NDHHS Security CamerasAttac4WCEIV
(valid p'r�c�ne number and V -mail address required)
3. Contact Person for Further Information on Application
NamelTitle:l�l�-2x% G a 1��' & PU 1 Ae L.�
( a �' C
Phone: "' tl1 o f 1 Errai� �5 GI h�n,a r, e
(valid phone number and e-mail address required)
4. Identify the securitylemergency response improvements that will be addressed by this public
water system security grant for each facility (well, storage, etc.) and include estimated-cost
for each facility. Please make- this an itemized list with the individual cost associated with
Siqnature Date
Fax or Mail Completed Application to:
Kristin Luebbe, Water System Security Coordinator
Nebraska Department of Health and Human Services
Division of Public Health
P.O. Box 95026
Lincoln, NE 68509 -5026
Fax: 402/471 -6436
1
18434 Y3
1 all = 44L93INTItiA=1 &1 *6111:1 WA63W el XA il,k
- i i ■ ♦ Tj . ♦ -
i l k • ! - . ' • A
This subgrant is entered into by and between the Nebraska Department of Health and Human
Services, DIVISION OF PUBLIC HEALTH OFFICE OF DRINKING WATER AND
ENVIRONMENTAL HEALTH (hereinafter "DHHS "), and CITY OF BLAIR, NEBRASKA
(hereinafter "Subrecipient ").
CFDA Title & #: Capitalization Grants for Federal Agency: U.S. EPA
Drinking Water State
Revolvinq Funds /66.468
Award Name: Drinking Water State Federal Award Identifier # FS997805
Revolving Fund
Issue Date: 9/7/2011 This award is not for research and
Award Date: 7/15/2013 does not include ARRA funds.
PURPOSE The purpose of this subgrant is: to provide funds to community and non - transient
non - community public water systems serving a population of 10,000 or less for improving the
protection of public water systems.
A. TERM This award is in effect from July 15, 2013 the effective date through June 30, 2014,
the completion date.
B. TERMINATION This subgrant may be terminated at any time upon mutual written consent
or by either party for any reason upon submission of written notice to the other party at least
Thirty (30) days prior to the effective date of termination. DHHS may also terminate this
subgrant in accord with the provisions designated "FUNDING AVAILABILITY' and "BREACH
OF SUBGRANT." In the event either party terminates this subgrant, the Subrecipient shall
provide to DHHS all work in progress, work completed, and materials provided by DHHS in
connection with this subgrant immediately.
A. TOTAL SUBGRANT DHHS shall pay the Subrecipient a total amount, not to exceed
$10,000.00 (ten thousand dollars and no cents) for the activities specified herein.
B. PAYMENT STRUCTURE Payment shall be structured as follows:
1. A single payment will be paid to the Subrecipient upon receipt of items referenced in
Item III.A.
Subgrant
Rev. 10/2011
C. BUDGET CHANGES. The Subrecipient is permitted to reassign funds from one line item to
another line item within the approved budget. If funds are reassigned between line items,
prior approval from DHHS is required for cumulative budget transfer requests for allowable
costs, allocable to the subgrant exceeding five percent (5 %) of the current total approved
budget. Budget revision requests shall be submitted in writing to DHHS. DHHS will provide
written notification of approval or disapproval of the request within thirty (30) days of its
receipt.
FWI
A. The Subrecipient shall:
1. Notify Kristin Luebbe at 402/471 -1007 or kristin.luebbe aanebraska.gov that the
material /equipment in the application, Attachment 3, has been installed and is ready
for an inspection.
2. Provide a copy of the billing invoice(s) and a copy of the cancelled check(s) (front and
back) or a copy of the bank statement showing the check has cleared the bank for the
materials, equipment and installation.
3. Have a current public water system Emergency Response Plan that has been
approved by the DHHS.
4. Have a designated water system operator successfully obtain certification for
completed courses on Incident Command and the National Incident Management
Systems (Courses ICS 100, 200 and 700) and provide copies of the certification to the
DHHS.
5. Provide a 10% match of Subrecipient's funds to improve the protection of the public
water system.
6. Pay Davis Bacon wage provisions if the labor cost within the contract is greater than
$2000.00 (two thousand dollars and no cents). If the Subrecipient performs the work
(i.e., Force Account), the Davis Bacon wage provisions do not apply.
B. DHHS shall:
1. Inspect the installation of the materials /equipment before payment can be issued.
A I i a A
A. ACCESS TO RECORDS AND AUDIT RESPONSIBILITIES
1. All Subrecipient books, records, and documents regardless of physical form, including
data maintained in computer files or on magnetic, optical or other media, relating to work
performed or monies received under this subgrant shall be subject to audit at any
reasonable time upon the provision of reasonable notice by DHHS. Subrecipient shall
maintain all records for three (3) years from the date of final payment, except records
that fall under the provisions of the Health Insurance Portability and Accountability Act
(HIPAA) shall be maintained for six (6) full years from the date of final payment. In
addition to the foregoing retention periods, all records shall be maintained until all issues
related to an audit, litigation or other action are resolved to the satisfaction of DHHS. The
Subrecipient shall maintain its accounting records in accordance with generally accepted
accounting principles. DHHS reserves and hereby exercises the right to require the
Subrecipient to submit required financial reports on the accrual basis of accounting. If
the Subrecipient's records are not normally kept on the accrual basis, the Subrecipient is
not required to convert its accounting system but shall develop and submit in a timely
manner such accrual information through an analysis of the documentation on hand
(such as accounts payable).
2. The Subrecipient shall provide DHHS any and all written communications received by
the Subrecipient from an auditor related to Subrecipient's internal control over financial
Subgrant 2
Rev. 10/2011
reporting requirements and communication with those charged with governance
including those in compliance with or related to Statement of Auditing Standards (SAS)
112 Communicating Internal Control related Matters Identified in an Audit and SAS 114
The Auditor's Communication with Those Charged With Governance. The Subrecipient
agrees to provide DHHS with a copy of all such written communications immediately
upon receipt or instruct any auditor it employs to deliver copies of such written
communications to DHHS at the same time copies are delivered to the Subrecipient, in
which case the Subrecipient agrees to verify that DHHS has received a copy.
3. The subrecipient shall immediately commence follow -up action on findings arising from
audits or other forms of review. Follow -up action includes responding to those
conducting such examinations with clear, complete views concerning the accuracy and
appropriateness of the findings. If the finding is accepted, corrective action, such as
repaying disallowed costs, making financial adjustments, or taking other actions should
proceed and be completed as rapidly as possible. If the subrecipient disagrees, it should
provide an explanation and specific reasons that demonstrate that the finding is not
valid.
4. In addition to, and in no way in limitation of any obligation in this subgrant, the
Subrecipient shall be liable for audit exceptions, and shall return to DHHS all payments
made under this subgrant for which an exception has been taken or which has been
disallowed because of such an exception, upon demand from DHHS.
B. AMENDMENT This subgrant may be modified only by written amendment executed by
both parties. No alteration or variation of the terms and conditions of this subgrant shall be
valid unless made in writing and signed by the parties.
C. ANTI - DISCRIMINATION The Subrecipient shall comply with all applicable local, state and
federal statutes and regulations regarding civil rights and equal opportunity employment,
including Title VI of the Civil Rights Act of 1964; the Rehabilitation Act of 1973, Public Law
93 -112; the Americans with Disabilities Act of 1990, Public Law 101 -336; and the Nebraska
Fair Employment Practice Act, NEB. REV. STAT. §§ 48 -1101 to 48 -1125. Violation of said
statutes and regulations will constitute a material breach of this subgrant. The Subrecipient
shall insert this provision into all subgrants and subcontracts.
D. ASSIGNMENT The Subrecipient shall not assign or transfer any interest, rights, or duties
under this subgrant to any person, firm, or corporation without prior written consent of
DHHS. In the absence of such written consent, any assignment or attempt to assign shall
constitute a breach of this subgrant.
E. ASSURANCE If DHHS, in good faith, has reason to believe that the Subrecipient does not
intend to, is unable to, has refused to, or discontinues performing material obligations under
this subgrant, DHHS may demand in writing that the Subrecipient give a written assurance
of intent to perform. Failure by the Subrecipient to provide written assurance within the
number of days specified in the demand may, at DHHS's option, be the basis for terminating
this subgrant.
F. BREACH OF SUBGRANT DHHS may immediately terminate this subgrant and agreement,
in whole or in part, if the Subrecipient fails to perform its obligations under the subgrant in a
timely and proper manner. DHHS may withhold payments and provide a written notice of
default to the Subrecipient, allow the Subrecipient to correct a failure or breach of subgrant
within a period of thirty (30) days or longer at DHHS's discretion considering the gravity and
nature of the default. Said notice shall be delivered by Certified Mail, Return Receipt
Subgrant 3
Rev. 10/2011
Requested or in person with proof of delivery. Allowing the Subrecipient time to correct a
failure or breach of this subgrant does not waive DHHS's right to immediately terminate the
subgrant for the same or different subgrant breach which may occur at a different time.
DHHS may, at its discretion, obtain any services required to complete this subgrant and hold
the Subrecipient liable for any excess cost caused by Subrecipient's default. This provision
shall not preclude the pursuit of other remedies for breach of subgrant as allowed by law.
G. CONFIDENTIALITY Any and all confidential or proprietary information gathered in the
performance of this subgrant, either independently or through DHHS, shall be held in the
strictest confidence and shall be released to no one other than DHHS without the prior
written authorization of DHHS, provided that contrary subgrant provisions set forth herein
shall be deemed to be authorized exceptions to this general confidentiality provision. As
required by United States Department of Health and Human Services (hereinafter "HHS ")
appropriations acts, all HHS recipients and DHHS Subrecipients must acknowledge Federal
and DHHS funding when issuing statements, press releases, requests for proposals, bid
invitations, and other documents describing projects or programs funded in whole or in part
with Federal and DHHS funds. Recipients are required to state: (1) the percentage and
dollar amounts of the total program or project costs financed with Federal and DHHS funds;
and (2) the percentage and dollar amount of the total costs financed by nongovernmental
sources. This provision shall survive termination of this subgrant.
