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HomeMy WebLinkAboutBID DOCUMENT - GUNS N MORE i ' 6006 1 ikt 11, 111E. . ,. "PRESERVING OUR 2ND AMENDMENT RIGHTS" HUMBOLDT,IOWA GUNS N MORE, LLC l� "Preserving Our Second Amendment Rights" 9 5th St N. Humboldt, IA 50548-1731 Phone: (515) 890-7460 Fax: (515) 332-3352 Email: gunsnmore@hotmail.com website: www.gunsnmore.net September 16, 2011 FY 12 Ammunition Bids City of Waterloo City Clerks Office 715 Mulberry Street Waterloo, IA 50703 We submit our bid for FY 12 Ammunition and offer our warranty that is given by the manufacture of the ammunition sold to you from our supplier as "Factory New Service Ammunition"as you have requested in this bid, and "Not Reloads". We attach our$1,000,000.00 Product Liability Insurance certificate naming you as certificate Holder FY 12',as to show that we are a legitimate FFL dealer we enclose for your record's our FFL License also. We also submit a Department of Treasury Exemption Certificate along with a State Sales Tax Exemption Certificate, and finally a W-9. DEVIATIONS: Guns N More, LLC has two deviations from the attached specification; Item#5 you have requested (P223E) our supplier does not have enough at this time they have suggested (T223E) .223 Federal Tactical TRU 55, Grain Sierra Gameking BTHP Law Enforcement ammunition which is comparable to your request. #7 (FC308MC)they do not have at all and they are showing a comparable of(AE308D) Federal American Eagle Ammunition AE308D, 308 Winchester, Metal Case Boat-Tail, 150 GR, 2820 fps. I am still searching for these two of the exact requests at this time of submission. Sincerely zr'Z .......1 .......L.: Barry Ellis Owner/Manager GUNS N MORE, LL C. "Preserving Our Second Amendment Rights" 9 5th St N. Humboldt, IA 50548-1731 Phone: (515) 890-7460 Fax: (515) 332-3352 Email: gunsnmore@hotmail.com website: www.gunsnmore.net BILLING STATEMENTS Our billing is clear; we send a confirmation order to you before we place any of your orders. This eliminates mistakes and that there is no confusion. Once we receive a confirmation approval,your order is placed, sending in your signed authorized purchased order. Your payments will need to be sent to-GUNS N MORE on a Net 30 days from date of receiving your order. Payments that are 30 days late FEE charge of a 2.5%of the unpaid balance due from Date of receiving product. The Bid Prices are listed below: "FY 12 Ammunition" PRODUCT DESCRIPTION: 1 (P4OHST1) $348.99 X 7 cases=$2,442.93 2 (AE4OR1) $269.80 X 65 cases=$17,537.00 3 (LEF132-00) $125.65 X 8 cases=$1,005.20 4(LEF127-RS) $129.92 x 12 cases=$1,559.04 5 (T223E) $365.78 x 12 cases=$4,389.36 6 (AE223) $246.56 x 56 cases=$13,807.36 7 (AE308D) $341.56 x 8 cases=$2,732.48 Sub-Total $43,473.37 Shipping $ 2,000.00 TOTAL COST $45,473.37 This bid price is good for 30 days from 09/15/2011 Sincerely, C-3 , Barry Ellis Owner/ Manager BID PRICES Factory New Service Ammunition 1. 7,000 rounds of.40 S&W, 180 grain,jacketed hollow point, Federal HST, (P4OHST1). $ I7 y `M per 500 rounds 2. 65,000 rounds of Federal American Eagle .40 S&W, 180 grain, full metal jacket (AE40R1). $ 13 4' ?D per 500 rounds 3. 2,000 rounds of Federal 12 gauge 2 3/4 inch shot shell, 00 Buckshot, 9 pellet, low recoil (LEF132-00). $ I S• 6S per 250 rounds 4. 3,000 rounds of Federal 12 gauge 2 3/ inch shot shell 1 ounce low recoil slug. (LEF127-RS). $ /A 9. 9 a per 250 rounds 5. 6,000 rounds of Federal .223 caliber, 55 grain, Sierra boat- tail hollow point Tactical Rifle Urban. (P223E). $ 3(oS,?$ per 500 rounds 6. 28,000 rounds of Federal American Eagle .223 caliber, 55 grain FMJ (AE223). $ 2114 •56 per 500 rounds 7. 4,000 rounds of Federal .308 Winchester caliber, 168 grain Sierra MatchKing boat tail hollow point. (FC308MC). $ 3 W.S—(, per 500 rounds BID PROPOSAL AMMUNITION CITY OF WATERLOO, IOWA POLICE DEPARTMENT PREAMBLE The undersigned being a corporation under the laws of the State of Tot,: ; a partnership consisting of the following partners: ifmizlz y L u s A AM tick:, S'i Lci4,2 J- 61 LI s , or an individual doing business as t t tta+rc'> L,cc 01,),1 C0.