HomeMy WebLinkAboutCAG2021-015 - Original - PFVT Motors - Replacement Police Vehicle - 01/19/2021ApprovalOriginator:Department:
Date Sent:Date Required:
Authorized to Sign:
o Director or Designee o Mayor
Date of Council Approval:
Budget Account Number:
Budget? o Yes o No
Grant? o Yes o No
Type:Review/Signatures/RoutingDate Received by City Attorney:Comments:
Date Routed to the Mayor’s Office:
Date Routed to the City Clerk’s Office:Agreement InformationVendor Name:Category:
Vendor Number:Sub-Category:
Project Name:
Project Details:
Agreement Amount:
Start Date:
Basis for Selection of Contractor:
Termination Date:
Local Business? o Yes o No*
*If meets requirements per KCC 3.70.100, please complete “Vendor Purchase-Local Exceptions” form on Cityspace.
Notice required prior to disclosure?
o Yes o No
Contract Number:
Agreement Routing Form
For Approvals, Signatures and Records Management
This form combines & replaces the Request for Mayor’s Signature and Contract Cover Sheet forms.
(Print on pink or cherry colored paper)
Visit Documents.KentWA.gov to obtain copies of all agreementsadccW22373_1_20
December 15, 2020
POLICE DEPARTMENT
Rafael Padilla, Chief of Police
Phone: 253-856-5885
Fax: 253-856-6800
Address: 220 Fourth Ave S
Kent, WA 98032-5895
Memorandum
DATE: 1/13/2021
TO: Mayor Ralph
FROM: Cmdr. Rob Scholl
RE: Request for waiver from bidding requirements for the purchase of a 2020 Ford
Police Pursuit SUV from Peoria Ford in Arizona
Mayor,
In 2020 the Police Department had several black and white fully marked vehicles
involved in collisions which resulted in them being totaled. At least two of them
were of no fault of the officer, but were crashed into by an uninsured suspect.
While our fleet is able to absorb a couple of total vehicle losses a year, the number
this year has us to the point of impacting our ability to provide the level of service
expected to our community.
This issue was brought forward a few months ago by the Chief and he was
authorized to purchase one replacement vehicle immediately. Because police
vehicles are specialty vehicles, they are not normally stocked by any Ford
dealerships. They need to be ordered and take a minimum of 90 days and because
of COVID are taking upwards to 180 days. A search was done to see if there were
any Ford Police SUV’s that met our specification available. Our up-fitter, Systems
for Public Safety was able to locate one that was not spoken for at Peoria Ford in
Arizona. It had already been drop shipped to SPS in Lakewood so was immediately
available for purchase.
Memorandum:
January 13, 2021
Page: 2
We ask that you waive the bidding requirements for this purchase, because it
meets the exceptions set forth in KCC 3.70.110 in that this purchase is limited to a
single source of supply within the near vicinity, it involves special facilities or
services and the bidding requirements are not practicable or in the City’s best
interest.
