ ~~~ ti~~~ € a C~ m~ ~~ ~~ ~~ ~~ ~~ ~~ ~~ ~ a~ ~~~ ~~ bB ~~~~~ ~~ ~~~~~ ~~~ a ~~ ~ds~~~~ .~ Y N a 8~ ~~ a~~ rg 8 ~~~~ ~oJP~..~....s4~ ~~~; ~, .~` Q~ W Schedule (01) EXHIBIT A DESCRIPTION OF EQUIPMENT RE: Lease With Optign to Purchase Agreement dated as of December 1, 2005, between Security State Bank & Trust (Lessor) and 1~rr Countv (Lessee) Bebw is a detaAed description of sll the items of Equipment including quantity, model number and serial number where applicable: One (1) Asphalt Zipper Milling Machine LocationotEquipment: Road & Bridge yard - 4010 San Antonio Hwy. - Kerrville, TX Schedule (01) EXHIBIT B PAYMENT SCHEDULE RE: Lease With Option to Purchase Agreement dated as of December 1, 2005, between Security State Bank & Trust Lessor) and Kerr County (Lessee) Oats of First Payment: October 1, 2006 Original Balance: $79,119.25 Total Number of Payments: Three (3) Number of Payments Per Year. One (1) Pmt Due Rental Applied to Applied to "Purchase No. Date Payment Interest Principal Option PHce 1 1-Oct-06 $28,987.98 $3,541.03 $25,446.95 $53,672.30 2 1-0et-07 $28,987.98 $2,844.63 $26,143.35 $27,528.95 3 1-0ct-08 $28,987.98 $1,459.03 $27,528.95 $0.00 Kerr County \~c~\O~kR~ C Sig ~ 4'`~9a U .m ~7 Pat Tinley, Kerr County Judge Typed Name and Tills ~ t rn ~r< Q. Aaaumes ~r rtemer r~eymenra doe ro date sre psw ~`°9 . ,o' ~~-~ 9 ~oura~'~ Schedule (01) EXHIBIT C CERTIFICATE OF ACCEPTANCE RE: Lease With Option to Purchase Agreement dated as of December 1, 2005, between Security State Bank & Trust (Lessor) and Ken• County (Lessee) I, the undersigned, hereby certify that I am a duly qualified representative of Lessee and that 1 have been given the authodty by the Governing Body of Lessee to sign this Certficate d Acceptance wish resped to the above referenced Agreement. I hereby certify that: 1. The Equipment described on Exhibit A has been delivered and installed in accordance with Lessee's specifications. 2. Lessee has conducted such inspection and/or testing of the Equipment as it deems necessary and appropriate and hereby acknowledges that it accepts the Equipment for ati purposes. 3. Lessee has appropriated and/or taken other lauufiil actions necessary to provide moneys suFfiCient to pay aU Rental Payments required to be paid under the Agreement during Ole current Budget Y~r of Lessee, and such moneys will be applied in payment of all Rerttai Payments due and payable dudng such rxrrrent Budget Year. 4. Lessee has obtained insurance coverage as required under the Agreement from an insurer qualified to do business in the State. 5. Lessee is exempt from all personal property taxes and is also exempt from sales and/or use taxes with respect to the Equipment and the Rental Payments. 6. No event or condition that conelilules or would constihrle an Evert of Default exists as of the date hereof. ~. The governing body of Lessee has approved the authorization, execution and delivery of this Agreement on its behalf by the authorized representative of Lessee who signed the Agreement. 8. During the term of the Agreement, the Equipment wit be used for essential govemmenlal functions. Such functions are; Road work 9. Please list the Source of Funds (Fund Item in Budgeq for the Rental Payments that Dome due under Exhibit B of this Agreement. Tax revenues 10. Please state why you reasonably expect and anticipate that adequate funds will be available for ail future Rental Payments that will come due under ExhibH B. Ftrnded by tax revenues LCerr County ~~SgIONEgsco U~~G9o° Pat Tinley, Kerr County Judge ~~ ~ °~ = e +'P. `, Typed Name an8 Title ~°°°`'"~ ' ~~C°'~'`~`_~ KERB COUNTY ATTORNEY COUNTY COURTHOUSE, SUITE BA-103 ~ 700 MAIN STREET EXHIBIT D OPINION OF COUNSEL Date: t z[1 t t a f Security State Bank & Trust 1130 Junction Highway Kerrville, Texas 78028 REX EMERSON KERRVILLE, TEXAS 78028 RE: Lease with Option to Purchase Agreement dated as of December 1, 2005, between Security State Bank & Trust (Lessor) and Kerr County (Lessee) Ladies and Gentlemen: As legal counsel to Lessee, I have examined the foregoing Agreement and such other opinions, documents and matters of law as I have deemed necessary in connection with this Agreement. Based on the foregoing, I am of the following opinions: 1. Lessee is a political subdivision of the State of Texas, or a constituted authority authorized to issue obligations on behalf of a political subdivision of the State. 