+a,� ��y , being familiar with the specifications affecting the cost of this commodity, hereby offers to furnish said commodity to the City of Waterloo, Police Department, 715 Mulberry Street, Waterloo, Iowa, 50703. SUBMISSION OF BIDS Sealed bid proposals will be received by the City of Waterloo, City Clerk's Office, 715 Mulberry Street, Waterloo, Iowa, 50703, no later than Noon on the 26th of September 2011. Any bid submitted after the specified time shall be rejected. Bids should be clearly marked FY 12 Ammunition Bids. SPECIFICATIONS The bidder proposes to deliver to the City of Waterloo Police Department, 715 Mulberry Street, Waterloo, Iowa, 50703, the below specified items during fiscal year FYE 2012 beginning July 1, 2011 through June 30, 2012, after notification that he/she is the successful bidder by issuance of a purchase order mailed, telegraphed or delivered to the undersigned vendor, accompanied by a copy of this proposal bearing the City Clerk's signature. Factory New Service Ammunition 1. 7,000 rounds of.40 S&W, 180 grain,jacketed hollow point, Federal HST, (P4OHST1). 2. 65,000 rounds of Federal American Eagle .40 S&W, 180 grain, full metal jacket(AE4OR1). 3. 2,000 rounds of Federal 12 gauge 2 3/ inch shot shell, 00 Buckshot, 9 pellet, low recoil (LEF132-00). 4. 3,000 rounds of Federal 12 gauge 2 3/ inch shot shell 1 ounce low recoil slug. (LEF127-RS). 5. 6,000 rounds of Federal .223 caliber, 55 grain, Sierra boat tail hollow point Tactical Rifle Urban. (P223E). 6. 28,000 rounds of Federal American Eagle .223 caliber, 55 grain FMJ (AE223). 7. 4,000 rounds of Federal .308 Winchester caliber, 168 grain Sierra MatchKing boat tail hollow point. (FC308MC). List any deviations from the specifications included herein: p22-3 - IS -171IN6 CEA CO T14- Eaj .1A1 P �C�G�LA) T2Z SAAAE SP`c-'s• toes use C AU i10-6;llNtv,ri+ iuy 5'+ 4 7 rc.-50g M C:.. Nel'f„uQ_ Tb G13 1 /'- EA0 .11k p WAS iLfUtiotAn 01,I.\ON Po tc`1ut vor-Cefi d t' AI`30z 1) 13y cEiJe►2,AI A-t11Ct'LICAi‘ 6-, I sC?4tl1C PC 1_ C—sCAWL OPENING AND ACCEPTANCE OF BIDS Sealed bid proposals will be opened and read at 5:30 P.M. on the 26th of September 2011, during the Waterloo City Council Meeting at Waterloo City Hall, 715 Mulberry Street, Waterloo, Iowa. All bidders understand that they may be in attendance at the bid opening. Bids will be acted upon at that time or at a later time, which shall then be established. CANCELLATION The successful bidder understands that the City of Waterloo shall cancel this agreement within thirty days notice, if the City has knowledge that all conditions as stated in this bid proposal have not been fulfilled. PAYMENT PROCEDURES The City of Waterloo Police Department, 715 Mulberry Street, Waterloo, Iowa', 50703, shall make a lump sum payment within thirty days of receipt of billing from the vendor and acceptance of commodity by the City. The bidder, having read this document, hereby acknowledges that bid proposal completely reflects the total bid as contained herein. By 73Ai y Ll,s Title /3o/41 14 6��L Date 9- d-c 'I ATTEST: , City Clerk Date Proof of Insurance Coverage ' jaCi i r n 4 Mn //1SueL rat Company Name .57.1 S>' A' )J►Nhldr .6-0SVP= Address 6/5-) 896 -),I C0 Telephone CPS I ?•03 Policy Number *Attach Certified Copy of Insurance Coverage ® DATE(MM/DD/YYYY) A o CERTIFICATE OF LIABILITY INSURANCE 09/06/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. 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). PRODUCER CONTNAME: WORTHINGTON,WORTHINGTON, MIKE R PHONE 515-332-3326 FAX 515-332-3352 WORTHINGTON INSURANCE & R.E. 0/C.No.EA: (AIC,No): 9 NORTH 5TH STREET ADDRESS: mike@worthingtonins.net P.O. BOX 707 HUMBOLDT, IA 50548 INSURER(S)AFFORDING COVERAGE NAIL# INSURER A: INSURED INSURER B: BARRY ELLIS DBA INSURERC: GUNS AND MORE INSURERD: 9 N 5TH ST HUMBOLDT, IA 50548 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRL TYPE OF INSURANCE ADDL SUBR POLICY NUMBER (MMIDDIYYYY) (MMID POLICY EFF DIYY EXP YYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 500,000 X COMMERCIAL GENERAL LIABILITY CPS1262031 02/01/2011 02/01/2011 PREMI ETORENTED 500,000 PREMISES(Ea occurrence) $ CLAIMS-MADE X OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADVINJURY $ 500,000 GENERAL AGGREGATE $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000,000 X POLICY PEA LOC $ AUTOMOBLE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $HIRED AUTOS AUTOS (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATOR WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY OF WATERLOO ACCORDANCE WITH THE POLICY PROVISIONS. 