For your review,
Cmdr. Rob Scholl
Signature of the Mayor
_________________________________
Dana Ralph
DATE: ___________________________ 01/19/2021
01 19 21
CONTRACT NUMBER: ADSPO17-166117
QUOTE DATE:12/3/2020
CUSTOMER:CITY OF KENT PD
CONTACT:
SANDRA GONZALEZ E-MAIL:
REFERENCE:FORD PIU
Cell: 505-850-5504 VIN:1FM5K8AW2MNA02046
Email: sgonzalez@peoriaford.com LEAD TIME:In Stock
LINE ITEM ORDER CODE DESCRIPTION PRICE
1 K8A 2020 FORD POLICE INTERCEPTOR UTILITY - 3.3L
HYBRID 35,957.00$
2 86T TAIL LAMP HOUSING 55.00$
3 63B SIDE MARKER LED 280.00$
4 60A PREWIRE FOR GRILL LIGHTS AND SIREN 50.00$
5 60R NOISE SUPPRESSION BONDS 95.00$
6 17T CARGO LAMP RED/WHITE 50.00$
7 43D DARK CAR FEATURE 20.00$
8 47A ENGINE IDLE FEATURE 255.00$
9 52P HIDDEN DOOR LOCK/REAR INOPER 155.00$
10 76R REVERSE SENSING SYSTEM 270.00$
11 68B POLICE PERIMETER ALERT 660.00$
12 76P PRE-COLLISION ASSIST 140.00$
13 55F KEYLESS ENTRY 330.00$
14 85R REAR CONSOLE PLATE 40.00$
15 51T SPOTLAMP WHELEN DRIVER 400.00$
16 76D UNDERBODY DEFLECTOR PLATE 335.00$
17 85S REAR CENTER SEAT DELETE -$
18 52T RECEIVER - CLASS IV 75.00$
19 19K H8 AGM BATTERY UPGRADE 105.00$
20 61B OBD SPLITTER 50.00$
-$
TAXABLE TOTAL 39,322.00$
SALES TAX
WARRANTY COST -$
TIRE TAX 5.00$
FREIGHT NO CHARGE
TOTAL PER UNIT 39,327.00$
QUANTITY OF UNITS 1
PO TOTAL 39,327.00$
THANK YOU FOR YOUR BUSINESS!
PFVT MOTORS, INC.
9130 West Bell Road
Peoria, Arizona 85382
Direct: 480-696-5930
Fax: 480-393-5536
w-9
Request for Taxpayer
Give Form the
Form
(Rev. October2018)
Identification Number and Certification
to
requester. Do not
I]eparimentofthe Treasury
Infernal Revenue service
► Co to www.irs.gov/FormW9 for instructions and the latest information.
send to the IRS.
f Name (as shown on your Income tax return). Name is required on this line; do not leave this line blank,
PFVT MOTORS LLC, DBA PEORIA FORD
2 Business name/disregarded entity name, if different from above
r'
�P
3 Check appropriate box for federal tax classification of the person whose name Is entered on line 1. Check only one of the
Y
4 Exemptions codes apply only to
P { PP Y Y
N
following seven boxes,
certain entitles, not Individuals; see
a.
o
❑ Indivldual/sole proprietor or ❑ C Corporation ❑ S Corporation ❑ Partnership ❑ Trust/estate
instructions on page 3):
single -member LLC
Exempt payee code (if any)
0
❑ Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnershlp) ►
o
Note: Check the appropriate box in the fine above for the tax classification of the s€nglo-member owner. Do not check
Exemption from FATCA reporting
Q q
LLC If the LLC Is classified as a single -member LLC that Is disregarded from the owner unless the owner of the LLC Is
another LLC that Is not disregarded from the owner for U.S, federal tax purposes. Otherwise, a single -member LLC that
code (If any)
Is disregarded from the owner should check the appropriate box for the tax classification of Its owner,
9
❑ Other (see Instructions)►
(Appose to aocounfs malwalnedoursfde lha U.S)
U0
b Address (number, street, and apt. or suite no.) See Instructions,
Requester's name and address (optional)
tn
9130 W BELL RD
6 City, state, and ZIP code
PEORIA, AZ 85382
7 List account number(s) here (optional)
11111*7911111
Taxpayer Identification Number (TIN)
Enter your TIN In the appropriate box. The TIN provided must match the name given on line 1 to avoid
Lsocial security number
- M -
backup withhold
sour s number (Sater However, far a
sole .For individuals, this is generally your a Instructions
resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other
entities, It Is your employer Identification number (EIN). If you do not have a number, see How to get a
TIN, later. or
Note: If the account Is In more than one name, see the Instructions for line 1. Also see What Name and I Employer identliloatfon number
Number To Give the Requester for guidelines on whose number to enter.
