~~~~~Ol~l~~ - Illinois.gov

ILLINOIS INDEPENDENT

TAX TRIBUNAL

SAMARITAN DISPLAY GROUP INC. ) ) ) ) )

v.

ILLINOIS DEPARTMENT OF REVENUE

PETITION

~~~~~Ol~l~~ av· 1;-( / 1--; (

Petitioner, Samaritan Display Group Inc. ("Petitioner") by and through their attorneys,

Sorling Northrup, John R. Simpson, of counsel, complains of the Illinois Department of Revenue

("Department"), and alleges as follows:

JURISDICTION, VENUE AND PARTIES

1. Petitioner brings this action pursuant to Rule Section 5000.310 of the Tax

Tribunal 86 Ill.Admin. Code § 5000.310.

2. The Petitioner is Samaritan Display Group Inc.

3. The Petitioner's identification number is 00611-27648.

4. The Department determined that Petitioner had failed to pay Illinois sales tax

during tax year 201 7.

5. The Department issued to Petitioner certain Notices of Tax Liability and Use Tax

Reports which are attached as Exhibits A-1 through A-14.

6. By letter of July 16, 2021 by the Department's Chief Administrative Law Judge,

Petitioner has been granted a discretionary hearing. Said letter is attached as Exhibit B.

44K3974 8/13/2021 of 5

7. The Tax Tribunal has jurisdiction over this matter pursuant to the Illinois Tax

Tribunal Act of 2012, 35 ILCS 1010/1-1 et seq.

STATEMENT OF FACTS

8. The taxes asserted herein are the Illinois Use Tax imposed under the Illinois Use

Tax Act, 35 ILCS 105/1 et seq.

9. However, Petitioner is a reseller of tangible personal property and would more

correctly be subject to Illinois Retailers' Occupation Tax.

10. Petitioner sold tangible personal property during 201 7.

11. Most sales of Petitioner were to out of state entities.

COUNTI

Petitioner realleges and incorporates by reference the allegations made in Paragraphs 1

through 11, inclusive, hereinabove.

12. Sales in interstate commerce are not subject to Retailers' Occupation Tax or Use

Tax.

13. Each sale in interstate commerce or for resale referenced in Exhibits C - F was

believed to be exempt from Retailers' Occupation Tax.

14. The sales referenced in Exhibits C - F should be determined to be exempt from

Retailers' Occupation Tax and Use Tax.

15. Petitioner has voluminous invoices, shipping documents, etc. that will be supplied

to the Office of Legal Services contemporaneously with filing this Petition. Said documents

substantiate interstate sales.

44K3974 8/13/2021 of 5

16. In August 2017, some assets of Petitioner were sold to AMD Industries for resale

by AMD Industries. See Exhibit G. Said assets sold for resale are not subject to Retailers'

Occupation Tax or Use Tax.

17. Petitioner's Exhibits reveal a small number of sales into Illinois and Petitioner

agrees that sales tax is due thereon.

18. There is an actual controversy between Petitioner and the Department concerning

Petitioner's liability.

WHEREFORE, Petitioner requests that the Tax Tribunal enter an Order that finds and

declares that Petitioner's sales referenced in Exhibits C - G are not subject to Retailers'

Occupation Tax or Use Tax.

COUNT II

Petitioner realleges and incorporates by reference the allegations made in Paragraphs 1

through 18, inclusive, hereinabove.

19. The Notices of Tax Liability and Use Tax Reports calculate and include penalty

and interest due by Petitioner.

20. Section 3-8 of the Uniform Penalty and Interest Act, 35 ILCS 735/3-8 states:

No penalties if reasonable cause exists. The penalties imposed under the provisions of Sections 3-3, 3-4, 3-5, and 3-7 .5 of this Act shall not apply if the taxpayer shows that his failure to file a return or pay tax at the required time was due to reasonable cause. Reasonable cause shall be determined in each situation in accordance with the rules and regulations promulgated by the Department. A taxpayer may protest the imposition of a penalty under Section 3-3, 3-4, 3-5, or 3-7.5 on the basis of reasonable cause without protesting the underlying tax liability.

