Key Government Finance 2010Friday, February 26, 2010
Robin Brock
City of Okeechobee
55 SE Third Avenue
Okeechobee, FL 34974 -2932
Re: Key Government Finance, Inc.
Lease No. 40467
Property Schedule No. 2
Dear Ms. Brock:
Key Government Finance, Inc.
1000 South McCaslin Boulevard
Superior, CO 80027 -9456
Enclosed please find true, exact and correct copies of the fully executed contracts for
the recent City of Okeechobee leasing transaction.
Thank you for choosing Key Government Finance, Inc. to handle your equipment
acquisition. We look forward to meeting your business needs in the future.
Sincerely,
Suzanne Hoff
720 -304 -1419
Enclosures
Property Schedule 2*
DOCUMENTATION CHECKLIST
Property Description and Payment Schedule Exhibit 1
LI Lessee's Counsel's Opinion Exhibit 2. Exhibit 2 is the standard legal opinion used by Key Government Finance,
Inc.. This opinion will need to be processed by your attorney on their letterhead. Your attorney will want to review
the Lease /Purchase Agreement.
Lessee's Certificate Exhibit 3. Please fill in the date of the meeting of the governing body, referenced in section 1.
We would also like a copy of those minutes or board resolutions for our files.
Payment of Proceeds Instructions Exhibit 4. This is the Vendor payment information.
Acceptance Certificate Exhibit 5. The date of Acceptance will need to be filled in with the date the equipment
is installed and accepted. *Will be submitted when delivery is complete.
Bank Qualified Tax Exempt Obligation Exhibit 6
Request for Certificate of Insurance Please fill out the form and fax it to your insurance company.
The Insurance Certificate is required prior to funding.
Notification of Tax Treatment
8038 -G The purpose of this form is to report to the IRS that we have completed a tax exempt financing.
Per the Internal Revenue Service, you are required to fill in the Report Number information for Line 4 (the
form included in your package is an 8038 -G).
**We must have this information in order to complete your financing.**
8038 -G Line 4. After the preprinted 3, enter two self- designated numbers. Number reports consecutively during any
calendar year (e.g., 334, 335, etc.).
LI Invoicing Instructions The information you provide enables us to invoice you correctly.
Invoice for 1st Payment
*The items above marked with an asterisk require a signature in the presence of a witness /attestor. The attesting of the
signature does not require a notary, but the signature of a person present at the time the document is signed.
KEYCORP CONFIDENTIAL This is counterpart of manually executed counterparts. Only counterpart 1 constitutes chattel paper
Lessee:
Okeechobee
B y
REGINA EUKtNDORE
SENIOR CONTRACTS MANAGER
Title:
Name:
James
E. Kirk
Title:
Mayor
Lessor: Key Government Finance, Inc.
By: 41 0 3 0.4.4,,,.
Name:
REGINA EUKtNDORE
SENIOR CONTRACTS MANAGER
Title:
Property Schedule No. 2
Master Tax Exempt Lease /Purchase Agreement
This Property Schedule No. 2 is entered into as of the Commencement Date set forth below, pursuant to that certain Master Tax
Exempt Lease /Purchase Agreement (the "Master Agreement dated as of 2/3/2009, between Key Government Finance, Inc., and City
of Okeechobee.
1. Interpretation. The terms and conditions of the Master Agreement are incorporated herein by reference as if fully set forth herein.
Reference is made to the Master Agreement for all representations, covenants and warranties made by Lessee in the execution of this
Property Schedule, unless specifically set forth herein. In the event of a conflict between the provisions of the Master Agreement and
the provisions of this Property Schedule, the provisions of this Property Schedule shall control. All capitalized terms not otherwise
defined herein shall have the meanings provided in the Master Agreement.
2. Commencement Date. The Commencement Date for this Property Schedule is 1/19/2010.
3. Property Description and Payment Schedule. The Property subject to this Property Schedule is described in Exhibit A hereto. Lessee
shall not remove such property from the locations set forth therein without giving prior written notice to Lessor. The Rental Payment
Schedule for this Property Schedule is set forth in Exhibit 1.