2. Lease has the requisite power and authority to purchase the Equipment and to execute and deliver the Agreement and to perform its obligations under the Agreement. The Agreement and the other documents either attached hereto or required herein have been duly authorized, approved and executed by and on behalf of Lessee, and the Agreement is a legal, valid and binding obligation of Lessee enforceable in accordance with its terms. 3. The authorization, approval and execution of the Agreement and all other proceedings of Lessee relating to the transactions contemplated hereby have been performed in accordance with all open meeting laws, public bidding laws and all other applicable state and federal laws. 4. There is no litigation, action, suit or proceeding pending or before any court, administrative agency, arbitrator or governmental body that challenges the authority of the Lessee or any of the Lessee's officers or employees to enter into the Agreements. 5. The above opinion is for the sole benefit of the Lessor listed above and can lied upon by the Lessor or any permitted assignee or subassignee of Lessor under the agree en . ature of Legal Counsel MAIN NUMBER (830) 792-2220 HOT CHECKS (830) 792-2221 FAX (830) 792-2228 Schedule (01) EXHIBIT E LESSEE RESOLUTION RE: Lease With Option to Purchase Agreement dated as of December 1, 2005, between Security State Bank & Trust (Lessor! and Kert County (Lessee) At a duly called meeting of [he Governing Body of the Lessee (as defined in the Agreement} held on necembr r 12, 'nnr' the following resolution was introduced and adopted: BE IT RESOLVED by the Governing Body of Lessee as follows: 1 Determination of Need. The Governing Body of Lessee has determined that a true and very real need exists for the acquisition of the Equipment described on Exhibit A of the Lease WAh Option to Purchase Agreement dated as of December 1, 2005, between Kerr County (Lessee) and Security State Bank & Trust (lessor). 2. Approval and Authorization. The Governing Body of Lessee has determined that the Agreement, substantially in the form presented to this meeting, is in the best interests of the Lessee for the acquisition of such Equipment, and the Governing Body hereby approves the entering into of the Agreement by the Lessee and hereby designates and authorizes the following person(s) to execute and deliver the Agreement on Lessee's behalf with such changes thereto as such person(s) deem(s) appropriate, and any related documents, inGuding any Escrow Agreement, necessary to the consummation of the transaction contemplated by the Agreement. Authorized lndividual(s}: Yet Tinley, Kerr County Judge (Punted or Typed Name and Title ~ individual(s) authorized to execute the Agreement) 3. Adoption of Resolution. The sgnatures below from the desgnated individuals from the Governing Body of the Lessee evidence the adoption by the Governing Body of this Resolution. ~_ ~ (Signature of Secretary, Board Chairman or other member 'f 3 Y'~ ~ t TypedName8Title r~.~t 'r.'iniey nerr ~:~unty .iuu«e ~4~...a~yt--- (Typed Name and Tifle of individual who signed directly above) ~~4, " _ ' -: ^.. Attested (Signature of o{Se addi5onal person tivho can witness the passage of this Resolution} Typed NameBTftle: ~'heryl ta. Thomt~son, Administrative Deputy Clerk (Typed name of individual who signed diredly above) Schedule (01) EXHIBIT F BANK QUALIFIED CERTIFICATE RE: Lease nth Option to Purchase Agreement dated as of December 1, 2005, between Security State Bank & Trust (Lessor) and Kerr County (Lessee) Whereas, Lessee hereby represents that it is a "Bank Qualified" Issuer for the calendar year in which this Agreement is