21. Petitioner was acting reasonably in that it had taken actions to document exempt

sales.

44K3974 8/13/2021 of 5

22. The Notices of Tax Liability and Use Tax Reports include an amount of penalty

assessed.

23. Petitioner had reasonable cause not to pay the amounts in the Notice.

WHEREFORE, Petitioner requests that the Tax Tribunal enter an Order that:

(a) Finds and declares that the Petitioner had reasonable cause not to pay the liability

as in the Notices and abates the penalties from that Notices as assessed against

Petitioner; and

(b) Grants such further relief as the Court deems appropriate under the circumstances.

Sorling Northrup John R. Simpson, of Counsel 1 North Old State Capitol Plaza, Suite 200 P.O. Box 5131 Springfield, IL 62705 Telephone: 217-544-1144 Fax: 217-522-3173 E-Mail: [email protected]

44K3974 8/13/2021

SAMARITAN DISPLAY GROUP INC., Petitioner,

By: \.l)~~ One of Its Attorneys

Page4 of5

PROOF OF SERVICE

The undersigned hereby certifies that a copy of the foregoing document was served by

placing same in a sealed envelope addressed:

Illinois Department of Revenue Office of Legal Services 100 W Randolph Street, 7-900 Chicago, IL 60601

and by depositing same in the United States mail in Springfield, Illinois, on August \ ~ , 2021,

with postage fully prepaid.

44K3974 8/13/2021 of 5

Taxpayer Statement

#BWNKMGV #CNXXX1561343 3445# SAMARITAN DISPLAY GROUP INC 1230 REMINGTON RO SCHAUMBURG IL 60173-4812

EXHIBIT A STATE OF

llinois D PARTME.NT(()F.;~eVENOE· ~ tax.illinois.gov ~ 1 800 732-8866

217 782-3336

April 15, 2019 TDD 1 800 544-5304

11m111~1~ 11~,~~,~~1~m11111~1111111~1111nm1~11111111~11~ Letter ID: CNXXX15613433445

Account ID: 00611-27648

Total amount due: $26,868.26

This statement lists our most recent information about your unpaid balance, available credits, or returns you have not filed. A payment voucher is included so you may pay the balance due.

ST-44 lllinols Use Tax Account 10: 00611-27648

Period Tax Penalty Interest Other Payments/Creclfts Balance

11-Jan-2017 8,314.00 1,828.70 796.41 10,939.11

30-Mar-2017 124.00 27.20 6.50 157.70 27-Apr-2017 6,229.00 1,370.45 534.43 8,133.88 19-May-2017 4,409.00 969.45 363.79 5,74224

12-Jun-2017 1,459.00 320.95 115.38 1,895.33

SOA

Retain this portion for your records, Fold and detach on perforation, Return bottom portion with your payment.

?-000079 ......................................................................................................................................................................................................................................... , Taxpayer Statement <R-12,os) (136)

Letter ID: CNXXX15613433445 SAMARITAN DISPLAY GROUP INC

Mail this voucher and your payment to:

ILLINOIS DEPARTMENT OF REVENUE PO BOX 19006 SPRINGFIELD IL 62794-9006

llll!llllllllllllllll!lllllllllllllllllllll!lllllilillllll!ll!llilll!l!llllill Total amount due: $26,868.26

Write the amount you are paying below.

$ ________ ~ ---

Write your Account ID on your check.

ODO 006 016377022560 731 123199 3 0000002686826

A-1

October 24, 2018

llllllillmn11n111~1111m1 Letter ID: CNXXXX789X892322

Details of Transactions Entry Date Tariff Entry Number Value Product Description

000 000.0000 CLUTCH GLOBAL LOGISTICS, INC. 01/03/2017 9403200030

01/11/2017 9403608081

03/30/2017 9403608081

04/04/2017 9403200030

04/05/2017 9403200030

04/27/2017 9403200030

05/09/2017 9403200026

05/19/2017 9403200030

06/01/2017 9403200026

06112/2017 9403200030

Group Total:

Grand Total:

EDA-13~Multi (R-OS-13)