2 0 -1317 5 9 7 8 3
JIMM Certification
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be Issued to me); and
2.1 am not subject to backup withholding because; (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report all Interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding; and
11 am a U.S. citizen or other U,S. person (defined below); and
4. The FATCA code(s) entered on this form (If any) indicating that I am exempt from FATCA reporting Is correct.
Certification Instructions. You must cross out Item 2 above If you have been notified by the IRS that you are currently subject to backup withholding because
you have failed to report all Interest and dividends on your tax return. For real estate transactions, Item 2 does not apply. For mortgage Interest paid,
acquisition or abandonment of secured property, cancellation of debt, contributions to an Individual retirement arrangement (IRA), and generally, payments
other than Interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part 11, later.
`J'V'I Signature of %
Here U.S. person ► = Date ► ////2 a Z n
General Instructions
Section references are to the Internal Revenue Code unless otherwise
noted,
Future developments. For the latest Information about developments
related to Form W-9 and Its Instructions, such as legislation enacted
after they were published, go to wwwJr:s.gov/FormW9.
Purpose of Form
An Individual or entity (Form W-9 requester) who Is required to file an
Information return with the IRS trust obtain your correct taxpayer
Identification number (TIN) which may be your social security number
(SSN), Individual taxpayer Identification number (ITIN), adoption
taxpayer Identification number (ATIN), or employer Identification number
(EIN), to report on an Information return the amount paid to you, or other
amount reportable on an Information return. Examples of information
returns Include, but are not limited to, the following.
• Form 1099-INT (Interest earned or paid)
• Form 1099-DIV (dividends, Including those from stocks or mutual
funds)
• Form 1099-MISC (various types of Income, prizes, awards, or gross
proceeds)
• Form 1099-B (stock or mutual fund sales and certain other
transactions by brokers)
• Form 1099-S (proceeds from real estate transactions)
• Form 1099-K (merchant card and third party network transactions)
• Form 1098 (home mortgage Interest), 1098-E (student loan Interest),
109E-T (tultion)
• Form 1099-C (canceled debt)
• Form 1099-A (acquisition or abandonment of secured property)
Use Form W-9 only If you are a U.S. person (including a resident
alien), to provide your correct TIN.
If you do not return Form W-9 to the requester with a TIN, you might
be subject to backup withholding. See What Is backup withholding,
later.
Cat. No. 10231X Form W-9 (Rev. 10-201I3)
Arizona Department of Revenue ARIZONA FORM
CERTIFICATE TO ESTABLISH RESIDENCY IN ANOTHER 5011
U.S. STATE PURSUANT TO A.R.S. § 42-5009(I)
FOR PURPOSE OF A STATUTORY DEDUCTION PROVIDED BY ARS § 42-5061, SUBSECTION (A)(14), (A)(28)(a), (A)(45), OR (U); OR ARS § 42-6004 (A)(4)
SECTION 1 - INFORMATION TO RESUPPLIED BYSELLER - -
SELLER'S NAME AND ADDRESS:
PEORIA FORD
YEAR:
MAKE:
MODEL:
VIN NO.:
90 DAY PERMIT NO.:
2020
FORD
EXPLORER
1 FM5K$AW2MNA02046
SALES PRICE:
PRICE ADJUSTMENTS:
NET PRICE:
TOTAL TAXES PAID:
$ 39 327.00
39 327.00
$ 0.00
DRIVER'S LICENSE NO. OF
STATE OF ISSUANCE:
EXPIRES:
PURCHASER (or Entity Rep.): \pj(0)--, 9L-i (L21 -2_j4'2,
W fyS�i l 4&-\k
1 01 /77, -20Z�
You may now print your form; click the blue print button.