715 MULBERRY ST WATERLOO, IA 50703 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD • GUNS N MORE,It "PRESSIVON Re BM AKIIIMESI IYAWDT,IOWA 9 5th St N Humboldt,IA 50548-1731 Phone (515)890-7460 Fax (515)332-3352 Email; gunsnmorePhotmail.com web; www.gunsnmore.net OMB No.1513-0128(04/30/2011 DEPARTMENT OF THE TREASURY ALCOHOL AND TOBACCO TAX AND TRADE BUREAU EXEMPTION CERTIFICATE(USE BY STATE OR LOCAL GOVERNMENTS) For use by State and local governments(section 4221(a)(4)of the Internal Revenue Code) , 20 I hereby certify that I am (month &day) (Title Officer) Of ;that I am authorized to execute this certificate; and that (State or local government) (check applicable type of certificate): ❑ The Article or articles specified in the accompanying order, or on the reverse side hereof, (or) ❑ All order placed by the purchaser for the period commencing 9.` 1"ov) and ending R' (Date) (Date) (period not to exceed 12 calendar months) Are, or will be, purchased from c,o A) MO it , f- LC for the (Name of Dealer) Exclusive use of (Governmental Agency) Of (State or local government) I understand that the exemption from tax in the case of sales of articles under this exemption certificate to a State,etc., is limited to the sales of articles purchased for its exclusive use(1). I understand that a fraudulent use of this certificate for the purpose of securing this exemption will subject me and all parties making such fraudulent use of this certificate to all applicable criminal penalties under the Internal Revenue Code. SIGNATURE ADDRESS ATF 5600.35(2-94) 1 A sale of an article to a state or local government for resale is not considered to be the sale for the"exclusive use"of the State or local government,within the meaning of section 4221(a)(4)of the code,and,therefore,such sales may not be made tax-free.Such sales may not be made tax-free even if the resales are made to government employees,or the article is an item of equipment the employee is required to possess in carrying out his duties. • e H.,,,, Iowa Department of Revenue www.state.ia.us/tax Iowa Sales Tax Exemption Certificate This document is to be completed by a purchaser whenever claiming exemption from sales/use tax. Certificates are valid for up to three years. Seller:Keep this certificate in your files. Purchaser:Keep a copy of this certificate for your records.Do not send this to the Department of Revenue. Purchaser Name Seller Name ff VUNS rii 61011-L-, i- L C. Address Address 9 ,11 5T- 1 /.A HU City State Zip Code City State Zio Code General Nature of Business Telephone Number Purchaser is claiming exemption for the following reason: Purchaser is doing business as a: ❑ Resale ❑ Leasing ❑ Processing ❑ Retailer ❑ Qualifying Farm Machinery/Equipment Sales tax permit No. (if required): ❑ Qualifying Industrial Machinery/Equipment ❑ Retailer Car Dealer DOT No.: ❑ Wholesaler ❑ Farmer ❑Lessor ❑ Qualifying Replacement Parts ❑Qualifying Computer El Manufacturer ❑ Nonprofit Hospital ❑ Pollution Control Equipment 0 Recycling Equipment ❑ Private Nonprofit Educational Institution Governmental Agency including public schools ❑ Research and Development Equipment Qualifying Residential Care Facility ❑ Direct Pay (permit no. required): El Non-Profit Museum 0 Other: ❑ Other: Description of Purchase: Attach additional information if necessary. Under penalty of perjury, I swear or affirm that the information on this form is true and correct. Signature of Purchaser: Title: Date: 31-014a(08/18/09) Exemption Certificate Instructions This exemption certificate is to be completed