H. CONFLICTS OF INTEREST In the performance of this subgrant, the Subrecipient shall
avoid all conflicts of interest and all appearances of conflicts of interest. The Subrecipient
shall immediately notify DHHS of any such instances encountered, so that other
arrangements can be made to complete the work.
I. COST PRINCIPLES AND AUDIT REQUIREMENTS. The Subrecipient shall follow the
applicable cost principles set forth in OMB Circular A -87 for State, Local and Indian Tribe
Governments; A -21 for Colleges and Universities; or A -122 for Non - Profit Organizations.
Federal audit requirements are dependent on the total amount of federal funds expended by
the Subrecipient, set in the table below and Attachment 1, Audit Requirement Certification.
Audits must be prepared and issued by an independent certified public accountant licensed
to practice. A copy of the annual audit is to be made electronically available or sent to:
Nebraska Department of Health and Human Services, Financial Services, P.O. Box 95026,
Lincoln, NE 68509 -5026.
J. DATA OWNERSHIP AND COPYRIGHT Except as otherwise provided in the Federal
Notice of Award, DHHS shall own the rights in data resulting from this project or program.
The Subrecipient may copyright any of the copyrightable material and may patent any of the
patentable products produced in conjunction with the performance required under this
subgrant without written consent from DHHS. DHHS and any federal granting authority
hereby reserve a royalty -free, nonexclusive, and irrevocable right to reproduce, publish, or
otherwise use, and to authorize others to use the copyrightable material for federal or state
government purposes. This provision shall survive termination of this subgrant.
K. DEBARMENT SUSPENSION OR DECLARED INELIGIBLE. The Subrecipient certifies that
neither it nor its principals are presently debarred, suspended, proposed for debarment,
declared ineligible, or voluntarily excluded from participation in this transaction by any
federal department or agency.
Subgrant 4
Rev. 10/2011
Amount of annual federal expenditure
Audit Type
$100, 000 to $499,999
Financial Statement Audit
500, 000 or more in federal expenditure
A -133 audit
J. DATA OWNERSHIP AND COPYRIGHT Except as otherwise provided in the Federal
Notice of Award, DHHS shall own the rights in data resulting from this project or program.
The Subrecipient may copyright any of the copyrightable material and may patent any of the
patentable products produced in conjunction with the performance required under this
subgrant without written consent from DHHS. DHHS and any federal granting authority
hereby reserve a royalty -free, nonexclusive, and irrevocable right to reproduce, publish, or
otherwise use, and to authorize others to use the copyrightable material for federal or state
government purposes. This provision shall survive termination of this subgrant.
K. DEBARMENT SUSPENSION OR DECLARED INELIGIBLE. The Subrecipient certifies that
neither it nor its principals are presently debarred, suspended, proposed for debarment,
declared ineligible, or voluntarily excluded from participation in this transaction by any
federal department or agency.
Subgrant 4
Rev. 10/2011
L. DOCUMENTS INCORPORATED BY REFERENCE All references in this subgrant to laws,
rules, regulations, guidelines, directives, and attachments which set forth standards and
procedures to be followed by the Subrecipient in discharging its obligations under this
subgrant shall be deemed incorporated by reference and made a part of this subgrant with
the same force and effect as if set forth in full text, herein.
M. DRUG -FREE WORKPLACE Subrecipient agrees, in accordance with 41 USC §701 et al.,
to maintain a drug -free workplace by: (1) publishing a drug -free workplace statement; (2)
establishing a drug -free awareness program; (3) taking actions concerning employees who
are convicted of violating drug statutes in the workplace; and (4) in accordance with 2 CFR
§180.230, identify all workplaces under its federal awards.
N. FEDERAL FINANCIAL ASSISTANCE The Subrecipient shall comply with all applicable
provisions of 45 C.F.R. §§ 87.1 -87.2. The Subrecipient certifies that it shall not use direct
federal financial assistance to engage in inherently religious activities, such as worship,
religious instruction, and /or prose lytization.
O. FEDERAL FUNDING ACCOUNTABILITY AND TRANSPARENCY ACT REPORTING. The
Subrecipient shall complete the Subrecipient Reporting Worksheet, Attachment 2, sections
B and C. The Subrecipient certifies the information is complete, true and accurate.
P. FORCE MAJEURE Neither party shall be liable for any costs or damages resulting from its
inability to perform any of its obligations under this subgrant due to a natural disaster, or
other similar event outside the control and not the fault of the affected party ( "Force Majeure
Event "). A Force Majeure Event shall not constitute a breach of this subgrant. The party so
affected shall immediately give notice to the other party of the Force Majeure Event. Upon
such notice, all obligations of the affected party under this subgrant which are reasonably
related to the Force Majeure Event shall be suspended, and the affected party shall do
everything reasonably necessary to resume performance as soon as possible. Labor
disputes with the impacted party's own employees will not be considered a Force Majeure
Event and will not suspend performance requirements under this subgrant.
Q. FUNDING AVAILABILITY DHHS may terminate the subgrant, in whole or in part, in the
event funding is no longer available. Should funds not be appropriated, DHHS may
terminate the award with respect to those payments for the fiscal years for which such funds
are not appropriated. DHHS shall give the Subrecipient written notice thirty (30) days prior to
the effective date of any termination. The Subrecipient shall be entitled to receive just and
equitable compensation for any authorized work which has been satisfactorily completed as
of the termination date. In no event, shall the Subrecipient be paid for a loss of anticipated
profit.
R. GRANT CLOSE -OUT. Upon completion or notice of termination of this grant, the following
procedures shall apply for close -out of the subgrant:
1. The Subrecipient will not incur new obligations after the termination or completion of the
subgrant, and shall cancel as many outstanding obligations as possible. DHHS shall
give full credit to Subrecipient for the federal share. of non - cancelable obligations
properly incurred by Subrecipient prior to termination, and costs incurred on, or prior to,
the termination or completion date.
2. Subrecipient shall immediately return to DHHS any unobligated balance of cash
advanced or shall manage such balance in accordance with DHHS instructions.
Subgrant 5
Rev. 10/2011
3. Within a maximum of 90 days following the date of expiration or completion,
Subrecipient shall submit all financial, performance, and related reports required by the
Subrecipient Reporting Requirements. DHHS reserves the right to extend the due date
for any report and may waive, in writing, any report it considers to be unnecessary.
4. DHHS shall make any necessary adjustments upward or downward in the federal share
of costs.
5. The Subrecipient shall assist and cooperate in the orderly transition and transfer of
subgrant activities and operations with the objective of preventing disruption of services.
6. Close -out of this subgrant shall not affect the retention period for, or state or federal
rights of access to, Subrecipient records, or Subrecipient's responsibilities regarding
property or with respect to any program income for which Subrecipient is still
accountable under this subgrant. If no final audit is conducted prior to close -out, DHHS
reserves the right to disallow and recover an appropriate amount after fully considering
any recommended disallowances resulting from an audit which may be conducted at a
later time.
S. GOVERNING LAW The award shall be governed in all respects by the laws and statutes of
the State of Nebraska. Any legal proceedings against DHHS or the State of Nebraska
regarding this award shall be brought in Nebraska administrative or judicial forums as
defined by Nebraska State law. The Subrecipient shall comply with all Nebraska statutory
and regulatory law.
T. HOLD HARMLESS
1. The Subrecipient shall defend, indemnify, hold, and save harmless the State of
Nebraska and its employees, volunteers, agents, and its elected and appointed officials
( "the indemnified parties ") from and against any and all claims, liens, demands,
damages, liability, actions, causes of action, losses, judgments, costs, and expenses of
every nature, including investigation costs and expenses, settlement costs, and attorney
fees and expenses ( "the claims "), sustained or asserted against the State of Nebraska,
arising out of, resulting from, or attributable to the willful misconduct, negligence, error,
or omission of the Subrecipient, its employees, consultants, representatives, and agents,
except to the extent such Subrecipient's liability is attenuated by any action of the State
of Nebraska which directly and proximately contributed to the claims.
2. DHHS's Liability is limited to the extent provided by the Nebraska Tort Claims Act, the
Nebraska Contract Claims Act, the Nebraska Miscellaneous Claims Act, and any other
applicable provisions of law. DHHS does not assume liability for the action of its
Subrecipients.
U. INDEPENDENT ENTITY The Subrecipient is an Independent Entity and neither it nor any
of its employees shall, for any purpose, be deemed employees of DHHS. The Subrecipient
shall employ and direct such personnel, as it requires, to perform its obligations under this
subgrant, exercise full authority over its personnel, and comply with all workers'
compensation, employer's liability and other federal, state, county, and municipal laws,
ordinances, rules and regulations required of an employer providing services as
contemplated by this subgrant.
Subgrant
Rev. 10/2011
V. REIMBURSEMENT REQUEST. Requests for payments submitted by the Subrecipient shall
contain sufficient detail to support payment. Any terms and conditions included in the
Subrecipient's request shall be deemed to be solely for the convenience of the parties.
W. INTEGRATION This written subgrant represents the entire agreement between the parties,
and any prior or contemporaneous representations, promises, or statements by the parties,
that are not incorporated herein, shall not serve to vary or contradict the terms set forth in
this subgrant.