ERP000926B1

ERP00093400

ERP00098490

ERP00097955

ERP00097799

ERP00099209

ERP00100627

ERP00101815

ERP00101732

ERP00103308

$23,164.00 Furniture (o/lhan seats) of me1al nesoi, o/than of a kind used in offices

$109,857.00 Furniture (otlhan seats & ofthan or 9402) of wooden (o/lhan bentwood) nesoi

$1,986.00 Furniture (o/lhan seats & o/than of 9402) of wooden (o/than bentwood) nesoi

$32,411,00 Furniture (o/lhan seats) of melal nesoi, o/than of a kind used In offices

$10,931.00 Furniture (o/than seals) of metal nesol, olthan of a kind used In offices

$58,320.00 Furniture (o/lhan seals} of metal nesoi, o/lhan of a klnd used in offices

$68,787.00 Fumlture (o/than seats) of metal nesoi, o/than or a kind used in offices

$1,757.00 Furniture (ofthan seats) of metal nesoi, o/than of a kind used In offices

$22,086.00 Furniture (o/lhan seats) of metal nesoi, a/than of a kind used In offices

$1,264.00 Furniture (ofthan seats) of me1al nesol, olthan of a kind used In offices

$328,563.00

$328,563.00

A-2

/ ~~tice of Tax Liability

#BWNKMGV #CNXX X157 6476 7849# SAMARITAN DISPLAY GROUP INC 1230 REMINGTON RD SCHAUMBURG IL 60173-4812

STATE OF

llinois DEP.ARTr,.,ENT-iOfJRJ;V!;N!JE· Tf tax.illlnois,gov

January 28, 2019

lllllll~IIIIIINlllilll~lllml~llmlllllillmliimll~imllll~IIII Letter ID: CNXXX15764767849

Account ID: Date of purchase:

00611-27648 January 11, 2017

We have audited your account for the transaction listed above and the audit liability has been processed on Form EDA-94, Auditorprepared Use Tax Report. As a result, we have assessed the amounts shown below

If you agree, pay the assessment total as soon as possible to minimize additional penalty and interest. Mail a copy of this notice and your payment with the voucher on the enclosed Taxpayer Statement. By including a copy of this notice, your payment will be properly applied to the audit liability.

If you do not agree, you may protest this notice by following the instructions listed below within specific time periods. • If the amount of this tax liability, exclusive of penalty and interest Is more than $15,000 or if no tax liability is assessed

but the total penalties and interest Is more than $15,000, file a petition with the Illinois Independent Tax Tribunal within 60 days of this notice. Your petition must be In accordance with the rules of practice and procedure provided by the Tribunal (35 ILCS 1010/1-1, et seq.).

• In all other cases that do not fall within the jurisdiction of the llllnois Independent Tax Tribunal, file a protest with us, the Illinois Department of Revenue, and request an administrative hearing within 60 days of the date of this notice, which is March 29, 2019. Submit your protest on Form AH-4, Protest and Request for Administrative Hearing with the Illinois Department of Revenue-(available on our website at tax.illinols.gov). Mall Form AH-4 along with a copy of this notice to the address on the form. lf you do not file a protest within the time allowed, you will waive your right to a hearing, and this liability will become final. An administrative hearing is a formal legal proceeding conducted pursuant to the rules adopted by the Department and Is presided over by an administrative law judge. A protest of this notice does not preserve your rights under any other notice.

• Instead offiling a petition with the Illinois Independent Tax Tribunal or a protest with us, the Illinois Department of Revenue, you may, under Sections 2a and 2a.1 of the State Officers and Employees Money Disposition Act (30 ILCS 230/2a, 230/ 2a.1 ), pay the total liability under protest using Form RR-37 4, Notice or Payment Under Protest (available on our website al tax.illlnols.gov), and file a complaint wtth the circuit court for a review of our determination.

If you do not timely protest this notice or pay the assessment total In full, we may take collection action against you for the balance due, which may include levy of your wages and bank accounts, filing of a tax lien, or other action.

Note: If you are under bankruptcy protection, see the "Bankruptcy Information" section on the following pages of this notice for additional information and Instructions.