by the purchaser claiming exemption from tax and given to the seller.The seller must retain this certificate as proof that exemption has been properly claimed.The certificate must be complete to be accepted by the seller.The seller can accept an exemption certificate only on property that is qualified(see the exemptions below)or based on the nature of the buyer.If property or services purchased for resale or processing are used or disposed of by the purchaser in a nonexempt manner,the purchaser is then responsible for the tax. Exemptions: Resale:Any person in the business of selling who is purchasing items to resell may claim this exemption.The purchaser can be acting as either a retailer or wholesaler and may not be required to have a sales tax permit.Retailers who do have a sales tax permit number must enter it in the space provided. Processing:Exempt purchases for processing include tangible personal property which by means of fabrication,compounding,manufacturing,or germination becomes an integral part of other tangible personal property ultimately sold at retail;chemicals.solvents,sorbents,or reagents used,consumed,dissipated, or depleted in processing personal property intended to be sold ultimately at retail; fuel used to create heat, power, or steam for processing or used to generate electric current;and chemicals used in the production of free newspapers and shoppers. Qualifying Farm Machinery/Equipment:The farm machinery or equipment must be directly and primarily used in agricultural production;and must be: I.a self-propelled implement such as a tractor 2.a grain dryer(heater and blower only) 3.an implement customarily drawn or attached to a self-propelled implement in the performance of its function,such as a plow 4.auxiliary equipment improving safety,maintenance and efficiency of items I,2,3 5.tangible personal property that does not become a part of real property used directly and primarily in dairy and livestock operations 6.a replacement part for I,2,3,4,5 7.bailing wire,twine,wrapping,and other similar items used in agricultural,livestock,or dairy production 8.auger systems,curtains,curtain systems,drip systems,fans,and fan systems,shutters,inlets,shutter or inlet systems,and refrigerators used in livestock or dairy production.aquaculture production,or the production of flowering,ornamental,or vegetable plants. Qualifying Industrial Machinery/Equipment:This machinery or equipment must be: •used by a manufacturer •directly and primarily used in processing tangible personal property or certain other research activities •certain replacement parts for the above;this does not include supplies Qualifying Computers: •sold to commercial enterprise,insurance company,or financial institution •certain replacement parts;this does not include supplies Direct Pay:Businesses and individuals who pay their taxes directly to the Department rather than to the seller must enter their Direct Pay permit number in the space provided. Private Nonprofit Educational Institutions:Purchases made by Iowa private nonprofit educational institutions used for educational purposes are exempt. NOT EXEMPT from sales tax are purchases by most other private nonprofit organizations such as churches,fraternal organizations,etc.,for use by those organizations. 31-014b(08/18/09) fi Farm W-9 Request for Taxpayer Give Form to the (Rev.January 2011) Identification Number and Certification requester. Do not Department of the Treasury send to the IRS. Internal Revenue Service Name(as shown on your income tax return) N Business name/disregarded entity name,if different from above o, GUNS N MORE, LLC °- Check appropriate box for federal tax c o classification(required): ['AI Individual/sole proprietor ❑ C Corporation ❑ S Corporation ❑ Partnership ❑Trust/estate c TLI Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,P=partnership)► ❑Exempt payee 0 2 c N C c v El (see instructions)II. E. Address(number,street,and apt.or suite no.) Requester's name and address(optional) u a 9 5th St N cn City,state,and ZIP code in Humboldt, IA 50548-1700 List account