X. LOBBYING
1. Subrecipient certifies that no Federal appropriated funds shall be paid, by or on behalf of
the Subrecipient, to any person for influencing or attempting to influence an officer or
employee of any agency, a Member of Congress, an officer or employee of Congress, or
an employee of a Member of Congress in connection with this award for: (a) the
awarding of any Federal agreement; (b) the making of any Federal grant; (c) the entering
into of any cooperative agreement; and (d) the extension, continuation, renewal,
amendment, or modification of any Federal agreement, grant, loan, or cooperative
agreement.
2. If any funds, other than Federal appropriated funds, have been paid or will be paid to
any person for influencing or attempting to influence: an officer or employee of any
agency, a Member of Congress, an officer or employee of Congress, or an employee of
a Member of Congress in connection with this subgrant, the Subrecipient shall complete
and submit Federal Standard Form -LLL, "Disclosure Form to Report Lobbying," in
accordance with its instructions.
Y. NEBRASKA NONRESIDENT INCOME TAX WITHHOLDING. Subrecipient acknowledges
that Nebraska law requires DHHS to withhold Nebraska income tax if payments for personal
services are made in excess of six hundred dollars ($600) to any Subrecipient who is not
domiciled in Nebraska or has not maintained a permanent place of business or residence in
Nebraska for a period of at least six months. This provision applies to: individuals; to a
corporation, if 80% or more of the voting stock of the corporation is held by the shareholders
who are performing personal services, and to a partnership or limited liability company, if
80% or more of the capital interest or profits interest of the partnership or limited liability
company is held by the partners or members who are performing personal services.
The parties agree, when applicable, to properly complete the Nebraska Department of
Revenue Nebraska Withholding Certificate for Nonresident Individuals Form W -4NA or its
successor. The form is available at:
http : / /www.revenue.ne..qov /tax /current /f w- 4na.pdf or
http: / /www.revenue.ne.gov /tax /current /fill -in /f w- 4na.pdf
Z. NEBRASKA TECHNOLOGY ACCESS STANDARDS The Subrecipient shall review the
Nebraska Technology Access Standards, found at
http: / /www.nitc.ne.gov/ standards /accessibility /tacfinal.html and ensure that products and /or
services provided under the subgrant comply with the applicable standards. In the event
such standards change during the Subrecipient's performance, the State may create an
amendment to the subgrant to request that Subrecipient comply with the changed standard
at a cost mutually acceptable to the parties.
AA. NEW EMPLOYEE WORK ELIGIBILITY STATUS The Subrecipient
immigration verification system to determine the work eligibility statu s
physically performing services within the State of Nebraska. A
Subgrant
Rev. 10/2011
shall use a federal
of new employees
federal immigration
7
verification system means the electronic verification of the work authorization program
authorized by the Illegal Immigration Reform and Immigrant Responsibility Act of 1996, 8
U.S.C. § 1324a, known as the E- Verify Program, or an equivalent federal program
designated by the United States Department of Homeland Security or other federal agency
authorized to verify the work eligibility status of a newly hired employee.
If the Subrecipient is an individual or sole proprietorship,, the following applies:
1. The Subrecipient must complete the United States Citizenship Attestation Form,
available on the Department of Administrative Services website at www.das.state.ne.us
2. If the Subrecipient indicates on such attestation form that he or she is a qualified alien,
the Subrecipient agrees to provide the U.S. Citizenship and Immigration Services
documentation required to verify the Subrecipient's lawful presence in the United States
using the Systematic Alien Verification for Entitlements (SAVE) Program.
3. The Subrecipient understands and agrees that lawful. presence in the United States is
required and the Subrecipient may be disqualified or the subgrant terminated if such
lawful presence cannot be verified as required by NEB. REV. STAT. § 4 -108.
BB. PUBLICATIONS. Subrecipient agrees that all publications that result from work under this
subgrant will acknowledge that the project was supported by "Grant No. XXXX" under a
subgrant from "Federal Agency" and DHHS.
CC. PROGRAMMATIC CHANGES The Subrecipient shall request in writing to DHHS for
approval of programmatic changes. DHHS shall approve or disapprove in whole or in part in
writing within thirty (30) days of receipt of such request.
DD. PROMPT PAYMENT Payment shall be made in conjunction with the State of Nebraska
Prompt Payment Act, NEB. REV. STAT. §§ 81 -2401 through 81 -2408. Unless otherwise
provided herein, payment shall be made by electronic means.
Automated Clearinq House (ACH) Enrollment Form Requirements for Payment.
The Subrecipient shall complete and sign the State of Nebraska ACH Enrollment Form and
obtain the necessary information and signatures from their financial institution. The
completed form must be submitted before payments to the Subrecipient can be made.
Download ACH Form:
http://www.das.state.ne.us/accounting/nis/address book info.htm
EE. PUBLIC COUNSEL In the event Subrecipient provides health and human services to
individuals on behalf of DHHS under the terms of this award, Subrecipient shall submit to
the jurisdiction of the Public Counsel under NEB. REV. STAT. §§ 81 -8,240 through 81 -8,254
with respect to the provision of services under this subgrant. This clause shall not apply to
subgrants between DHHS and long -term care facilities subject to the jurisdiction of the state
long -term care ombudsman pursuant to the Long -Term Care Ombudsman Act.
FF. RESEARCH The Subrecipient shall not engage in research utilizing the information
obtained through the performance of this subgrant without the express written consent of
DHHS. The term "research" shall mean the investigation, analysis, or review of information,
other than aggregate statistical information, which is used for purposes unconnected with
this subgrant.
GG. SEVERABILITY If any term or condition of this subgrant is declared by a court of
competent jurisdiction to be illegal or in conflict with any law, the validity of the remaining
Subgrant 8
Rev. 10/2011
terms and conditions shall not be affected, and the rights and obligations of the parties shall
be construed and enforced as if this subgrant did not contain the particular provision held to
be invalid.
HH. SMOKE FREE. Public Law 103 -227, also known as the Pro - Children Act of 1994 (Act),
requires that smoking not be permitted in any portion of any indoor facility owned or leased
or contracted for by an entity and used routinely or regularly for the provision of health, day
care, early childhood development services, education or library services to children under
the age of 18, if the services are funded by Federal programs either directly or through State
or local governments, by Federal grant, contract, loan, or loan guarantee. The law also
applies to children's services that are provided in indoor facilities that are constructed,
operated, or maintained with such federal funds. The law does not apply to children's
services provided in private residences; portions of facilities used for inpatient drug or
alcohol treatment; service providers whose sole source of applicable Federal funds in
Medicare or Medicaid; or facilities where WIC coupons are redeemed. Failure to comply
with the provisions of the law may result in the imposition of a civil monetary penalty of up to
$1000 for each violation and /or the imposition of an administrative compliance order on the
responsible entity. By signing, the Subrecipient certifies that the Subrecipient will comply
with the requirements of the Act and will not allow smoking within any portion of any indoor
facility used for the provision of services for children as defined by the Act.
II. SUBRECIPIENTS OR SUBCONTRACTORS The Subrecipient shall not subgrant or
subcontract any portion of this award without prior written consent of DHHS. The
Subrecipient shall ensure that all subcontractors and subrecipients comply with all
requirements 'of this subgrant and applicable federal, state, county and municipal laws,
ordinances, rules and regulations.
. - ,
JJ. TIME IS OF THE ESSENCE Time is of the essence in this subgrant. The acceptance of late
performance with or without objection or reservation by DHHS shall not waive any rights of
DHHS nor constitute a waiver of the requirement of timely performance of any obligations on
the part of the Subrecipient remaining.
NOTICES Notices shall be in writing and shall be effective upon receipt. Written notices,
including all reports and other written communications required by this subgrant shall be sent to
the following addresses:
FOR DHHS:
FOR SUBRECIPIENT:
Kristin Luebbe
James Realph
NE Department of Health & Human Services
City of Blair
PO Box 95026
218S16 th Street
Lincoln, NE 68509 -5026
Blair, NE 68008 -1674
402/471 -1007
402/426 -4191
IN WITNESS THEREOF, the parties have duly executed this subgrant hereto, and each party
acknowledges the receipt of a duly executed copy of this subgrant with original signatures.
FOR DHHS:
Mary Sue Semerena
Environmental Health Unit Administrator
DATE:
FOR SUBRECIPIENT:
kAl\
m s Realph
M r
DATE:
9 1191) , 3
Subgrant
Rev. 10/2011
�7
Attachment 1
9 ITI 1 :1 al I an a 1 0 VA 0 111 0 IJU ivi Wawa=
1 - * 0 1911 V -
Subrecipients and certain contractors receiving funds from the Nebraska Department of Health
and Human Services are required to complete this document. Reference to the Office of
Management and Budget Circular A -133, Audits of States, Local Governments and Non - Profit
Organizations, in this document is "Circular A- 133".
Grant Name Capitalization Grants for Drinking Water State Revolving Funds
Grant # FS997805 CFDA* # 66.468
*(Catalog of Federal Domestic Assistance)
Contractor's Name City of Blair
Address: 218 S 16 Street
City: Blair
State: NE Zip Code: 68008 -1674
Federal Tax Identification Number (FTIN) 476006106
Contractor's Fiscal Year I , 201 to _ , 20
All written communications from the Certified Public Accountant (CPA) engaged under #1 or #2
below, given to the contractor related to Statement of Auditing Standards (SAS) 112
Communicating Internal Control related Matters Identified in an Audit and SAS 114 The
Auditor's Communication with Those Charged With Governance and any additional reports
issued by the auditor as a result of this engagement must be provided to the DHHS immediately
upon receipt, unless the Subrecipient or contractor has directed the CPA to provide the copy
directly to the DHHS and has verified this has occurred.
Check either 1 or 2
1. _ As the subrecipient or contractor named above, we expect to expend less than $500,000
from all Federal Financial Assistance sources, not just the grant named above, and
including commodities in our current fiscal year. Therefore, we are not subject to the
audit requirements of Circular A -133.
