Res 2017-089/Approve a Vehicle Titling Addendum to add the lease-purchase of a 12-Yard Dump Truck

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Form 8038-G (Rev. 9-2011) Page 2 Miscellaneous 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 (GIC) (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . 36a b Enter the final maturity date of the GIC ► c Enter the name of the GIC provider 0- 37 37 Pooled financings: Enter the amount of the proceeds of this issue that are to be used to make loans to other governmental units . . . . . . . . . . . . . . . . . . . . . . . . 37 38a If this issue is a loan made from the proceeds of another tax-exempt issue, check box ► ❑ and enter the following information: b Enter the date of the master pool obligation P- c C Enter the EIN of the issuer of the master pool obligation Po- d d Enter the name of the issuer of the master pool obligation Do - 39 39 If the issuer has designated the issue under section 265(b)(3)(B)(i)(III) (small issuer exception), check box . . . . ► ❑ 40 If the issuer has elected to pay a penalty in lieu of arbitrage rebate, check box . . . . . . . . . . . . . ► ❑ 41a If the issuer has identified a hedge, check here ► ❑ and enter the following information: b Name of hedge provider ► c Type of hedge ► d Term of hedge Do - 42 42 If the issuer has superintegrated the hedge, check box . . . . . . . . . . . . . . . . . . . . ► ❑ 43 If the issuer has established written procedures to ensure that all nonqualified bonds of this issue are remediated according to the requirements under the Code and Regulations (see instructions), check box . . . . . . . . ► ❑ 44 If the issuer has established written procedures to monitor the requirements of section 148, check box . . . . . ► ❑ -- --45a--If-some-portiomof the -proceeds -was used -to -reimburse -expenditures; cheek-here-►--❑-and-enter-the-amount-- - -- --- -- of reimbursement . . . . . . . . . ► b Enter the date the official intent was adopted ► Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge Signature and belief, they are true, correct, and complete. I further declare that I consent to the IRS's disclosure of the issuer's return information, as necessary to and process t is r n, to the person thaLibave autho ' ed above. Consent O (j Charles W. Daniels, Interim City Manager S ture of issuer's authorized representative Date Tvoe or print name and title Paid Print/Type preparer's name Preparer's signature Date Check ❑ if PTIN Preparer self-employed Use Only Firm's name ► Firm's EIN ► Firm's address ► Phone no. Form 8038-6 (Rev. 9-2011)