executed by making the fogowing designations with respect ro Section 265 of the Internal Revenue Code. (A "Bank Qualified Issuer is an issuer that issues less than ten million ($10,000,000) dollars of tax-exempt obligations during the calendar year). Now, therefor, Lessee hereby designates this Agreement as follows: 1. Designation as Qualified Taxfarempt Obligation. Pursuant to Section 265(bx3xBxi) of the Internal Revenue Code of 1986 as amended (the °Code"), the Lessee hereby specficagy designates the Agreement as a "qualified tax-exempt obligation" for purposes of Section 265(bx3) of ttre Code. In ~mpliance with Section 265(bx3)(D) of the Code, the Lessee hereby represents that the Lessee wiq not designate more than $10,000,000 of obligations issued by the Lessee in the calendar year during which the Agreement is executed and delivered as such `qualified tax-exempt obligations°. 2. Issuance Lknitafion. In compliance with the requirements of Section 285(bx3xC) of the Code, the Lessee hereby represents that the Lessee (inducting all subordinate entities of the Lessee wghin the meaning of Section 285(bx3XE) of the Cade) reasonably anticipates not to issue in the calendar year during which the Agreement is executed and delivered, obligations bearing interest exempt from federal income taxation under Section 103 of the Code (other than "private activity bonds" as defined in Section 141 of the Code) in an amarnt greater than $10,000,000. Kerc County ~~\5g1OPdE~cO s, G U i~-d nature_ i7~ $° 1~7 Pat Tinley, Kerr County Judge ~ BC.j Typed Name and Title 9 _ "....~.~-~°~ INSURANCE REQUIREMENTS Pursuant to Article V in the Lease With Option to Purchase Agreement, you have agreed to provide us evidence of insurance covering the property in the Agreemenk A Certificate of Insurance naming all insured parties and coverages must be determined to us as soon as possible, but no later than the date on which delivery of equipment occurs. if you have not taken possession of the equipment please write a memo to Security State Bank & Trust statingyour carrier, insurance agent and telephone number to reach them upon delivery. In the case of self-insurance, the amounts of liability and physical damage coverage aze to be listed on some form of certificate supplied by you. In addition, i~armation regazding the nature of your self-insurance program should also be forwazded to us as soon as possible. INSURANCE REQUIREMENTS BY Security State Bank lk Trust: 1. LIABILITY / Minimum of $1,000,000.1 combined single-limit on bodily injury and property damage. / Security State Bank & Trust MUST be listed as additional insured and loss payee. 2. PHYSICAL DAMAGE / All risk coverage to guarantee proceeds sufficient to pay the applicable Purchase Option Price as set farth in Exhibit B of the Agreement. Security State Bank & Trust MAST be listed as additional insured and loss payee. 3. ENDORSEMENT / Lessor will receive at least thirty (30) days written notice from Insurer prior to alteration, canceltation or reduction of insurance coverage. PLEASE FAX THE CERTIFICATE TO US AS SOON AS POSSIBLE_AT (0311) 895-2000, AND MAIL THE ORIGINAL TO: Security State Bank & Trust 1130 Junction Highway Kerrville, Texas 75028 YOUR ASSISTANCE IS GREATLY APPRECIATED TO COMPLETE THIS TRANSACTION, IF YOU HAVE ANY QUESTIONS, PLEASE GIVE US A CALL AT (830) 895-100. Kerr County Insurance Company: Texas Association of counties Agent's Name: Karen 'I$errien Telephone #: 000-456-5974 FaX #: 512-478-1426 AddreSS, City, State & Zip: P. O. Box 2131, Austin, Texas 78768 7317.9!2005 11:53 801-7950857 INVOICE Plen9c remit payment to: Asphalt hipper, drtc 3i0W700S Pleasant Grove, UT 84062 To16Froe (888) 805-3010 Faxi801) 7R5-0857 ASPHALT ZIPPER PAGE 02 AsNddt IipN~r~ aill'fn : COUKF. GOIRJTY OF KERB RGAD u BRIDGE. 