We are, however, responsible for engaging a licensed Certified Public Accountant (CPA)
to conduct an audit of our organization's financial statements if we have total federal
expenditures over $100,000. We acknowledge the audit must be completed no later
than nine months after the end of our organization's current fiscal year. A copy of the
report must be submitted to DHHS address as shown below within the earlier of 30 days
after receipt of the auditor's report(s), or nine months after the end of the audit period.
2. 1 As the subrecipient or contractor named above, we expect to expend $500,000 or more
from all Federal Financial Assistance sources, not just the grant named above, and
Subgrant 10
Rev. 10/2011
including commodities in our current fiscal year. Therefore, we are subject to the single
audit requirements of Circular A -133.
We will engage a licensed Certified Public Accountant to conduct and prepare the audit
of our organization's financial statements and components of the single audit pertaining
to those financial statements. We acknowledge the audit must be completed no later
than nine months after the end of our current fiscal year.
We further acknowledge, that a single audit performed in accordance with Circular A -133
must be submitted to the Federal Audit Clearinghouse. The reporting package, as
evidence the audit was completed must contain:
• financial statements,
• a schedule of Expenditure of Federal Awards,
• a Summary Schedule of Prior Audit Findings (if applicable),
• a corrective action plan (if applicable) and
• the auditor's report(s) which includes an opinion upon financial statements and
Schedule of Expenditures of Federal Awards, a report of internal control, a report of
compliance and a Schedule of Findings and Questioned Costs.
We further acknowledge the auditor and this contractor or subrecipient must complete
and submit with the reporting package a Data Collection Form for Reporting on Audits of
States, Local Governments and Non - Profit Organizations (SF -SAC).
We further acknowledge a copy of the contractor's financial statements, auditor's report
and SF -SAC must be submitted, at the time these documents are submitted to the
Federal Audit Clearinghouse, to:
Nebraska Department of Health and Human Services
Financial Services
Grants and Cost Management
P.O. Box 95026
Lincoln, NE 68509 -5026
The foregoing submissions must be made within the earlier of 30 days after receipt of the
auditor's report(s), or nine months after the end of the audit period.
Subgrant 11
Rev. 10/2011
• - ' - • • • •
- • - • • •
Attachment 2
Federal Award Identifier Number (FAIN) FS997805
Federal Awarding Agency Name U.S. Environmental Protection Agency
Award Date 9/712011
CFDA Program Number 66.648
Subgrant Amount From This
Award: $10,000.00
*See instructions if the subgrant is funded from more than one funding source
JeGtl ®fl 0 — OU[JFUclPiWnL in1urn1cauv11
Subrecipient DUNS 164443947
Subrecipient Name City of Blair
Subrecipient Address: Street 216 S 16 Street
City Blair
State NE
Country USA
Zip Code + 4 68008 -1674
Congressional District 1
Amount of Subgrant $10,000.00 Subgrant Date 3/7/2013
Subrecipient Principal City Blair
State NE
Place of Performance:
Country USA
Zip Code + 4 68008 -1674
Congressional District 1
Subgrant Number 18434 -Y3 (Will be completed by Support Services)
Subgrant Project Description Public Water System Security
Grant
Subgrant 12
Rev. 10/2011
aection t. — vrrncer vompensaiion
1. In your business or organization's previous fiscal year, did your business
organization (including parent organization, all branches, and all affiliates
worldwide) receive 80% or more of your annual gross revenues in U.S. federal
contracts, subcontracts, loans, grants, subgrants, and /or cooperative agreements
AND $25,000,000 or more in annual gross revenues from U.S. federal contracts,
subcontracts, loans, grants, subgrants, and /or cooperative agreements?
❑ Yes — answer Question 2
CI No — not required to provide officer compensation
2. Does the public have access to information about the compensation of the senior
executives in your business or organization (including parent organization, all
branches, and all affiliates worldwide) through periodic reports filed under section
13(a) or 15(d) of the Securities Exchange Act of 1934 (15 U.S.C. 78m(a), 78o(d))
or section 6104 of the Internal Revenue Code of 1986?
❑ Yes — not required to provide officer compensation
❑ No — provide the names and total compensation of the five most highly
compensated officers of the entity below
Compensation
Compensation
Compensation
Compensation
Compensation
Subgrant
Rev. 10/2011
13
Name
2.
Name
3.
Name
4.
Name
5.
Name
Compensation
Compensation
Compensation
Compensation
Compensation
Subgrant
Rev. 10/2011
13
• • q 11111
• • • • •
Use this page only if the subgrant is being funded by multiple sources (multiple federal grants or
a combination of federal and state funds)
Federal Award Identifier Number (FAIN)
Federal Awarding Agency Name
Award Date
CFDA Program Number
Subgrant Amount From This
Award: $
Federal Award Identifier Number (FAIN)
Federal Awarding Agency Name
CFDA Program Number
Award Date
Subgrant Amount From This
Award: $
Federal Award Identifier Number (FAIN)
Federal Awarding Agency Name
CFDA Program Number
Award Date
Subgrant Amount From This
Award: $
Amount funded from Federal Grants $10,000.00
Amount funded from State General Funds $
Amount funded from State Cash Funds $
Amount funded from Federal Cash Funds $10,000.00
Total amount funded from all sources $10,000.00
Subgrant
Rev. 10/2011
total of grants in Section A
fed sources other than grants
should equal total of subgrant
14
Proposal .Nu Mbor: 909046,0
Date: 71812013
City of Slaiel N�_
Intake Camera. Addit.ion
PrepdredFor,
Kgyip Frphm
City of -Blafr,
Pi qpp-Ted gy;
Kept Caflin
S's-pur"ty Eqvipment Inc.
Sales 0pnS4[t
Em.all: kca
- I MTV. - .8 t NE; 68144.: p 778 - 37.21! Rw,
NE QOM. 1A
eoposol gmberm'9099 -1 -0
I�afie: W812Q�� .
City of B161r, WE
Situ 218 S 16th St., Blair ICE, 68008
C Kevin Frahm, ..2,426 -8688
Mak " 1 Ad dition
4 � 1
mci.bi�r.:ne:us,
oo Of Work
17 2OMP 1 -1.264 Day/Nigh 3 .606 Paz�o��aPIle, �9lnerR '(>`ta�ta� a �311i�iiin9
Ttistest Frame Rate .011
It� kket; - 3.51:ps 20A1P onci 1 l fps a 5A4I'
iJiip�z tllelecl kiigTZ D� iliitioii Reooltllion !o E.tibstittite:tip io Si t�� -five ntilog Catiler s
Ail ata -otli kl.2G I ��►y�lt�iglit SllreoilndVideo 60 - I
IP66'aiid Vatidt►l re- sistabi Doliie
Easily 4111staUID- 2 ca111era tlll 1S'ltll 36R. °.11at111 1 5° tilt
Hard re'tlil ni OUIit and 511gj1 e lllolllit' vjtll Qptlgnal pchdatit iitotlilt find iva11 ttio'luit
4-/- 10 acllstialerlt to.' lo�'titc sensor -angle
DbM Eticotl r T1.264 (MPEG.pgt 10),iiid ii R1 P
]3it ItatG Conl.'r
R�ul(i- Strelill]i'I]g '
Torensic 2ooiiiing
13iltncd -Mode ta- iuerease 8.ensrtiili.ty
Mesh Wireles.s Radio ; ystpi -for cauiera,(s) wifli alitei!11P
2 Wiretes's •R -d {l.an top of fm i er, l .t nfaltc 1�lt lcliiig)
4 ,Atiteii um (2 tacr rfid ti)
It3F1 3 comPlttltit
ET ,51 Dyltttiilio xGclncnc�t SeleetiotX (DT�S) i�: 'rilllsniisszoti Pot�Tet' Go'tt.trat u ?C
l.ip to 99 \jbps tl rougbolt
NN?P. A2; At-S 0k `KIP enet• ?'Pd011
Up fo 2 Mill output RF 04�'6r selcclabtc
Etimaec1 operating twuperattlrco
IP66 cMittg
ltetuote titt�gemei]t
Distance 7djllstmen't Por long.ronge, t.rtinsmissiott
Gm Meat inapj1ng ;dynat4C vieiv of.�Ysteili eoiifigtlratioil .&hdaitli
IEEE $02;a�jf CbIilpl ni t
1 5Q 'G 8tre E,t64 ' P;
rN1f`1W:Sei- o.maha NE ®Linco.1 ®Des Moines IPA, o Kansas Giiy ,KS
Pro osM NOmbefix 9090-16-0
Financial -summary
$Y TOal $12 3
Monthly
y ervices; $164
This Pr6pQsW for the -abov protection does ndt inglUde tax is. q6Vb*W by �t
aind Year PAds, 1abpr*gnd s�Nlo
guarantee .
ah h
g.Q M�j
q . ne5 IA q'
AroOdt VNi6h
Art e Oh:t V'4'sd'a n*
i p-Y-M ff
'.SVj8A
pql� A�01�f f Qr . AW0365
V
J-04606ff E�ox A4P16r �e 4s.bomora
'I
Cli toy
:b�-�4Ab4-4
T4 Oi 0
W
(NO
I
EkAUt
$A-EV1P.-'05
,8 Feat GatnePa License Update
TE GIES,
1w6c.4VOLO *
l
Riaqw Cable
-$QW8
C-aW bw"101 Outdb6r Ca(bjhg
KRO-
N4�-SH(1.-AA-OA
Wlrelesis.Mes)j Rejwqrk.Rpq6
4
100
KPC.NeNiqrka
take Gable
-PAT §M
vl.a2QR
Pjrqqt'Ongl Afflqpa
181213tow/outdoor Cabling
I
N e*tg ea r
- -8 Poet 01gabit NE*.SMaa
I
United Elpotr1r,
Viso
Mik M66 Hardware (Pole, efto)
Financial -summary
$Y TOal $12 3
Monthly
y ervices; $164
This Pr6pQsW for the -abov protection does ndt inglUde tax is. q6Vb*W by �t
aind Year PAds, 1abpr*gnd s�Nlo
guarantee .
ah h
g.Q M�j
q . ne5 IA q'
Proposal Nurr 40r; 9090 -1609
Date: 7181 -018
THIS AGREEMENT is made July 08, 2013 by and between SECURITY EOU:IpMENT; INC and its directors, officers,
shareholders, employees and agents, {coltective)y 4 8b) -and City of Blair. NE , Location of Customer's premises218 116th
Blair; NE;6$tlb8.
ta'the' #erins rid con iCions hereinafier. set qnf�, SEl .agrees fo Aed riYOVide instaRafion services end provide (C Ce rRercial
ich Is tneor orated here [n by refer n ,
CCTV Maintenance) o the qumeit spcfid'at "Sched.ule afi Proteottoh' y Y++t?.. , , p .. .
