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SCANTRON, <br />BILL TO: <br />ATTN: ACCOUNTS PAYABLE <br />CITY OF SANTA ANA <br />HUMAN RESOURCES M 24 <br />20 CIVIC CENTER PLZ <br />SANTA ANA CA 92701 <br />INVOICE <br />LOCATED AT: <br />INVOICE NUMBER: <br />3162170 <br />DATE: <br />13-MAR-20 <br />Page 1 of 1 <br />CUSTOMER NO: <br />200301493 <br />CREDIT <br />REF NO: <br />TAX LID NO: 95-2767912 <br />200301493 <br />ATTN: MARIBEL CARMONA <br />CITY OF SANTA ANA <br />HUMAN RESOURCES <br />20 CIVIC CENTER PLZ FL 5 <br />SANTA ANA CA 92701 <br />Reference Num:SCT ORDER ENTRY 1605753 <br />PURCHASE INFORMATION <br />SHIPPING INFORMATION <br />PAYMENT INFORMATION <br />PURCHASE ORDER: <br />- <br />TERMS: NET 30 <br />SIGNED AGREEMENT <br />SHIP DATE: 13-MAR-20 <br />DUE DATE: 12-APR-20 <br />AGREEMENT NUMBER: <br />SALES REP: Hansen, Thomas J (Tom) <br />CARRIER: <br />CONTACT: Jay Nanda <br />(800) 228-3628 <br />ORDER SOURCE: <br />B/L NUMBER: <br />Fax (844) 364-3126 <br />ScantronAR@HarlandClarke.com <br />T <br />DESCRIPTION <br />U/M <br />QTY <br />A <br />UNIT PRICE <br />EXTENDED PRICE <br />X <br />IN4/2304 IN4ES, DUAL <br />EACH <br />1 <br />Y <br />4,840.00 <br />4,840.00 <br />4FRT SCANNER FREIGHT & HANDLING <br />EACH <br />1 <br />N <br />55.00 <br />55.00 <br />IN4UOS INSIGHT 4ES UPGRADE ONSITE <br />Yearly <br />1 <br />N <br />448.00 <br />448.00 <br />STX101 Scantools Plus Scan Only/Edit <br />EACH <br />1 <br />Y <br />395.00 <br />395.00 <br />STX101-SA STX101 SOFTWARE ASSURANCE-1 Scantools <br />YEAR <br />1 <br />N <br />Plus Scan Only/Edit: 13-MAR-20 - 12-MAR-21 <br />FRT FREIGHT & HANDLING <br />EACH <br />1 <br />N <br />30.00 <br />30.00 <br />STX-50-CW SCANTOOLS PLUS SCAN ONLY ONLINE <br />EACH <br />1 <br />N <br />675.00 <br />675.00 <br />ININSTAL Onsite Installation - INSIGHT <br />EACH <br />1 <br />N <br />300.00 <br />300.00 <br />INVOICE SUMMARY: <br />TOTAL FOR ALL LINE ITEMS <br />6,743.00 <br />TOTAL FREIGHT <br />0.00 <br />6.00 % STATE TAX <br />308.10 <br />2.00% CITY TAX <br />102.70 <br />1.25% COUNTY TAX <br />64,19 <br />Amounts not paid when due are subject to finance charges of 1.5 % per month <br />or the highest rate permitted by law, whichever is less, compounded daily from <br />the due date until paid. <br />Please update remit to address if needed. <br />My check/money order is enclosed: <br />a Check # <br />Charge to my Credit Card <br />o <br />Visa MasterCard Amex <br />o <br />Card # <br />o <br />Name of Card Holder <br />o <br />Billing Address <br />o <br />Sionature <br />Date —/ <br />SUBTOTAL <br />TAX <br />TOTAL <br />6,743.00 <br />474.99 <br />(USD) <br />7,217.99 <br />Please Remit to: <br />SCANTRON CORPORATION <br />P O Box 93038 <br />Chicago, IL 60673 <br />CUSTOMER COPY <br />