4. Opinion. The Opinion of Lessee's Counsel is attached as Exhibit 2.
5. Lessee's Certificate. The Lessee's Certificate is attached as Exhibit 3.
6. Proceeds. Lessor shall disburse the proceeds of this Property Schedule in accordance with the instructions attached hereto as Exhibit
4.
7. Acceptance Certificate. The form of Acceptance Certificate is attached as Exhibit 5.
8. Additional Purchase Option Provisions. In addition to the Purchase Option provisions set forth in the Master Agreement, Rental
Payments payable under this Property Schedule shall be subject to prepayment as follows: See termination amount in Exhibit 1
(Payment Schedule), subject to per diem adjustment.
9. Bank Qualified Tax Exempt Obligation. Attached as Exhibit 6.
10. Expiration. Lessor, at its sole determination, may choose not to accept this Property Schedule if the fully executed, original Agreement
(including this Property Schedule and all ancillary documents) are not received by Lessor at its place of business by 1/29/2010.
IN WITNESS WHEREOF, Lessor and Lessee have caused this Property Schedule to be executed in their names by their duly authorized
representatives as of the Commencement Date above.
Attest By:
Name: Lane Gamiotea
qAti-
Title: City Clerk, -CMC
KEYCORP CONFIDENTIAL This is counterpart of manually executed counterparts. Only counterpart 1 constitutes chattel paper
Payment No.
Due Date
Rental
Payment
Principal
Interest
Termination Amount
1
19- Jan -2010
21,862.95
21,862.95
0.00
380,114.34
2
19- Apr -2010
21,862.95
17,389.23
4,473.72
362,203.44
3
19 -Jul -2010
21,862.95
17,600.03
4,262.92
344,075.41
4
19- Oct -2010
21,862.95
17,813.38
4,049.57
325,727.62
5
19- Jan -2011
21,862.95
18,029.33
3,833.62
307,157.41
6
19- Apr -2011
21,862.95
18,247.89
3,615.06
288,362.09
7
19 -Jul -2011
21,862.95
18,469.10
3,393.85
269,338.92
8
19- Oct -2011
21,862.95
18,692.99
3,169.96
250,085.14
9
19- Jan -2012
21,862.95
18,919.59
2,943.36
230,597.96
10
19- Apr -2012
21,862.95
19,148.95
2,714.00
210,874.54
11
19 -Jul -2012
21,862.95
19,381.08
2,481.87
190,912.03
12
19- Oct -2012
21,862.95
19,616.03
2,246.92
170,707.52
13
19- Jan -2013
21,862.95
19,853.82
2,009.13
150,258.08
14
19- Apr -2013
21,862.95
20,094.50
1,768.45
129,560.75
15
19 -Jul -2013
21,862.95
20,338.10
1,524.85
108,612.51
16
19- Oct -2013
21,862.95
20,584.65
1,278.31
87,410.32
17
19- Jan -2014
21,862.95
20,834.18
1,028.77
65,951.11
18
19- Apr -2014
21,862.95
21,086.75
776.21
44,231.77
19
19-Jul-2014
21,862.95
21,342.37
520.58
22,249.12
20
19- Oct -2014
21,862.95
21,601.09
261.86
0.00
Lessee: City of Okeechobee
By:
Name:
James
E.
Kirk
Title:
Mayor
EXHIBIT 1
Property Description and Payment Schedule
Re: Property Schedule No. 2 to Master Tax Exempt Lease /Purchase Agreement between Key Government Finance,
Inc. and City of Okeechobee.
The Property is as follows: The Property as more fully described in Exhibit A incorporated herein by reference and
attached hereto.
EQUIPMENT LOCATION: 55 SE Third Avenue, Okeechobee, FL 34974 -2932
USE: Police Cars This use is essential to the proper, efficient and economic functioning of Lessee or to the services that
Lessee provides; and Lessee has immediate need for and expects to make immediate use of substantially all of the
Property, which need is not temporary or expected to diminish in the foreseeable future.
Rental Payment Schedule
If the Due Dates are not defined in this Rental Payment Schedule, they shall be defined as the first day of each quarterly
period of this Rental Payment Schedule commencing with the Acceptance Date.