Note;
te)n
a cknowled g es and agrees'that ��� additional equ%pit�iln ; a't adciiftonal +aosi,:can. i?rQUide Increase rm 0 000
ilfLffo, Pt`e se` "s
customer . 9
C�istorneY fia;; voCuntarif�r elected to cce it fhe SAtOin based ari Customer's b rs[ttess.reasons, i.e s,, .
environment and tondiit[ons, .insurance requirement, etc i< � a eecond telephone I stem r ed �b SEi gusto ner shall at s
feleph" e inthile th'e .S sfem is (ransm�lfrnat to, a `:or[ 4.._ ga'Ii 4 if e
tip m [t nn t f ; O ih y... y .. , .
pg. y g greemetif 5usfarner
sole cost, promp iy end without demand return flue System to Sit at'the ex{iiratlon tir #erm[nation of f sres red[rctri f e alarms,
bi "s vol�ii tarily.eiected delayed. disPMa h or no re.j�eat'd spatch seiviaas checked( above fear ! tourer shall not! SEI of ail
notv�lifhs 'the inpreased rM of loss or .tia[ilage ifillerellt in Ccrser`s decision, j► all f
oroi,na[ices Qr pgiictes of p{gpe`eA6thorities that r. lti Ofre6t
§F . erfori i_aiic .of servlinan o t o e g lid :s�[ali p
a
and 'char 'es which ina be assessed to t✓ustamsr to cotpiy with State
pr roost statutes, ordinances, or regulations,
Installation Charges:
Custohl6(Ag'reOs to Pay SO the sum of: 512,128 plus tax, if applicable,
Qe.postf dame t[pon . P.rewIdng will ba ,ri0% non- refunda>jie
!f ner;essary, rertis[nmg b tatice will be due qi n sirbsta" Mai coi�iplei(ori bf insfal(ation,
Recurring Char I[cable, er inotth. for fhe lease or perrohase of the system
qya I'Qi 6t' pq'rg� to pay SEI the siu11 Of $104 plus tax, if [ � app' = , p....
, J'. o.... i• ' .
Commercial C Mainte included in Chia pro.posal re a[d annualsfTf nsfer[�dlf o j EFT is; desired G ihod stotinpaum on es
:.. .:
Ci[ - j --- : may b by cheek., [honey ord6f, c - redit card or EFT (Eiectron[c dun
periodic- debits yror.(? 0.. . mei's ai�k acc6i[nf as stated above.
SEi PlatiN61 ProteGti.M.
Ski PEatiniir[l - Protection package is an additional $ � per month (No tax 1ncl.uded)
Accept Decline
M
Submitted By: Kept Carlin
city of Blair, NE
C°1� I II(
Date: 42 ' I I O k
Approved By:
Date:
www.sei= security.cnm b_Orttah
ECint Name:
-n : ,r'e-t� (
Titi Gtco C" r
Emait:
i44 t P' (4UL1 I IZ -3 r/ 1 . 1 r:.t'ruz-J „y., M �..
a l,ia�ooirt NE o Des. oines.lA o'j<ansas Cify KS
Proposal NU
Date: 7181M
Ter s 8'
M. COhditions
9, Trta' ce and ate e' 9r de iznance.charge of one and one= iiiird (.1 . sixteen a) q� Oe!]vW Mill p 1h
- . n �1§0/ Fpn y o all Oblfgallon s not paid
jto "I 4n'id(Apercep� p n1iWl1virfbd',(Igte &dt� 50%) percent bf any payment due W&6ifer redetved
qr* to! f PJO 0 p
E U iayt* d"r (h bn yvhlcb such, 0 5jft �t Is'O ud 'i s liqUiddl do'nisUdf Ohd ho(s's.a peh Olij
ALutomatle 6f tli�lr -d 1q.V�, p
ip �yo4� quil 19 th.ojnilfqf'� 4 ql*r
Riftax-A pnoW und the ter j ana C006ljjOn
- P - 6j1Y,iv.6,s Voll'ted notice Offie least WIA� .
is .
(�Oj 4�s I5doi to 4plra(166 date tolernffiW Ithii 4`rWoldhl.. In thd 'i f"j ' lit prOisl4n
iorl . 11�'4olab;i
RIA116T&MI6616, No6fqj, n hef6th (6-(fi4.eohIrbrY, 881 ni6y Ilh%d. M hd
. ,
.Olp
.g sn its solo disdrell Wh, letinth6le this Abrb.6mehi 040;dt Vil 0 a
(
thirty M 1,41fis Ov$hl such i�rrdlnatlbn is Awfdaus% 4411; 6P.0 AO vff-itle�rvrgque�j
6 0 . . . . 4 , . ' Ousionigr,
-rdfun6L.p
41 '> .eae6 jl� CA 6'r'n'trid ih . 4VO i g tlghi to fricfiali*4 Pb rid d 1 mac'e's aloby lime drii 66i tiftdr W OxPJ(01loh.VM.d,(1) yo r Tr.Qm lhp.Aelta'ot his M(P a m9Gt lip 6 R
it dffiexba� illn'�VW Q6'U b "'1h .jpereased,charge,,:_Cusiotner must
n80ij fV Y tee
qqly (2d$.. $jays �flbr fO"the d e
01 envise e. qplh�e. �vl I be Ieii
�q6 ih t Adigotn f64 Vd ddtd of tire' tharge,'
ineya( its sole SEi
@969t0*4 fiiicfM & a 'ibkVj*0fl b`6 bl6dtdg ( th.lq& dh
lm,p.. a PrO100J lW
5, ear hk1w6(haK to I fi e 4Y6 O D � tje.abh
od El shat ( hA
etalitled (d retain all ptp RY
SMeAt'iV' - V� MOO litkiltj
dihib'ArM dOAf6M&r ?
T(no(S
- al'i'POT6 6is4tion p(�bd . a . dlqg is
, 46bqrsq SEI for 611 of Its ddsls
V P11% Teiqon-ib.te.alt.orliey*sl...jeI
Bj�Lm to RgM an . Cure. an th
j h'�btWb Ohd.jh$OMV[41dns oil
if the breach cannot be - rea§on'?.'L
'hef6k, ibis Aji.A tt 00( sfiA c6ij
in �Wgcijorwijih Cqr19qq
7. `:Suss I a nsion -of
the "i?arieP`J In -order B IlmiWed,
if the tyderh'q isNaly*sIg6a t
ilidt ihe Pd. w/ "s
.anq,rpfyte to unl6d0bo PanqL 1
or 04 'brd 6 l6i
or ag. tp-
IJ61
0 .
N
d
Dsg-bet-auk )n .(hqu qvqqnk:`. , E
AM` �00.0 '4'e0y:6ther . tg . tp . enj . d
trxercTse y or a11*ofjls: ts.*tfnc
'10. Sfff ut . UnabrhTnd Pidnbi
to
-ft'15elb� l'nq'1d*OUAt*b'ffi ,
t � . - grr;'T
U if"S A' I * " oll - S
. gfoof t
.. . I .
ft. AQi(Iqnai:Equtpmenf *o*t Servic
. 1. . 1. .... AI . d
sqVices OPP P
12, Cus't omer's
Trade iiriioti•:�urisdlctfoiiat dispute
sh*611'pay-.�kffor P11 such C
I I's 41. p I Mp_ Mt dr
rec eived apd. g6:6(Wir'sffi 'all I t pay` 11. �iR p $
h * li P b a, all pf 6 ..(2) ,9
dj�bl PEI.'(.f all pa' quits I jq' d
ply p�y'to
h N Orlaf
JA 6494 b a 1�4 thM p.q W.
I die ase on a. me.a 4 0 ra po .,Rqw i d
V&jq
.6 unexp(ted 16T1j1.
1pon Ouslop%N'WaO SEI �fieillbpye ho'fOrthar 6WId'911on to perform unfir i qWmOnf; n'aldil
Inifild6d aci is the - *"*6 ., u , * - b�i.fa6ti6li� , :Olr���*11.fng , V�hq w pagnip'nt, award, jljndlng''kf Otffenlebl 6u Vf�edfy or
ind .=pen'sds including, -A-AjhqufThjQ(1on Pr enftPlq'; s'lo A4 Pe g s , and casts including, without hmPNO
L 0 r
3�V:q _costs as WONYO bY - law.
0
. 0 - of 94Y beach or ihfs Agreegaent by Si Oa"�
J, Iprftdr Aqri:e's'Ip prQvjd.6 1vrA19A rlbtfo @ 5EI App ificai'videntl1iing 16 natvre r lr
is Agroemdfat bifedk4lherA' , ana to•-peinill bEYJA oqrp the "N
�uro an ys a
period, 6 Of6rf�t.y commence to &W �rbctod.Opill. ��6dc !as pfe4ed
Ue,&bs4ed 9'� iA 6 11 o i be 1 fa b I i I o b Ush �j6 r Y a N 'y: j 6s t �a`n*j'.O g a ter eix 46 P' rela , -
arice of any said breacfa
ioje'16 SEI.