4010 SAN ANTi]N1U HWY KERRVILtE. TX 78D28 Order Pak: 10.4N2009 PaeUna atip: 9309 Due Uate: 1111212405 Invorcc IA :AZ4flHD0z 19 Sala UMcr iD : 977a lavOiCe Date : 7N2A/I005 Ship Dak : lUlzt+l200S <,27:59 PM Cunmmur TO fD : Ng6•n01 Pape rvumbcr ;page t ar 1 Ahtp'f n C6(:13'PY OF KBRR ROAD & HRIDCiE dQ 10 SA`7 AN'CGN1Q HWY k:F.R RV tLLP., TX 78028 6UR: Currcnry Typr Ship adcthnd: ai0 nl I.nding: Plcstam Cleave (1.50 ComSn:ck l.;ne Nhd Item ID! tkm NamC Cnlt of Snipped ~ ~ ExrcWM O Linc ~ 1]11 I1en Ill Meu.nre ,Q~y rice az r.te[ 7 4Z480BR3HTr/gBOHD w/STD ea 19000 $!q,950.0000 E749S9.On Spray BaR 20" Pnm, q6" Ficavy Duty C.utu[hextl, Dawhk mete f T26cr 2 61001~ITRAR.P.R TAI.DL•M co L0000 5.t.000.000C 53,000.60 AXLE ELEC.?RIC ARAKF. AI1R0 A/.'S00 2 7 /AGAC FCC 10000 5f.76S39W $1,169.29 3 Total: 519.119.25 setts r.:: soon vnr rnx: 5a9o Shipping Cnargea: w.Ufi VAT EreigFt: SO.CU Ane Amaunh 5;9,119.29 ynrCial lnu: ECN%: +17,0661$65 4inc6inC q 4gHU0279-Ttailorx 109PS0626U023ug2.Oak Sbfayad- 1011/0$. 310 U'J6at 700 Souih, Pleasant Grave. UT 84062 . Phone: (807) 785-0706 . Fax: (801) 785-08?2 www.asphaltz) peer. cam Form 838-C7Ci InfonnaHon Retum for Small Tax~Ezempt OIvt6 No.15bl' (Check rt ~ a issue or on a c«rso6dated basis ) Ba Issue price of obfgation(s) (see inswctions) . .. .. Sa $ b Issue date (twgle i~ue) or « Y~ (rxxtsotidated) lase instructions) 9 An7«rnt of the reported odtga8on(s) on kne 8a: a Used b refixW prt« issue(s) .. .. 9a b Representing a ban from 81e proceeds of aratl7er tax~xerrtpt obligation (e.g., horxl bank) .. ~ 10 8 the issuer has designated any issue under section 265(bx3)(Bxixllq (smaN issuer exoepti«t), check this box .. ^ 11 8 any obligation is in the form a(a lease «insfallmeM sale, check tlris box lJnder penalties otperjwy, I derJare iheR 1 have exarrirred lris realm arM aomnrpanykg sctredutas and sfa[enrents, and, to the hest of my krwxledge and befef, they are tore, oonect, drat cortplate. Please n ~ yytp(14~~jUtei,'/,yy,~ L. Willic-uls, Corm Here 11/28/05 ~Y tY ra,ax oae rmeormK,wrearewe Auditor GENERAL INSTRUCTIONS Sasebo reAwarrces are b 8re ~mal Reverxve Coda urdeas o8remise noted. Purpose of Form Form 803BGC is used by the issuers aFfmc-®cemp[ govemrremal oblgeaons m provide the IRS w711t krfortnetion requied by secfiar 149(e)and io monilorthe requirstnerrts ofsecdorr. 141- 750. Who Must File Issuers of bxexenpt govarrxnernal a6igatiacs wih issue prioBS of less than 5700.000 rrarstfile Fdnn 803&GC. Issuers of a tax~xempt governarraraal od'rpetion with an issue price of $100,000 «mae ntuet file Form 8038.6, Mkrrrteohn Rekan krr Tex- F~rempt Govemnrental061yaUOrw. F81rg a eeperffie rebm--lavers have the ap8on to tie a sepemte Fann 8030-GC forary tax~xenpl govemmerrtel a6igetion w8h an issue P~ afiless then $100,000. An issuer ors tax~xempt frond used b firrarrca corrstrrrction exParrdiWres mrrstfle a separate Form 8038-GC f«earh issue to give rptice to the 8iS Uret an election was made to pay a perreiy n ieu of artlitrage rebate (sea the Ogre 12 irshrrctions). Flling a corrMldabd rabarr-Far aitax~exempt govemmemel obegatiore witlr ire prices d Its then $100,OOD shat era not r an a separate Form8038-GC, en ~ar must 81e a corsotidated bdanrelbn return irrcirdirg a1 sudr isacres issued wltidn tae calendar year. Thus, an issuer may fle a separate Fonn 803&GC tar eafi da numbar of arts/ trscres and report the rerrr~rdaraf snrai issues iesrred dung 9re calerMar year an one mrrs0idated Farm 8038GC. However. a separate Fonn 8036GC must be fled tb give the IRS notice of Ste eleclim b pay a penally in lieu of When to File To file a sgnrab relrm, tie Fam X38-GCan « before are 15e day of the>recpd calendar nromh afierthe close ortha calendar quarter in which the issue is isared. To lie a carreoiidased realm, tie Farm 803&GC on «bef«e FeMuary 15e of the calarrd0r year in which the Issue is rued. lab Blirg. An ®suarmay be greMed en extdcsion oftime b tie Fans 8036GC ranter Section 3 oFRev. Prot 88-10.1988.1 C.6.635, f 8 is de7ennired ltret the fable tb tie an 8rtre is not due 7o waful neglect. Typo «prim at the Sop of Sts ksrrr, °fh's Statement is SuMitted it Atx:ordarroe wih Rev. pr'oc. 88-10.' Attach 1o the Farm8038-GC a b8« dksfly etalig why tae form was not submited lotbe 8tS an time. Also