SECTION 2 - TO RF COMPLETED BYPURCHASER (OR ENTITYrrc-rrrr- rrV
FULL NAME:
ISA NONRESIDENT ENTITY, COMPLETE THE FOLLOWING.,
FEIN:
ENTITY NAME:
CITY OF KENT
FULL BUSINESS ADDRESS:
TELEPHONE NO.:
e 220 4th AVENUE SOUTH, KENT, WA 98032
253-856-5200
QUESTIONS TO BE ANSWERED AND INITIALED BY PURCHASER (OR ENTITY REP.):
NOTE: DO NOT answer questions 1, 2, and 3 if you are either a Nonresident U.S. Military Service member
officially stationed
at an Arizona military facility, or a Nonresident Student enrolled at an Arizona Educational Institution paying out-of-state tuition
fees. (PROVIDE COPY OF MILITARY ORDERS OR CURRENT STUDENT I.D. CARD)
True False Initial
1. I am physically present in Arizona for at least seven (7) months of the year. ............................ .......... ------
❑
2. 1 am engaged in a trade, profession or occupation in Arizona in other than seasonal
agricultural work or temporary seasonal work....... ............................................................... - .........................
❑
3. 1 am employed in the State of Arizona.............................................................................................................
❑ El
4. 1 have placed my children in an Arizona public school (K-12) without payment of nonresident tuition. .... ...............
❑ IX
5. 1 attend an Arizona educational institution and pay resident status tuition rates. ... ...................... .......... .......
❑ IX
6. 1 am an individual, partnership, company, firm, corporation or association that maintains
a main office, a branch office or warehouse facilities in this state and that bases and
operates motor vehicles in this state...............................................................................................................
❑ IX
7. 1 am an individual, partnership, company, firm, corporation or association that operates
motor vehicles in intrastate transportation, for other than seasonal agricultural work .....................................
❑ 12
8. 1 am purchasing this vehicle for transfer to a resident of Arizona... .... ............. ........ .................................
❑
9. 1 have a valid driver's license issued by the State of Arizona..........................................................................
❑ 1
10. 1 am registered to vote in the State of Arizona... ................ ...... — ... ................ ........ ................... ....... ..........
❑ ER
11. 1 file Resident status income tax returns, or business tax returns in the State of Arizona ...............................
❑ IR
12. The insurance policy listed above (other than a temporary binder) is issued under the laws of Arizona ........
❑
SECTION 2 INFORMATION THAT INDICATES AN ARIZONA ADDRESS, OR AN ANSWER OF TRUE TO ANY OF THE ABOVE QUESTIONS,
WILL MAKE THIS PURCHASER INELIGIBLE FOR THE STATUTORYDEDUCTIONS LISTEDAT THE TOP OF THIS PAGE.
ADOR 60-5604f (9/08) Print Form :Reset Form;
E2
AFFIDAVIT OF NONRESIDENCY
AFFIRMATIONS OF PURCHASER:
1 will register this vehicle in the state of WASHINGTON prior to the expiration of the 90 Day
Nonresident Registration Permit, and will not use this vehicle in Arizona after this date for other
than purely temporary or transitory purposes.
I will personally be liable for an amount equal to the state, county and city taxes that would have
applied to a non-exempt sale, plus penalties and interest computed from the date of sale, if this
vehicle is registered in Arizona within 365 days of the date of sale.
I will personally be liable for an amount equal to the state, county and city taxes that would have
applied to a non-exempt sale, plus penalties and interest computed from the date of sale, if I
have provided false information on this certificate.
understand that in Arizona, it is a Class 5 Felony to "knowingly prepare, present or aid, procure or
advise in preparing or presenting any return, affidavit, claim or other document which is fraudulent
or is false as to any material matter, whether or not the falsity or fraud is with the knowledge
or consent of the taxpayer authorized or required to present the return, affidavit, claim or
document." [See A.R.S. § 42-1127(B)(2)]
understand that I will be subject to criminal penalties if I have either omitted required information or
provided false information on this certificate. [See A.R.S. § 42-1127(B)(4)]
I have verified that my driver's license information provided on Page 1 is correct.
I hereby certify that the information I have provided on this Certificate is true, accurate and
complete. Further, if I am the representative of a nonresident entity, I certify that I am
authorized to execute this Certificate on behalf of the nonresident entity named above.
Signed by:
Purchaser or Entity Representative
ADOR 60-5604f (9/08)
'i -- 15 _c22h
Date