Total Principal Amount $390,906.00
KEYCORP CONFIDENTIAL This is counterpart of manually executed counterparts. Only counterpart 1 constitutes chattel paper
(14) Crown Victorias
(5) Dodge Chargers
EXHIBIT A
Property Description
KEYCORP CONFIDENTIAL This is counterpart of manually executed counterparts. Only counterpart 1 constitutes chattel paper
January 19, 2010
Suzanne Wagner, Account Manager
Key Government Finance
1000 S. McCaslin Blvd.
Superior, CO 80027
Mayor James E. Kirk
City of Okeechobee
55 SE 3 Avenue
Okeechobee, FL 34974
Ladies and Gentlemen:
"EXHIBIT 2"
City of Okeechobee
RE: Property Schedule No. 2 to Master Tax Exempt Lease /Purchase Agreement between Key
Govemment Finance, Inc. and City of Okeechobee.
I have acted as counsel to City of Okeechobee "Lessee in connection with the Master Tax
Exempt Lease /Purchase Agreement, dated as of 2/3/2009 (the "Master Agreement between City of
Okeechobee, as lessee, and Key Govemment Finance, Inc. as lessor "Lessor"), and the execution of
Property Schedule No. 2 (the "Property Schedule pursuant to the Master Agreement. I have examined
the law and such certified proceedings and other papers as we deem necessary to render this opinion.
All capitalized terms not otherwise defined herein shall have the meanings provided in the
Master Agreement and Property Schedule.
As to questions of fact material to my opinion, I have relied upon the representations of Lessee
in the Master Agreement and the Property Schedule and in the certified proceedings and other
certifications of public officials furnished to me without undertaking to verify the same by independent
investigation.
Based upon the foregoing, I am of the opinion that, under existing law:
1. Lessee is a public body corporate and politic, duly organized and existing under the laws
of the State, and has a substantial amount of one or more of the following sovereign powers: (a) the
power to tax, (b) the power of eminent domain, and (c) the police power.
2. Lessee has all requisite power and authority to enter into the Master Agreement and the
Property Schedule and to perform its obligations thereunder.
3. The execution, delivery and performance of the Master Agreement and the Property
Schedule by Lessee have been duly authorized by all necessary action on the part of Lessee.
55 S.E. Third Avenue Okeechobee, Florida 34974 -2903 (863) 763 -3372 Fax: (863) 763 -1686
4. All proceedings of Lessee and its goveming body relating to the authorization and
approval of the Master Agreement and the Property Schedule, the execution thereof and the
transactions contemplated thereby have been conducted in accordance with all applicable open
meeting laws and all other applicable state and federal laws.
5. Lessee has acquired or has arranged for the acquisition of the Property subject to the
Property Schedule, and has entered into the Master Agreement and the Property Schedule, in
compliance with all applicable public bidding laws.
6. Lessee has obtained all consents and approvals of other govemmental authorities or
agencies which may be required for the execution, delivery and performance by Lessee of the Master
Agreement and the Property Schedule.
7. The Master Agreement and the Property Schedule have been duly executed and
delivered by Lessee and constitute legal, valid and binding obligations of Lessee, enforceable against
Lessee in accordance with the terms thereof, except insofar as the enforcement thereof may be limited
by any applicable bankruptcy, insolvency, moratorium, reorganization or other laws of equitable
principles of general application, or of application to municipalities or political subdivisions such as the
Lessee, affecting remedies or creditors' rights generally, and to the exercise of judicial discretion in
appropriate cases.
8. As of the date hereof, based on such inquiry and investigation as I have deemed
sufficient, no litigation is pending, (or, to my knowledge, threatened) against Lessee in any court (a)
seeking to restrain or enjoin the delivery of the Master Agreement or the Property Schedule or of other
agreements similar to the Master Agreement; (b) questioning the authority of Lessee to execute the
Master Agreement or the Property Schedule, or the validity of the Master Agreement or the Property
Schedule, or the payment of principal of or interest on, the Property Schedule; (c) questioning the
constitutionality of any statute, or the validity of any proceedings, authorizing the execution of the
Master Agreement and the Property Schedule; or (d) affecting the provisions made for the payment of
or security for the Master Agreement and the Property Schedule.