Ae mqnl shall at all fimos iereb er ten L
;r
% er
p.offi f or arty reA.
ij's spifid 1q " jc�; (2j
b .00y cause OthO Qibn 8 i's sole ridp,
>'(o the Panel to SEI ogly, El's htonitoririg .YA 4iAMI UgSna**46;C*U**s*foffi6r or
sleni; (3 e exercise 6 -ROPAS ", Ir.P.9i hq do qi signal 41fb*�O J. p r
e
811YOP of tUt
�. 1hal SEI vnj RgpredentdiM `h�ivo h'd.'know104qq,At Qisripq en pl�es'.y4C qz or . . other Like
end 61he
* r '11' Ot6db d W4 i �aldfi Oand �Rcq.�# s.40 ft -k� PMA199. 0 sq@P . -�Ojb! .
V 01
any OaMeill pp dieO or okpo'h6d§ fr6N, In connection With, as 61e t.
*sult pf, - roFa - Ae***8 , tq , : ,
or as a q nspqqqp63*
61 gq6lpffient or.bqh1rhendqrn.qq1,p
MA deig I .:
p
Fi.p� that d �t Ibis
slid' Cus6mer-'. pq g-dordUl. §Y. pnlqr vn
h� u I by CO n es pprmt.fift SEI to
�r:ahy'6r i O offO� j brWndbfi 16*016.01e pad ktolule h
disc(dillo
Of SE
6& Ls, -nu Aor " . ne r.b gr4 s 'res� - kbi hAti or'6p or.Ql§�M �.]hy qq� 61�.m e nt,.. dq&�, � t. prop �jy of afi.y
epfloiJe -- " * , :.1. lefti� . ."'d "'. - ' f
t ha't'b1l*r' b'dji ccinditi0so
s If, .2 s ty JtM teases,
$151 sh be s # p fi t his fi r eerpe a i or if y i , x cep i' t Fi a ' t a cat er e s y all.b. rNWe f 0 p satl d'iifonal QpO,
6hse'j Costs, *1o`1,vA16stan.dIng-Pnyl -if o6y. -�r f .4)06n, lot (h) art
f blog to to contrary contained Worn, 01 stpte. f jst4l.* b*�( 46b
Mion, p#�a h ghe'r �qlnp�nsa 19A' or �y qe.*rhlP$ jo)
�Wltsjn SEI 16-turripq pny extra 65�pehso including, Ifnia 6;
here,* y.conse'W' eh�
authoriz M td'(rtcQ such gNpqppe on b _ ff of.oj4o'for ql 4cp 961 of (hp -Ouslo a[ij Customer
d
8etv7 Cus' Untrer�fd dM4 afto�jWgU lh�t "the Syil�rn- day trait aal41d..& fi�cjtjjtQC1ng'fAclllty C. I re sin
ces. .. tprnle P 0 0 'q
or tefephon6 pr data] over
! � p9w �Iyq! .(I. -,
rqr,s�jnp,(Pq. ot%Orqjq�� -�'e.q., c;�Ilulai 6�'946&t lotnj-df (Ad16 tr6QAl'g*glqn).
— 11. !066
Ifn' q*s`*,-a- local. arba abtvvork - Vrs" A6i*i;r'a*Ti*6'.'f &.sn6fR..dt ffifr!0(r0
c el, Piul(fpfex,
I t6 it N&I I 's. c"o' 1mf A' f oni i;i' '01 sucli '?6MOdi W.66 !�AIAW
r forms - ot is.�Mca, �or- Ma rW1 .6v • a As* are
oypipm; ft hq'PJ(ptqn1.
I
jqIOphpna nvrh4er. shpt Is qlfferodt.ft " n receipt of data fro`m'the SYsierti, regardless accordingly, Customer uridersiap is,. ackrrntilled and 6f
Pystebi Is ndOdfafilIMP atrb the ansmissioii and the W�rfiuhf Gds equi pment
tfft'ilan bt unqbr�a
14s acknvtjl6d�es`thaj prom $red.
4, Trahf
..y�tem IncluOng, 416u'll -q:O
r
6616�116ns *e'q'*4l*' . t * , , , i t
used - qP0 Ihe i 6AWWW96 I lbdih
- P Pment. or service b�, any i Iffilitallvh ,
y ..!pddjt
shy - i6r(6FInfddar6nce (t.*g-. olfiq!w)se), qrl8e I*Ois'& aW60hOfid line 6r'd1W* tone '�ejth01( 4.qcqOU-tfi6 %lt*Or-,O.fher%
WA. 6e no IIMC�atiowor tcofi Jote unless 6ustome*v - elects ' to use an j .
is if1d64.9iibi*,
pled
received a l of Ion ... a dd itional -
.qqm�qfomi:of'Wreress cdi�munfca'flbn) orsomp fter:torm-�(j tco lcat!Pri `MQ4 'Nits - . .
jpe; k4 obl] oring consists -- We� Ulf sQVI 111 �gd�Q
1.16rifidrin "IeNlde Ce pers6nnbt ag8nejidt be'"the
(4'itti�ng'( d repsondble, ptrfo&r ( III'm
D
dt Onij(ailon �r ,�xatqpl�i-("t o�s joe " ip" *fit fig ewi"O Cod es' }, *"
Including, witho-(2).%-2hpn Ifit- 1 sfid
[6.pHo.M1y 61 the dai� that bas.beiri prVvf'
* ' I` " p)if d. in
:appeorf.'on the 01�6WM� Miule*`t` Ubeh, WKd muncti on o
for"algridls rdo.OvqdvjltM -aria p6t .tisied -6ode;,qr for voiq on)n.iVolcdd9p. %'Vhi
ch does not -requOt assistance.' r video
. pb &�- --V.11. !c I 'ls*obe6ked
-
transmission which does not clearly and cons k )r monitoring ii o el�Cybddlspad'teNe
P�� cu�oqsl� (Qy" the nacesslli �c mcbi it w6.1trp'sz
l
-0156�6, n6 monitoring �iivl�d vAll be tendered or ady*bur§W'alaihi Sy Unleis LlstedCW6 6orn 06�9 thM one zone of tfip'bprO alArm System are
received )' ilh(ri 'h se is �,hec�od O�PYG Listed
dpe.1 �!�pAq �p I no monitoring service villi b� it�deidd fohhi4a m. d
b L
Codes qr�one�s te'co from * * .. R' . ce d receipt - 5 - li Codes .. . . I .
[n!hpSisleni�d�hn .5[xty(.60.)minutes,a. erSE 0 r�o of Listed Odd66 al the
13505 "C" SV tt; - Onibhq; NE, '68144 1 P: (402) 77 . 3721 1 R FIR) T333-791
Incoth NE,-v A*Kans.as.
Proposal NUM4 9090-16-0
Dato: 71812015
ep. o
— on d Cod a
Tec';I�i
*k W) c
pre he ding onything.tgntAln�4 W alteMpl to Wact 1136 PreOlfsbs.lbr'Othit Wr�qePlpriq
}authorities, �d lii4y. tq lks RIP W absolute discrellon Arid WthRql in ... .. to report tlie 6t of
proper 4ubrly dg-SM 4.iqetbs apropAale t ) j e jjTy the, nw��hy
rturiip 0 61eblronla iirtioll hd&�6iei 0.*Ided W ttit!*6 Iii ikltlii� 6:6 il - aid the of the Listed Code 6t videp I
a Listed Code (o PromAdthodlim VA d*.(b) upon r e r elpj o f. an abort qod4 or oral a6lce t�.dl§m .0(6per.4 re00pt.QT
SEI � 0
Oa�, p'o 15016 6h OPP fi dlkfelloh a� Mityt- rerrdin r6m o
Ropoch
L%s I al 8rviddo jrdnSfi1h4f&I'$ WOffs. to Poll Y qqj
l: 'c1h6'! sle.0 Q
r 0, �`prid
i lei at thp 10-
verin p66 num OW ' V'ld*. to 'Fl ill' irillrlg
advice b telephone to any pqsqj ans% A 81 dff 0 -b rrn# I. I n 9`1 Up 16 16 ... tq t�t ri bis I
Q c d(olher'Jec
4ni c a ecIrb e :. d' t Camm unlcatlons.
e ffj�. je -rinb deiN�.Ica br any WeCh ' d b 4f-h era �
ii ,, k- 0 �dtiiifo Dafto, Cuadf y - EI as'
i t s to 91ye-aTmU " ' " ' n
c, SE7 as Ag&6,1�6isdiflo m 11 '.. ... , I , . .. , ' ' d '
s I U$.fomer.conce.rill.n.0-ony. Q 1n4 all rij opt.`Of, �pnnedon.Mlb br-relatO. Wthe
iM r
.... a
d'" u6db ffils 0 St Y fi664ri or
%-jhjtb-ld`�'tu&or1traqlOf gebtlon 664 44MO96 0 Vriding up
, P0N(m8.nc* of moriffbabo s9ty1o., I b t r qtq..
gf bf.SEI n r
l rd(561�et.li.j f6 Stl $0*. tilt , , `
Whtfpq f(or bf �Oid- �q
ems . 1 61
"A� WON Puf�qsij * t 1
Qu,
h' I Or
V
use A
a
on-exclul%
fi6:80!i E-11A W sa 1,
F•'• noktcTad es ;end a reel shad bf< srid.is de'entgd i4 b� relro�ft[ve.i'o !1T *lriltai date �u, Ei �ri,Ite monCtorSng
,p r. 8
C PL
....... I -bit InfognIMIA4 p8w.or Ago
,
'th th .. . ...... p
.Ih Inf6rmd 6*h .1*r .1te
R ba
, sl�jy)� absol]qt6y
-bA too an .
