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FY- 12 CTP CAPITAL <br />2011 LIFT EQUIPPED VAN ORDER FORM <br />Send to: The Braun Corporation Vendor No.: 35- 1282638 (Federal ID) <br />P.O. Box 310 <br />Winamac, IN 46996 <br />Phone: 800-946-7513; 574- 946 -4139 FAX: 574 - 946 -6016 <br />ATTN: Karen Shidler (ext. 3123) e-mail: karen. shirt ler(a) bra unlift.com <br />Scott Alexander (ext. 3145) scott.alexander( @_braunlift.com <br />Re: Bid no. 701983/ Contract No. 070L (Statewide Bid) <br />N.C. Department of Transportation /Public Transportation Division <br />P.O. No.: Pending Approval Project No.: <br />Order Date 8/17/2011 <br />(date order placed with vendor) <br />From: County Of Lee Transit System Contact : Sidney Morgan <br />(grant applicant/recipient) e-mail: smorgan @leecountync.gov <br />919. 776 -0501 919 - 718 -4626 <br />(phone number) (FAX number) <br />VEHICLE ORDE <br />0 3 Interior Side Lift w/ 2 WC stations <br />0 4 Interior Side Lift w/ 3 WC stations <br />All vehicles include as standard: Strobe <br />light (with onloff switch), Driver's step & <br />grab bar, Portable VxV step, Emergency <br />side exit window, Rear door alarm (diagrams <br />3 & 4), Sure -Lok Titan tie -down system, <br />HawkEye Reverse Assistance System and <br />Braun Millinium wheelchair lift. <br />( Quantity <br />Item no. <br />Description <br />0 <br />5 <br />Letterino <br />0 <br />6 <br />Steowell de -icer <br />0 <br />7 <br />O- Straint CRT MAX - # 2 & 3 <br />0 <br />8 <br />O- Straint CRT MAX - # 4 <br />0 <br />9 <br />Electronic Door Opener <br />Non - Participating Options (local cost only): <br />0 <br />10 <br />0 <br />11 <br />0 <br />12 <br />0 <br />13 <br />0 <br />14 <br />$ 38 971.00 <br />$ 39 263.00 <br />Unit Cost <br />$ <br />250.00 <br />$ <br />200.00 <br />$ <br />300.00 <br />$ <br />400.00 <br />SUBTOTAL wl PARTICIPAING OPTIONS <br />$ <br />200.00 <br />Total Cost <br />$ <br />S _ <br />1 GRAND TOTAL $ 119.109.00 1 <br />IVAN COLOR: WHITE with GRAY INTERIOR PANELS AND SEATING <br />Lettering information: <br />Color and Style of 6" lettering: <br />Striping information: <br />Vehicle to be titled to: Countv of Lee <br />System Name & Phone No. <br />Terms: Payment to vendor must be made within 30 days of acceptance of vehicle (sign off on insp. form). <br />613 <br />PTONOF -lift van'. rev. 8111 <br />