krdca0e wheltrar lheobfgation ~ question b undar eimrtirretlonMtlb BtS. Do nw scirmi capias ofarry bond dogmrents, teases. «irstairnen[ sale dowments. Whereto File Fie Farm 8038GC wf8t 1ha Imarnal Revenue service Cerr~r, ogaen, lrT 8420'1. Other Forms that May l1e Required For relrelin9 (« IgYing a pena8y h ieu of ard3age rebab)to the Federal govemnent. use Farm Ba39-T, AroNiage Rebate and Pene!!y M Lieu ofArN6age Reese. Far private activity bonds, use Fotm 8038. Mfarrrre8on Refum for Tax-Exempt PlArafe AcBWyBord temrea. Rounding to Whole Dollars Yau may show the m«rey 8errs on this return es wholedoler anqurda. To do so, drop enyamwM less than 50 cents and kraease arty amourrt from 50 ~ ihrocgh 99 oetds b the next higher ddlar. Deflnidorrs O611gatlorn. Tfds raters toe secgle tax-axenpt garemmeMal obligafion if Fonn 8038~GC b used f« separate raportkng «to multlple tax~xempt govemmentel obligations i dre tam is used f« oortsofdated reporting. Taxexampt obligatlon. This is a bond, irretaimem prsdrase agreanrarrL «finenael lease, on which 8re kdareat ie excprded irarrr itcarrre under section 103. Texaxempt govammanW abligdlon. Atax- exempt ataBgaBOnthat boot aprivate activity bond, (sae halav) b a tmc-exenp[ goremmantal obigetbn. This irxdWes a bond issued fry a quai8ed volunteer 1Fe departrrrarrt urxlar section 150(e). Privees acavay bond This irrChrdes an abigation tssued ~ pert of an'ssue in which: Afore than tOX of are proceeds are to be used for arty private aaMiry busirre~ use PROPERTY AND CASUALTY SELF INSURANCE FUND CERTIFICATE OF PROPERTY COVERAGE The Texas Association of Counties Property and Casualty Self Insurance Fund is created to enable each county or county-related governmental entity to provide self insurance coverage against physical damage claims. The specified county or county related governmental entity participates in this Fund under an agreement pursuant to the provisions of and operates under the Chapter 791, Texas Government Code Annotated. NAME AND ADDRESS OF COVERED COUNTY: Kerr County ~ ~ .-- '^ ^^ ~ U. 700 Main Sheet Kerrville, Tx 7ao2s DEG 0 2 X005 Coverage Agreement No.: 1330/10 Coverage Period: 10/24/05 to 10/1/06 PROPERTY Includes the following coverages: All risk of physical loss subject to coverage terms, exclusions and conditions. With respect [o the following property: AZ480 HB Milling Machine #AZ48HB00219 mounted on trailer # 109FS0826U023442 [X] Actual cash value Deductible: $1,000 Total Value: $79,019 This certificate is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not amend, extend or alter the coverage afforded by the Fund. The certificate does verify that coverage has been placed in force for the period indicated above. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate may be issued or may pertain, the coverage provided by the Fund described herein is subject to all the terms, exclusions and conditions of the coverage document issued by the Fund. The coverage is primary without right of contribution from any insurance carried by any additional insured. Should any of the above described coverage be altered or cancelled the Fund will endeavor to mail ten days written notice to the certificate holder, but failure to mail such notice shall impose no obligation or liability of any kind upon the Fund. Lien Hotder /Loss Payee Authorized Representative SECURITY STATE BANK & TRUST Texas Association of Counties P.O. BOX 29004 1210 San Antonio St. 1130 JUNCTION HIGHWAY Austin, TX 78701-1834 KERRVILLE,TX 78029 (512)478-8753 Certifrcate Issued November 28, 2005 TAC 7/97 COUNTY GOVERNMENT RISK MANAGEMENT FUND CERTIFICATE OF GENERAL LIABILITY COVERAGE The Texas Association of Counties County Government Risk Management Fund (the "Fund") is created by Chapter 119 of the Local Government Code to enable each county to provide self insurance coverage against liability claims. The specified county participates in this Fund under an agreement pursuant to the provisions of and operates under the Chapter 791, Texas Government Code Annotated. NAME