number(s)here(optional) Part I Taxpayer Identification Number(TIN) Enter your TIN in the appropriate box.The TIN provided must match the name given on the"Name"line Social security number to avoid backup withholding. For individuals,this is your social security number(SSN).However,for a resident alien,sole proprietor,or disregarded entity,see the Part I instructions on page 3.For other - - entities,it is your employer identification number(EIN).If you do not have a number,see How to get a TIN on page 3. Note.If the account is in more than one name,see the chart on page 4 for guidelines on whose Employer identification number number to enter. 2 7 - 2 1 1 2 2 5 0 Part II Certification Under penalties of perjury,I certify that: 1. The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me),and 2. I am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that I am no longer subject to backup withholding,and 3. I am a U.S.citizen or other U.S.person(defined below). Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return.For real estate transactions,item 2 does not apply.For mortgage interest paid,acquisition or abandonment of secured property,cancellation of debt,contributions to an individual retirement arrangement(IRA),and generally,payments other than interest and dividends,you are not required to sign the certification,but you must provide your correct TIN.See the instructions on page 4. Sign Signature of77Z-a Here U.S.person► Date► 9- /jr /I General Instructions Note.If a requester gives you a form other than Form W-9 to request your TIN,you must use the requester's form if it is substantially similar Section references are to the Internal Revenue Code unless otherwise to this Form W-9. noted. Definition of a U.S.person.For federal tax purposes,you are Purpose of Form considered a U.S.person if you are: A person who is required to file an information return with the IRS must •An individual who is a U.S.citizen or U.S.resident alien, obtain your correct taxpayer identification number(TIN)to report,for •A partnership,corporation,company,or association created or example,income paid to you,real estate transactions,mortgage interest organized in the United States or under the laws of the United States, you paid,acquisition or abandonment of secured property,cancellation •An estate(other than a foreign estate),or of debt,or contributions you made to an IRA. •A domestic trust(as defined in Regulations section 301.7701-7). Use Form W-9 only if you are a U.S.person(including a resident alien),to provide your correct TIN to the person requesting it(the Special rules for partnerships.Partnerships that conduct a trade or requester)and,when applicable,to: business in the United States are generally required to pay a withholding tax on any foreign partners'share of income from such business. 1.Certify that the TIN you are giving is correct(or you are waiting for a Further,in certain cases where a Form W-9 has not been received,a number to be issued), partnership is required to presume that a partner is a foreign person, 2.Certify that you are not subject to backup withholding,or and pay the withholding tax.Therefore,if you are a U.S.person that is a 3.Claim exemption from backup withholding if you are a U.S.exempt partner in a partnership conducting a trade or business in the United payee.If applicable,you are also certifying that as a U.S.person,your States,provide Form W-9 to the partnership to establish your U.S. allocable share of any partnership income from a U.S.trade or business status and avoid withholding on your share of partnership income. is not subject to the withholding tax on foreign partners'share of effectively connected income. US.Department of Justice Bureau of Alcohol,Tobacco,Firearms and Explosives Federal Firearms License (18 U.S.C. Chapter 44) In accordance with the provisions of Title I,Gun Control Act of 1968,and the regulations issued thereunder(27 CFR Part 478),you are licensed to engage in the business specified in this license,within the limitations of Chapter 44.Title 18,United States Code.and the