A or, -n
A
dioj Inrl t6i UPbdt t
q s Omer lh� P.
and Qifiq0 (1600,
isuipon'.1ion °of*lfiO ken's tFl may 1mr
any
or �i�er gq6z4A 08,94.
R61' - i$(&*ij�reld.6ti lo, bihO ftbYce of qbr[A dUsaMilrig of.the
' 946' * - -�toijoq, N the
-in the . event C N� -dentral
a . lq�. . I , . .:, - a p
S "" d' 't b an such nonce i s conditioned 6h
.. t ... I . I �j -Y
P0
p h
"n e!.
Ut i1nj%4tq R
, qj arising ciol o b*r
; maiftiric�ron or delay in "pf4cess[ng :, '" unica &rft r6tpqg�.I. tro
' -bf-tomm' "' -1ioh ec servpes,-sy�.�,
q fMare. SEFis
or tra1*p1l!Ih4 the
g f - r,:Obrlep� -Mijuco m �lftihr$on o r d or py 4§OR,
ort yA(h the lay dapy �qc� notice
shall.(J) P.rq�qq �Pq ftl aInt e in add poVW,:and li fotall.dafflOW Of other
V!de6.S?1(Qdk01 if W,gw.. . Vte & Oftit 'the u ge--.df 91dop-
I .... .. I - - .. � .. ... : 1"' * b - .' .. : 0 by' videb,;
. $')I*& &Qig 1W they *Wy '6 lijonito
Video-to q t q 0 f vur4 q d -pn aq pbtiairt -of mqn,
vyhel e My 61766h ffi�y Ave. or
_ uhla
licenses requitijd•fot
SE I' o bit 1� l's. 0
ie. I
g. SVgPqWQ,1)-A Pgry, o �'Oqitqmpr-�url on is'rdls§loh.�Ysitem e r6
- M tj b pipeg, hehWr bf seNldos, or th r
e mbrilt �c
all loss,-d'i @ i A d'0xp d
�.of b lnj6rr�glidn.. PR A
e .-TorM. raloi, be
des rQ1 hr(ob OdId"Tor
. . , rQ L �j,Q
Wi�jwr's&ent of the tineamed th qvps.
A RE
o WAk - NTIE8. EXT END .38Y61 THE 1)1�80RIPT-10140 THF-jFA.C�gbR
EXPRIE�6� 5A -I*Mp,,Lft,, W� i" PXJ
' ttq WAR� RTWA,JflE. V .60LAR PU,00�151
-NERCHAN
P�tP-(� ARMNI,.. , ., I . . weptlf
RFE 'Wil aq d je pp�y@t �gd*tfijogljje "tho:q 'to
.: . 6U.pg $EIIi5.p(.qqa1lIrlg i
16 * t *h6.-- s ysi o �jW Lf.C.,W
n tr,6fed, oustomdr s b
-1, U.L.,Cett t . n lf -i1}1 I d*1'9pit0h4*iii*%hdI,
QVIat jjCq Ot 16 D.U00 $10
gyaltnfls tat' ) out Objective pfi�ysicqj
Vylih
fbr
,-. r(ific�.(dd 'i�steni� WNTY the rei4direnWks jol - j (',0 u AQmq, . perrorm al
l
%o e r of'sd* agar( pon recqi�..i o(wrikeh pops
bgij6IrL0§`1ioh.t fD� d �i� ip e
r the $ql, pgroes u
1110"rylure* pts nq� Ir
is y
cess $0 a lj�V�L or,' syedto. igns of Aq.
gerylbe the bf
J. R tit 6r.�Qrviqe$ bhts greqq�qk-
.. ,
su f qy�jpda�s
I)d t to �Ef a t se
forifi tieri iii to usiomer, and bind
I * , "'d
lc�prd�l to any subconEracTbrs His Aqw1R6 I;nqrq .('& , 66'd 'effe ;a`j'tUY bik.UsC6W' 6 G�f,
Cus(oiiler to said
) 1�eO agar l Uf§,P�R�m ringM
Go se'ii( tc.triterce' t, Rebozii Disclose and Use,�o�itenis of itself and quIhop g en
Pp ,
rtlem6eTs, rifficefs; directors, ipvrfees, .guests, ?gems, representative's and eriiplayees:(indigi+lually and collect 1v`1 >:,
conlen s b a elpohoriCMI 0 . -rqrms of
A rty §.Efaro parparties: i�
f
r costs; eii'p'ens2s and penaltfes'assessed against Customer or by . phy court ar
)n. Is
gggj awff Ftifibtlon. s
1.4, Cqgtom or's Re�i �&Mbllll �tc;Vdfl- and se rvices
'�*'b * * " , d .1 Lt
C h
I f6ilffta , q i� J6 trant6% data -b
PUA guv Or
th6 S.jst an hion
IN ' T4, t3p or
yq 4ln db �Q , , ,
d' g & re d? 'Must -test the S
-6*ah§Tr) in �
ri 'm �8.11 *wltipg, a �c
q saldllle.bi
-., ... — - ' I
VbIP ,s e�yk% - or art Idti-,commu-bi . kj rqdj(� Internet, if" tirade n j6nt, tephb6t�qX:'qt 0qfdO (Q 1 01-
Ca d " Oeyevb ari ilia 4 9 IPMMUP1 ca IQP[A-A U.1
u@rhent, tq�q nq lb g y. an d s ervice p6nodl IIY �O Vill Oil
ier.un O.Wapi[4,
n e n t al LoLtemu Op pgn
Prernses,.ag (C Ukqdi� V ry
%OPOISA lipbmtogy P . t §.*VOOP used . t07 t f an s ni lf- data behyberl, P)e* S PQq .511y monif0iThd jdcll 6r �Ali :I to a dvallable r .e 6.
t @eP64'�,
rfj�66 iVallalt)Ie Jq 'or
' , r jo
�hahga IA 66nii6cil6n wih any'cPmn196ICa'fi0n4 AquiP.M.40, lqllml 6.; -myo. RF ? and bece- s. commercially ��a�onhbli� Ai
aulh6d -ei 8 "th h 91WMWV
it . I-%. y
xopi ihfj- Abreqireal, Cuil.6`meir htrbb�; ft - i b'td:pf6vjda 9 A ) la r �y �uq. -che'r.gel, b
A 1 9 d j if y , tubstitula 1p,* r ropl�pP. POY
e s6nsjb16 0 -pal bt all N�ts
shall
bd f p t shalt - p0mptfy T91 'ng jj� q thAll a101 0J."R'l * t d, l an�
a' troilrer-tal SE6* ihep -prgYalll !kql vAM.m, - . f . I I . ... . I
'sef"ce or
A§tW16d6fo*r jeiie,:SeNIm.., foorifto* ( Ii-j , gt eto 'ittsin but '.61 or On lis el W1.111, Of Qr.176 14
:,; .... ... .. . . I.. .- .. 'ji rn'td 6Cthd:pq0) .1pps-pq P t
[norease rl Mon 'e qo d 1 lf j �aII*6h�--8*fib q " j nVal.0t
f �pdtflcajloq. pNinbo kd .9. r UNtipp OQ9 .4�e % , - .. I m2rit
dst a , Imm idlilb V r '
r ealty �6 ed I
kt-.fej
dIscoh,1lr100ftqj,. & Sbr.VIc4Qr.-Fr�VI N
�roWer;-(3j'Any equipni j MqSY
r 6 1 , PLIP,
ereuoder p @ no n
t he ]p[ovide - r,-a n jor.Ma! jLoW SE ir6es.
I)MMIR.P; Q. r on dWed as ygjjv 9 'f arty p�e keqO
'6 h1t sholl-61 W� h. :$9N.0AP:M
I f S E I %WIV6 6 6bch y C ��st 0 r ri q , maliA tQ41nb mt3y
It O or W r4te(rbld to heroin. (E) Duties -01 1 -
a6e� and i nclud e all remedies. ayaII my 1 7 N*r&h 6*n T .at tat
�09�e�f
, ..,. 66re�dsmb -AInsIQlIWIJ er pad
Yj*Til*(4)6I!C4frqfft Ii surer ) Ihetperson. av�
Upon reco.01 of C�iQ�ir,-Wlo
Mild es . Upon , - f , . . ro nsurdr, or i jKjay
Em y Ce
at SE-is ihert gi:py�lrina
te rell Ma C(r§16pTer a for all OW
n q tl V ps are r� as d.for any IQ.qs d � �§�Sa
0010bril * " 1: , pm
e 9
( � p se. I to Customer due to'the lass or theft +if
'arty keys.
Initials:
15 T44 R 778':
.7777= 13605 T" �trqof, 0,Mpi i W,
- wv
ty NE
Proposal N_tArfl .9090-16-0
Date: 71812618
Is,
Is TH€1�
EE . �TA t l
IER L ,
j
PASSIVE W E; qOINT -QR. SEVER�A - - _.� OF ANY - OF-GRPE"OF !3EI 01� R5PA_5SWrATIVE8-'PRODUcroR sTRioT. LIABILITYILQR A
.LN # NY
Y'K
C RA FOR% 00RANIOEM, NIFICATON, WHETHER IN C '- .RTPk
ONTR&IIJO EQPI:TY..
(N6iWITHSTAND ..
W WfAf
'HING i� �E`Q EREIV 0A
sRAGKKvR
SHALL N6Y.APPLV' T.0 §Af4D
I GAW 'Y
TO.
