ATTACHMENT #2
DPW: 370-35\ev\Council\2025\062425\Purchase of Vehicles Att 2.pdf Customer: CITY OF THOUSAND OAKS - CA ACCTS PAYABLE Quote Number BBBQ55781-03 Project Title: Supershot 125D Date 05-14-25
SALES TAX EXEMPT CERT/FICA TE MUST BE PROVIDED AT THE TIME OF ORDER OR SALES TAX WILL BE Part#
COMMENTS:
ADDED TO YOUR ORDER
Description Unit Qty.
DUCK BILL VALVE W/SLOT REV.B EA
Training will be provided on the day of delivery.
Warranty: 2 Years
Contract Price
Sales Tax
Shipping
Contract Total
For questions contact Gary Lewis at 619-994-9995 or [email protected] 05/14/25 07:45:26 We value your business.
Ext. Price
$5,235.74
$700.00
$78,152.7900
LEVINE ACT DISCLOSURE FORM
The Levine Act (Gov Code § 84308) DOES NOT apply to this Agreement/ContractThe Levine Act (Gov Code § 84308) DOES apply to this Agreement/Contract and the required disclosure is set forth below:1. Have you or your company, or any agent on behalf of you or your company,made campaign contributions totaling more than $0 (aggregated) to anycouncil member in the 12 months preceding the date you submitted yourproposal, the date you completed this form, or the anticipated date of anyCouncil action related to this Agreement/Contract?YESNO
2. Do you or your organization, or any agency or representative on behalf ofyou or your organization, anticipate or plan to make any campaigncontributions of more than $0 (aggregated) to any City Council memberin the 12 months following any City Council action related to thisAgreement/Contract? ** There may be legal restrictions on makingcontributions during the 12 months following City Council Action. Itis recommended that you consult with your own legal counselregarding the requirements of law.YESNOCouncil Member Name Payee Name Payment Date Payment A mountAnswering “YES” to either question above does not preclude the City of Thousand Oaks from entering into or taking any subsequent action related to this Agreement/Contract. However, it may preclude the identified Council member(s) from participating in any actions/decisions related to this Agreement/Contract. ____________ ______________________________ _______________________ Date Printed Name/Title of Authorized Name of Business/Legal Representative Entity ____________________________________________________________________________ Signature *** You must submit a supplemental form if you make any new reportable contribution(s) while the Agreement/Contract is being considered *** ** “Aggregated” contributions, as described in FPPC Regulation §18438.5, include the following types of contributions made during a 12-month period: (1) all contributions made by the party or participant; (2) all contributions made by an agent of the party or participant; and (3) all contributions made by an individual or entity required to be aggregated with the party or participant, and any agent of the party or participant. 5/29/2025 Gary Lewis/Territory ManagerCrafco Inc.