9. The Lessee is a political subdivision within the meaning of Section 103 of the Internal
Revenue Code of 1986, as amended, and the related regulations and rulings thereunder, and the
portion of payments identified as the interest component of the rents (as set forth in the payment
schedule attached to the Property Schedule) will not be includable in Federal gross income of the
recipient under the statutes, regulations, court decisions and rulings existing on the date hereof and
consequently will be exempt from Federal income taxes.
This opinion may be relied upon by Lessor, its successors and assigns, and any other legal
counsel who provides an opinion with respect to the Property Schedule.
Kindest Regards,
John R. Cook
City Attorney
JRC /rb
EXHIBIT 3
Re: Property Schedule No. 2 to Master Tax Exempt Lease /Purchase Agreement between Key Government Finance,
Inc. and City of Okeechobee.
The undersigned, being the duly elected, qualified and acting
"Lessee do hereby certify, as of 1/19/2010, as follows:
1. Lessee did, at a meeting of the governing body of the Lessee held on 01 19/10 by resolution
or ordinance duly enacted, in accordance with all requirements of law, approve and authorize the execution and delivery
of the above referenced Property Schedule (the "Property Schedule and the Master Tax Exempt Lease /Purchase
Agreement (the "Master Agreement by the following named representative of Lessee, to wit:
Mayor
Lessee's Certificate
of the City of Okeechobee
NAMEOF EXECUTING OFFICIAL
(Official who signed the documents.)
James E. Kirk
And/ Or
TITLE
OF EXECUTING OFFICIAL
Mayor
SIGNATURE
EXECUTING OFFICIAL
2. The above -named representative of the Lessee held at the time of such authorization and holds at the
present time the office set forth above.
3. The meeting(s) of the governing body of the Lessee at which the Master Agreement and the Property
Schedule were approved and authorized to be executed was duly called, regularly convened and attended throughout by
the requisite quorum of the members thereof, and the enactment approving the Master Agreement and the Property
Schedule and authorizing the execution thereof has not been altered or rescinded. All meetings of the governing body of
Lessee relating to the authorization and delivery of Master Agreement and the Property Schedule have been: (a) held
within the geographic boundaries of the Lessee; (b) open to the public, allowing all people to attend; (c) conducted in
accordance with internal procedures of the governing body; and (d) conducted in accordance with the charter of the
Lessee, if any, and the laws of the State.
4. No event or condition that constitutes, or with the giving of notice or the lapse of time or both would
constitute, an Event of Default or an Event of Nonappropriation (as such terms are defined in the Master Agreement)
exists at the date hereof with respect to this Property Schedule or any other Property Schedules under the Master
Agreement.
5. The acquisition of all of the Property under the Property Schedule has been duly authorized by the
governing body of Lessee.
6. Lessee has, in accordance with the requirements of law, fully budgeted and appropriated sufficient funds
for the current budget year to make the Rental Payments scheduled to come due during the current budget year under
the Property Schedule and to meet its other obligations for the current budget year and such funds have not been
expended for other purposes.
7. As of the date hereof, no litigation is pending, (or, to my knowledge, threatened) against Lessee in any
court (a) seeking to restrain or enjoin the delivery of the Master Agreement or the Property Schedule or of other
agreements similar to the Master Agreement; (b) questioning the authority of Lessee to execute the Master Agreement or
the Property Schedule, or the validity of the Master Agreement or the Property Schedule, or the payment of principal of or
interest on, the Property Schedule; (c) questioning the constitutionality of any statute, or the validity of any proceedings,
authorizing the execution of the Master Agreement and the Property Schedule; or (d) affecting the provisions made for the
payment of or security for the Master Agreement and the Property Schedule.
City of Okeechobee
Attest By:
Lane Gamiotea
Title:
City Clerk
SOMEONE OTHER THAN THE EXECUTING OFFICIAL(S) SHOWN ABOVE MUST SIGN HERE.
KEYCORP CONFIDENTIAL This is counterpart of manually executed counterparts. Only counterpart 1 constitutes chattel paper
Key Government Finance, Inc.