KP AMPLO AE S QN, U81 PR 61ISE�''MIIJEP W HAT ':W" I-6A_ 1 6 1 " .CA `6 A
VV
0141M AND AMAG IS SE ]DIRECT P%? ,T
4 I f-01i 1 0
EX'QEPT04
NaG IGENC THP SEII Isk VDW� FUfi E UNDER. T-jj.lS 1011 A,�L,13E LIPOT
ApAph b ,Et) T Itg
S O T
Ll
1 08.3N gi AA P , 9 044 TO
Pg. PP�jqy_qP.VERAGE AND T14E AMON.*t '0# Pj166R@D6 OA)b (ift A�dltive� �.R
A0
lk ins o6atr6mWirflenanc Wkbo'vei'
a. )nsp**b`b 't $'ytfqm affi'd a0rAcei, Insp6clign 'sgN1cp consists of prqviqlng.all labor Oepq�qtqpnq IeAQqg -�qulpr!Vqfilo )q.peq't' only ;the Mstbla
.9.4UIpmeof P rs.g�nt to 't p� he�jpf, fqf dl
0014"$Aern. u �p jeib �e sole p6rp6s6pf 6146W6g f661" 1 "' " " 19 operative, 16'� 6NIc4 66al) l
'i b
.q"0.d.;0.onv0.11ftn or ab r t�0 16 %ldilift, - .con lIf6A?0 '6n 0 pon%OTing 6EI to ichoA
art PP9 1),
b. Perlodid fijaf �16tq6q.�e wnol�ls qf -prqldl�q Pit la t
ne o inspect thei*vIs1blp Pb.rl� .9f the $�sterri orindilly dh'or aboull'th-a &*of4��r
4."., .1 . on 'Customer . y
:.daid 6t thl� Agroerngn or as blfi6 O§rde**d In') Milloned on 'Ws(odi44�b441 SJEQ ',-�ftdule ah.jpgojrljment for tueh si6N6, ppiq:(9
proVIjdW -all hens`sdry'jgbor, mote �qUipipe.ot' jo due 1.9. ordin n letnii
n se rvice dyslern at Ilia! time , y wpar 6nd tear q p!y,.� rs�qj o
klfdhqr�e iq�p p paid by Cust omer and rn`af6tj�i bQ§a(:�F1'sift arglas.
c. hereof,.
) hall 6 prdV@111566
c
'6441`6 on L�i fei d" '_�y.s`t shall b If If Wkifei� * 1h - ie4i� 96d dowe red by mainte
r -- 0 6Jv1 0 6 Vp0h xoc4t*pf hplico frkniCp(om.pr of ,the nqegejlt't�
Jh6*py4t�m; A* )
qrbes, putpant, t� shp(.q6f,'toprovjdeaIfMo� 16e'Sys(4K1CfU�'(Qorj1hji '
I palerial, parts a6d e0jpriiep(to 4e.Mop ry wear
'zijn4.tqqr only ,.*41I request to do
othe "'
Qf-ge bd*06ld by*qqtqm0 qq.a Ppp at $El's then pr'ei2aiirng charges
e W _ 4j@y in
r-To 11 . .... . tl'i Wo 9b) Lime oia
service 4
r.m ng �sJ6tv[P*0..S 1gaelon.;after r4ke. Ing -a pqry!.ce request to-d ispatch 4.§e(vk4 pri-109yee,10 fba �ranilsei �'Alm6 a f6 service �Mpl§yee A�wrn s av4tIdbIe p6rrf i u ome s;
i f Wilnets Ji6uis excl tdlutd�jk,-Suriday� 6d Wfda s, 44"4eblpt b! Cu'stomer •
$qr0c.0 of Systems Exclusive tc SELIL Is understood and agrqpd by the pirlie§ that all service to iho System sb@l, ba p666mea by 4ohV,• but
�r. agrdq 61, SEI'04ui� to )jd-ct to the4vailafillify.6f Ifio bilgIn"I 7 fr i
-�Wqple. . .:. . a l: filpmobf
I � .. ... t q4V�M.1myt . . . . . . . -
fd'r'mM* `6f this Aqte�mpnt and*'6* Nditlo*R�40'ii6h. CUstohW notifyi bEi bf th� n for su servjco.-du9tonjqr 09-teqg to py ,80.i mInIbiuni
. . 1��v . di the Pi - j ., , c'
4tow 106P event qq. r does not pr9v1do q0�q1riptqd q when 61�1 afiqmptp to 0r6vId&.;'6&icq Qigbi. Further, customer iQr*ebs that ST)
fl6a(lonto*lhdSys(efn*shalI rfornie by SEI only, s 1ee shalt be paid
by Gusion'ier bit a time m6 edal basts'at SEI's fhOh' p?0allitld dbofgis.
691 teM*66 6 k ls'tjnq Z'ysf'Qmp, it ` �$El'takqs over fqndering services tQ lrilvihplq�?Jri P60, b5l kederv�4'W tight, In UsWeand
b
.4 S.OILAe 'Wal at anytime by giving ten *,(1_Q) %Wilteo dofike to CQdUr trf!h6:W61 SE ijdef4rriiirfpi Ift. -S,86Iqlad
biif.ve-.t. I1Vjailohs 6f the 'Sy'stbn1.,'1hdt the Customer bas pbused1fie Syst'drh or fiat thpnuqlber-pfp(4!ei�
cosf of servie@ has been nr may become excessive; anc7 qLl,sto !.ner
V _
* sfigil 'I bit ' rn -� eftt o f I
" ** c pila(of*&Ifiiieifrf*w
0(itlod 19 rem. rs, I ` a pr -rj
period bn
(eque f ustorrier and thIs shaf! be th6 (61t 61 Stio 'fabliiij."
i s -:.*1..-:-. -z-.. . . S . .. - -
r9graifniq pNlpe�q.Rpnjolp pf§grbmmlng services ansjsf.s of inputting, rvdifying, Vefeting and Wrig ejqc1TonIc..d4la -9p6ralf6p 4
the Zy-stem 1hroy9h elklro6lp commuq and
�tfbn bbh veep the tystern SEI'i 6fifCo mQtodRg bdrL y dbnseh(s to 8 SCI' psiform6nee of
aft f6f such se'r'vices, '17. Ad licable Lay' p
Lava. dhdlc:'e:6fjr
0du%rnj.
(A) Confricttial Llri , Itailon bfAcIlons. All Oq!Dis, actions pr proceedings, legs) of equitable, 6pffrjstSEl.br8eprdsenta1iVe§ thbst bebo6rife6c6d In court Whin one (1)
yqqrafter . ue'hue ari.d,lNaiver of Jury
Treat. �adh Oa4.fibrgt� Vrbv&Afj a6Q's W(aI'd[4ate6.urlder th1q, 6gteqment shall n -a 66 Iiii0a exclus t uplas cour
We y1n4hei Do
yilthodt rolferpriceld ita tonflials rvIp II �01:be zoniiru r. Eat party consents.-to the luirV6
101 & 'Me Interpr6laliq of thli.AgreeMpni fW a i)(6
JU( s'dicl veni h 6 court &j0r any "615jectron that it'A)hy'ha`V`e to 166sdfction it 0 of qny
�?9 - . or yen. .-spc
-Adide**ni6'*nt.'Tbls, A"grqoji6"h11a'ho1 agglb6bleby Cu'sfqmereepqpt up P,T..liten cdnsenlpi! SEI, which shdIl lis rh .651's 'sole and abp6lute-d*i]sc(doq. fht0greeme t
0 'y
ponl.04 thi�.Q is A%i Ll(Q ' 8JScfeII0n. (Dj Credit [n\4siiwtPn R*qp'ori' 466� and consents , fci*dred)f
�Rn J6"blp WS I to 11; $610 and abs6l
:pers '1" * : 616ji� no to SEI oF to �ihoiii thli Agr&in6ff n" T!
fia�t �rb. I fay VdWss dned.
48. LIMITED WARRAN
'(A)QmfTr=D AND
IN A 600
WARRANTY.UP ATERAL IIflNTALLt
§IJ 1)
MATERIAL,,'881 HRREBY WARRANTS TO QUSfOM'Ek ALONE ONLY THAT OF THE M
RKMAI+LIKE't "HE OF ' ' ' ' INSTALLED YEA wo AANNEk. IN T E VENT PART, EXCEPT FOliWIRINQ SHALL bEFEdTIVEWT'HlN ONE (1)YEA RQMTHE DATE 9,17
- tioa,'6p. PW� T�kN4'EQUAL 0 T . 0 TH AT Pj� ORIG NA
St.113�tA� FoA *rHj§ KSULL OVIDEDBYJ�Ej I LEqUiPM�NT"'
�A �UFAGTQRER,
WHICHE . R I S LESS, &I $HALL.$EPLA N Akg.
(a
C� 6A R EPAIR T DEFECYA ]PART WITHOUT cHARG� Tob%tMk THIS WARMRTYT�
lmscbVik OF DEFECT. * b-tS9T0M`Ek DISCOVER ' A IJbUT`0 THE PRODUCTS SUPPLIED UNDER THIS _'*A6*1* .- - �PRS
35t ENT-CVSTON
TACT $E[ IN".MifiNG OR'BY. ELEPH0 AI)DRESS-AND.TELEPHON(EN u�'.bEk.sE*t'�*b� ABbVE,,,�NDULLY
'jDES'C'
IMMEDIATELY CON PAI R'iBtTHe
k. . . f Y
-Iqt� MAY 8E RENOE ED. (6)Ll*kll 0 1�§- 06&T bE.. foql R (9
A f4y Y — . 1. 1 11 "Y'V le X_ I
wW .0mWjd
.69M - -. � V _
PON ( I .
�t y. _6.,L1hc0[ij q JA i,.
I
3 05 :�: Sfl'e umana,. C'• i .� -: � � � �- r ,.
rsacurify.,co o OmnhalE ®.Lincoln {CIE Q Des M IA
MOM {{St,