AND ADDRESS OF COVERED COUNTY: f~, 5 ~, !y' ~' l ~ ~ t~~ Kerr County 700 Main Street Kerrville, Tx 7so2s ~ DEG 0 1 2005 Coverage Agreement No.: 1330 ':- 1 Coverage Period: Limits of Liability: Bodily Injury $100,000 per person $300,000 per occurrence Property Damage $100,000 per occurrence Deductible: $5,000 10/24/05 to 10/1/06 GENERAL LIABILITY With respect to the following property: AZ480 HB Milling Machine #AZ48HB00219 mounted on trailer #]09FS0826U023442 This certificate is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not amend, extend or alter the coverage afforded by the Fund. The certificate does verify that coverage has been placed in force for the period indicated above. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate may be issued or may pertain, the coverage provided by the Fund described herein is subject to all the terms, exclusions and conditions of the coverage document issued by the Fund. The coverage is primary without right of contribution from any insurance carried by any additional insured. Should any of the above described coverage be altered or cancelled the Fund will endeavor to mail ten days written notice to the certificate holder, but failure to mail su ~ notice shall impose no obligation or liability of any kind upon the Fund. ~ Additional Insured Authorized Representative SECURITY STATE BANK & TRUST Texas Association of Counties P.O. BOX 29004 1210 San Antonio St. ] 130 JUNCTION HIGHWAY Austin, TX 78701-1834 KERRVILLE, TX 78029 (512) 478-8753 Certificate Issued November 28, 2(105 TAC 7/97 GENERAL LIABILITY Automatic Additional Insureds Endorsement- Equipment Leases This endorsement modifies the General Liability Coverage Document to which it is attached. This change is effective on the inception date of the Document unless another date is indicated below. The following provision is added to Section II -Who is a Covered Person: Any person(s) or organization(s) (hereinafter called "Additional Insured") with whom the Named Member agrees in a written equipment lease or rental agreement to name as an insured is an insured with respect to liability arising out of the maintenance, operation or use by an employee of the Named Member of the equipment leased, as shown on the schedule below, to the Named Member, by such person(s) or organization(s) subject to the following additional exclusions. The coverage provided to the Additional Insured does not apply to: Bodily Injury, property damage or personal injury occurring after the Named Member ceases to lease the equipment. Bodily Injury, property damage or personal injury arising out of the sole ne ligence of the Additional Insured. ~ ~ C~ ^' ~'' ~' j ~ D Property damage to: ~ DEC G 1 2005 Property owned, used or occupied by or rented to the Additional Insured; or Property in the care, custody or control of the Additional Insured or over which the Additional Insured is for any purpose exercising physical control. ADDITIONAL INSURED: SECURITY STATE BANK & TRUST P.O. BOX 29004 1130 JUNCTION HIGHWAY KERRVILLE, TX 78029 SCHEDULE OF LEASED EQUIPMENT: AZ480 HB Milling Machine #AZ48HB00219 mounted on trailer #109FS0826U023442 ALL OTHER TERMS, CONDITIONS AND EXCLUSIONS OF THE COVERAGE REMAIN UNCHANGED. Endorsement: GL/AIEL Endorsement Effective Date: October 24, ?005 Named Member: Kerr County Attached to and forming part of Coverage Document Number: 1330 TAC-(iLAIEL (09/01) Page I of 1 Board Approved 08/16/01 BAYSTONE FINANCIAL GROUP 2312 Anderson Avenue Manhattan, KS 66502 'To: Security State Bank & Trust 1130 Junction Highway Kerrville, Texas 78028 DATA: November 22, 2005 Financing For: Ken County One (I) Asphalt Zipper Milling Machine DESCRIPTION AMOUNT Preparation of personal property documents for Kerr County 5500.00 Fee is due upon receipt of documents SUBTOTAL ;500.00 SALES TAX SHIPPING 8 HANDLING TOTAL DUE 5500.00 Make all checks payable to: Baystone Financial Group, 2312 Anderson Manhattan, KS 66502 If you have anv questions concernint this invoice, call: Amv Miller na, 800-752-3562.