1000 South McCaslin Blvd.
Superior, CO 80027
Re: Property Schedule No. 2 to Master Tax Exempt Lease /Purchase Agreement between Key Govemment Finance,
Inc. and City of Okeechobee
Ladies and Gentlemen:
In accordance with the above referenced Master Tax Exempt Lease /Purchase Agreement (the "Master Agreement the
undersigned "Lessee hereby certifies and represents to, and agrees with, Key Government Finance, Inc. "Lessor as
fol lows:
By:
(1) The Property, as such terms are defined in the above referenced Property Schedule, has been acquired,
made, delivered, installed and accepted on the date indicated below.
(2) Lessee has conducted such inspection and /or testing of the Property as it deems necessary and
appropriate and hereby acknowledges that it accepts the Property for all purposes.
(3)
Date: it 1 C
City of Okeechobee
as Lessee
No event or condition that constitutes, or with notice or lapse of time, or both, would constitute, an Event of
Default or an Event of Nonappropriation (as such terms are defined in the Master Agreement) exists at the
date hereof.
Nam' J ames E. Kirk
Title: Mayor
EXHIBIT 5
Acceptance Certificate
KEYCORP CONFIDENTIAL This is counterpart of manually executed counterparts. Only counterpart 1 constitutes chattel paper
Bank Name:
Sun Trust
Bank Address:
815 South Parrott Avenue
Bank City, State, Zip:
Okeechobee, FL
34974
Bank Phone:
(863) 763 6417
For Account of:
City of Okeechobee Capital Projects
Account No.:
0893001032321
ABA No.:
061000104
Key Government Finance, Inc.
1000 South McCaslin Blvd.
Superior, CO 80027
By:
Re: Property Schedule No. 2 (the "Property Schedule to Master Tax Exempt Lease /Purchase Agreement
between Key Government Finance, Inc. "Lessor and City of Okeechobee "Lessee
Ladies and Gentlemen:
The undersigned, an Authorized Representative of the Lessee hereby requests and authorizes Lessor to disburse the net
proceeds of the Property Schedule as follows:
Name of Payee: City of Okeechobee
By check By wire transfer X
If by check, Payee's address:
If by wire transfer, oav to:
City of Okee obee
Name: James E. Kirk
Title: Mayor
EXHIBIT 4
Payment of Proceeds Instructions
KEYCORP CONFIDENTIAL This is counterpart of manually executed counterparts. Only counterpart 1 constitutes chattel paper
Key Government Finance, Inc.
1000 South McCaslin Blvd.
Superior, CO 80027
EXHIBIT 6
Bank Qualified Tax Exempt Obligation
Re: Property Schedule No. 2 to Master Tax Exempt Lease /Purchase Agreement Key Government Finance, Inc. and
City of Okeechobee
Qualified Tax Exempt Obligation
Lessee hereby designates this Property Schedule as a "qualified tax exempt obligation" as defined in Section
265(b)(3)(B) of the Code. Lessee reasonably anticipates issuing tax exempt obligations (excluding private activity bonds
other than qualified 501(c)(3) bonds and including all tax exempt obligations of subordinate entities of the Lessee) during the
calendar year in which the Commencement Date of this Property Schedule falls, in an amount not exceeding $30,000,000.
Lessee: City of Okeechobee
By:
Name: James E. Kirk
Title:
Mayor
KEYCORP CONFIDENTIAL This is counterpart of manually executed counterparts. Only counterpart 1 constitutes chattel paper
AGORD CERTIFICATE OF LIABILITY INSURANCE
YY)
1/7/2010
PRODUCER (407) 445 -2414 FAX: (407) 445 -2868
World Risk Management, LLC
141 Terra Mango Loop
Ste A
Orlando FL 32835
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 POLICIES BELOW.
INSURERS AFFORDING COVERAGE
NAIC
INSURED
City of Okeechobee
55 S.E. Third Avenue
Okeechobee FL 34974 -2932
INSURER A: PRM/AMERICAN SAFETY
25433
INSURER B
INSURER C'.
INSURER D
INSURER E•
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. 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 INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.
AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
ADD'L
INSRD
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MMIDD /YY)
POLICY EXPIRATION
DATE (MM /DDIYY)
LIMITS
A
GENERAL
X
LIABILITY
COMMERCIAL GENERAL LIABILITY
PRM 09 012
4/1/2009
4/1/2010
EACH OCCURRENCE
2,000,000
PREM
PREMISES occu ante)
2,000,000
CLAIMS MADE
X
OCCUR
MED EXP (Any one person)
PERSONAL 8 ADV INJURY
GENERAL AGGREGATE
PRODUCTS COMP /OP AGG
Excluded
2,000,000
2,000,000
2,000,000
GENII AGGREGATED O APPLIES PER.
7 POLICY JECT LOC
A
AUTOMOBILE
X
X
X
LIABILITY
ANY AUTO
ALLOWNEDAUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
PRM 09 012
4/1/2009
4/1/2010
COMBINED SINGLE LIMIT
(Ea accident)
2,000,000
BODILY INJURY
(Per person)
BODILY INJURY
(Per accident)
PROPERTY DAMAGE
(Per accident)
GARAGE
LIABILITY
ANY AUTO
AUTO ONLY EA ACCIDENT
OTHER THAN EA ACC
AUTO ONLY
AGG
EXCESS /UMBRELLA LIABILITY
OCCUR CLAIMS MADE
EACH OCCURRENCE
AGGREGATE
DEDUCTIBLE
RETENTION
A
WORKERS COMPENSATION
EMPLOYERS' LIABILITY
ANY PROPRIETOR /PARTNER /EXECUTIVE
OFFICER /MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
PRM 09 012
4/1/2009
4/1/2010
WC STATU-
TORY LIMITS
OTH-
ER
E L EACH ACCIDENT
1,000,000
E.L. DISEASE EA EMPLOYEE
1,000,000
E.L. DISEASE POLICY LIMIT
1,000,000
A
OTHER
AUTO PHYSICAL DAMAGE
PRM 09 012
4/1/2009
4/1/2010
COMP DED. $1000.
COLL DED. $1000.
DESCRIPTION OF OPERATIONS /LOCATIONSNEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS
With respects to the listed coverages held by the named insured as evidence of insurance regarding the written
agreement of financing Police vehicles as follows;
5 2010 Dodge Chargers
14 2010 Ford Crown Victorias
ronrrcrr Arc uesr
ACORD 25(2001/08)
II fl'). no,
CANCELLATION
(720)304 -1479
Key Government Finance, Inc.
Suzanne Wagner Account Mgr
100 S. McCaslin Blvd
Superior, CO 80027
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT
FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Andrew Cooper /PATTI
ACORD CORPORATION 1988
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this
certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an
endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such
endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing
insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively
amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 25 (2001/08)
INS025 (0108) 08a
Page 2 of 2
Key Government Finance is listed as Loss Payee
Lessee: City of Okeechobee
By:
Name:
James
E.
Kirk
Title:
Mayor
Key Government Finance, Inc. is required to collect and remit sales /use tax in the taxing jurisdiction where your
equipment will be located. In the event we do not receive a valid sales tax exemption certificate prior to the date your
lease commences, you will be charged sales /use tax.
Personal property tax returns will be filed as required by local law. In the event that any tax abatements or special
exemptions are available on the equipment you will be leasing from us, please notify us as soon as possible and forward
the related documentation to us. This will ensure that your leased equipment will be reported correctly.
Please indicate below if you feel that your lease is subject to tax or whether a valid exemption exists.
I agree that my lease is subject to sales /use tax.
X I am exempt from sales /use tax and 1 have previously provided a copy of our exemption form.
I have previously provided a completed exemption certificate to Key Government Finance, Inc. which is
valid for this transaction.
I am exempt from state tax but subject to local tax. I have attached a completed exemption certificate.
I have a valid abatement or property tax exemption (documentation attached).
If applicable to the tax rates in your state, are you outside the city limits or in an unincorporated area?