regulations issued thereunder.until the expiration date shown. See"WARNINGS"and"NOTICES"on reverse. MINIM nr•"'wuMw MIME,!w Direct ATF ATF-Chief.FFLC License Correspondence To 244 Needy Road Number 5.42.091_01-3 J-02212 Martinsburg,WV 25405-943I Chief. e al irearms ' e ng Center(FFLC. Expiration Date September 1 , 2013 Name GUNS N MORE LLC Premises Address(Chance,° Notify the FFLC at least 30 days before the moi°e.t I9 5TH STN I HUMBOLDT, IA 50548-1731 Type of License 01-DEALER IN FIREARMS OTHER THAN DESTRUCTIVE DEVICES Purchasing Certification Statement Mailing Address(Changes? Notifs the FFLC of any changes.) The licensee named above shall use a copy of this license to assist a transferor of firearms to verify the identity and the licensed status of the licensee as provided by GUNS N MORE LLC 27 CFR Part 478. The signature on each copy must be an original signature 1 9 5TH ST N faxed,scanned or e-mailed copy of the license with a signature intended to be an HUMBOLDT. IA 50548-1731 original signature is acceptable. The signature must be that of the Federal Firearm, Licensee(FFL)or a responsible person of the FFL. [certify that this is a true eop. of a license issued to the licensee named above to engage in the business spec :red above u 'Type of Licensee/Re nsible Person Signature Position(Title o9-01'-. 26i0. Printed Name Date ATM Form 8(5310.11) Previous Edition is Obsolete GUNS SM01[Lai VSSTMSSSusJ541t-14}-ou2f2 Waster tNi3111-ouMERSI MAIM OTHER 71MYUESuooctIYEDUCES Revised September 2008 Federal Firearms License(FFL)Customer Service Information Federal Firearms Licensing Center(FFLC) Toll-free Telephone Number: (866)662-2750 ATF Homepage: www.atf.gov 244 Needy Road Toll-free Fax Number: (866)257-2749 FFL eZ Check: www.atfonline.gov/fflezcheck Martinsburg,WV 25405-9431 E-mail: NLC@atf.gov Change of Address (27 CFR 478.52). Licensees may during the term of their current license remove their business or activity to a new location at which they intend regularly to carry on such business or activity by filing an Application for an Amended Federal Firearms License,ATF Form 5300.38,in duplicate,not less than 30 days prior to such removal with the Chief,Federal Firearms Licensing Center. The application must be executed under the penalties of perjury and penalties imposed by 18 U.S.0 924. The application shall be accompanied by the licensee's original license. The license will be valid for the remainder of the term of the original license. (The Chief,FFLC,shall,if the applicant is not qualified,refer the application for amended license to the Director of Industry Operations for denial in accordance with§478.71.) Right of Succession (27 CFR 478.56). (a)Certain persons other than the licensee may secure the right to carry on the same firearms or ammunition business at the same address shown on,and for the remainder of the term of,a current license. Such persons are: (1)The surviving spouse or child,or executor,administrator,or other legal representative of a deceased licensee;and(2)A receiver or trustee in bankruptcy.or an assignee for benefit of creditors. (b)In order to secure the right provided by this section,the person or persons continuing the business shall furnish the license for that business for endorsement of such succession to the Chief,FFLC,within 30 days from the date on which the successor begins to carry on the business. (Continued on reverse side) Cut Here )( ., Federal Firearms License(FFL)Information CardEFL Newsletter Electronic Version Available License Name: GUNS N MQC Sign-Up Today! FFLs interested in receivingthe electronic version of the 1'FL Newslet- Business Name: ter,along with occasional additional information,should submit name, )/ '1 FFL number,and e-mail address to: FFLNewsletter@atf.gov. License Number 5-42-091-01-3J-02212 J g License Type: 01-DEALER IN FIREARMS OTHER THAN The electronic FFL Newsletter will enable ATF to communicate DESTRUCTIVE DEVICES information to licensees on a periodic basis. Expiration: September 1,2013 Please Note: Not Valid for the Sale or Other Disposition of Firearms.