Additional comments:
Notification of Tax Treatment
KEYCORP CONFIDENTIAL This is counterpart of manually executed counterparts. Only counterpart 1 constitutes chattel paper
21
Please
Form 8038 -G
Information Return for Tax Exempt Governmental Obligations
(Rev. November 2000) (Under Internal Revenue Code section 149(e))
Department of the Treasury See separate instructions.
Internal Revenue Service (Caution: If the issue price is under $100, 000, use Form 8038 -GC
Reporting Authority
If Amended Return, check here
Part I
1 Issuer's name
City of Okeechobee
3 Number and street (or P. O. box if mail is not delivered to street address
55 SE Third Avenue I Room /suite
City, o
5 ty, or post office, state, and ZIP code
Okeechobee, FL 34974 -2932
180 Other. Describe (see instructions)
19 If obligations are TANs or RANs, check box
If obligations are BANs, check box
20 If obligations are in the form of a lease or installment sale, check box
Part III
Part IV
Description of Obligations (Complete for the entire issue for which this form is being filed.)
Uses of Proceeds of Bond Issue (including underwriters' discount)
22 Proceeds used for accrued interest
23 Issue price of entire issue (enter amount line 21, column (b))
24 Proceeds used for bond issuance costs (including underwriters' discount)
25 Proceeds used for credit enhancement
26 Proceeds allocated to reasonably required reserve or replacement fund
27 Proceeds used to currently refund prior issues
28 Proceeds used to advance refund prior issues
29 (Total add lines 24 through 28)
30 Nonrefunding proceeds of the issue (subtract line 29 from line 23 and enter amount here)
Part V Description of Refunded Bonds (Complete this part only for refunding bonds.)
30 Enter the remaining weighted average maturity of the bonds to be currently refunded
31 Enter the remaining weighted average maturity of the bonds to be advance refunded
32 Enter the last date on which the refunded bonds will be called
33 Enter the date(s) the refunded bonds were issued
Part VI
Miscellaneous
OMB No. 1545 -0720
2 Issuers employer Identification number
59- 600093
4 Report number
6 Date of issue
7 Name of issue
Property Schedule No. 2 to Master Tax Exempt Lease /Purchase Agreement
9 Name and title of officer or legal representative whom the IRS may call for more information 10 Telephone number of officer or legal representative
Robin Brock
(863) 763 -3372
Part II Type of Issue (check applicable box(es) and enter the issue price for each) See instructions and attach schedule
11 Education
120 Health and hospital
1 30 Transportation
14® Public Safety
15 0 Environmental (including sewage bonds) $369,043
160 Housing
1 70 Utilities
8 CUSIP number
11
12
13
14
15
16
17
18
(a) Final maturity date
(b) Issue price
$369,043
(c) Stated redemption
price at maturity
N/A
(d) Weighted
average maturity
5 years
(e) Yield
N/A
N/A
N/A
N/A
4.849
24 N/A
25
26
27
28
N/A
N/A
N/A
N/A
22
23
29
30
N/A
N/A
35 Enter the amount of the state volume cap allocated to the issue under section 141(b)(5)
35
36a Enter the amount of gross proceeds invested or to be invested in a guaranteed investment contract (see instructions) 36a 0.00
b Enter the final maturity date of the guaranteed investment contract 0.00
37 Pooled financings: a Proceeds of this issue that are to be used to make loans to other governmental units
b If this issue is a loan made from the proceeds of another tax- exempt issue, check box 37a 0.00
issuer and enter the name of the
38 If the issuer has designated the issue under section 265 b 3 B i III (small issuer exception), check box date of the issue
39
If the issuer has elected to pay a penalty in lieu of arbitrage reb te, check box
40 If the issuer has identified a hedge, check box
Under pens •erjury, I declare that I have examined this return, and accompanying schedules and statements, and to best of to the
knowle..
e and belief, th y re t e, correct and complete.
Sign X--
Here James E. Kirk, Mayor
For Paperwork Reduction Act
Sig ice, see page 2 of the Instructions alive Cat. No. 63773S or print name Fond title
orm 8038 -G (Rev. 11 -2000)
KEYCORP CONFIDENTIAL This is counterpart of manually executed counterparts. Only counterpart 1 constitutes chattel paper
N/A
N/A
years
years