Liability Pavments/Credit Unoaid Balance Audit Tax 8,314.00 0.00 8,314.00 Audit Late Payment Penal!}' 415.70 0.00 415.70 Late Payment Penalty Increase 1,247.00 0.00 1,247.00 Late FIiing Penalty Increase 166.00 o.oo 166.00 Interest 691.18 0.00 691.18 Assessment Total $10,833.88 $0.00 $10,833.88

If you have questions, write or call us weekdays between 8:00 e.m. and 4:00 p.m. Our contact information is listed below

AUDIT BUREAU TECHNICAL REVIEW SECTION ILLINOIS DEPARTMENT OF REVENUE PO BOX 19012 SPRINGFIELD IL 62794-9012 217 785-6579 IDOR-8-PT (R-07/16)

A-3

P-0OOO07

Final Notice of Tax Due for Form ST -44. Illinois Use Tax Return

#BWNKMGV #CNXX XX69 66531689# SAMARITAN DISPLAY GROUP INC 1230 REMINGTON RD SCHAUMBURG IL 60173-4812

STAT~ OF

· llinoms DEPART\VIEl)JT;Of,REVENUE• ~;~ ~

tax.illinois.gov 1 800 732-8866

217 782-3336 April 15, 2019 TDD 1 800 544-5304

llll~l\l~ll~~~ll~l~illll!ll~l1~11111~111111~1111!1111 Letter ID: CN)Q(XX6966531689

Account ID: 00611-27648 Date of purchase: Jan 11, 2017

The Notice of Tax Liability issued on January 28, 2019 is final. Any correspondence and/or amended figures received for this liability have been processed.

As a result we have assessed the amounts shown below.

To avoid cost of collection fees, additional penalties and interest for this assessment, you must pay on or before May 15, 2019.

Please use the voucher on the enclosed Taxpayer Statement to make your payment.

Liability Pa~ments/Credit Un1:2aid Balance Audi1 Tax 8,314.00 0.00 8,314.00 Audit Late Payment Penalty 415.70 0.00 415.70 Late Payment Penalty Increase 1,247.00 0.00 1,247.00

Late Filing Penalty Increase 166.00 0.00 166.00 Interest 796.41 0.00 796.41 Assessment Total $10,939.11 $0.00 $10,939.11

For questions, visit our web site or call one of the numbers above.

IDOR-2P·BILL (R-06114)

P-000074

A-4

Final Notice of Tax Due for Form ST-44, Illinois Use Tax Return

#BWNKMGV #CNXXX177 X394 9929# SAMARITAN DISPLAY GROUP INC 1230 REMINGTON RD SCHAUMBURG IL 60173-4812

11ll 11 II 111111 I l I III I,, 11, 1 !11 I I II I, 111 I I 11! 1 I II II, I I 1111 I I I I I

STATE OF

llinois OE:P TMENT,.OE,REVENUE W ta,<,illinois,gov

1 800 732-8866 217 782-3336

April 15, 2019 TDD 1800 544-5304

llllllllillllll~l~lll~lll~llll~ll~l~IIIIIIIIIIIW~l~IIIIIIII Letter ID: CNXXX1 TTX3949929

Account ID: 00611~27648 Date of purchase: Mar 30, 2017





Liability Pal'.'.ments/Credit Un12aid Balance Audit Tax 124.00 0.00 124.00 Audit Late Payment Penalty 6.20 0.00 6.20 Late Payment Penalty Increase 19.00 0.00 19.00 Late Filing Penalty Increase 2.00 0.00 2.00 Interest 6.50 0.00 6.50 Assessment Total $157.70 $0.00 $157.70


IDOR-2P-BILL (R-06114)

P-000075

A-5

Final Notice of Tax Due for Form ST -44, Illinois Use Tax Return

#BWNKMGV #CNXXXX42 8217 7121# SAMARITAN DISPLAY GROUP INC 1230 REMINGTON RD SCHAUMBURG IL 60173-4812

I, ll,.ll,1111, lll,,,I nil,, 1,,1 l,,l11,,ll, ,I, I, ,ll,ll ,1111,1,I

STATE OF

-llinois DEP.ARTNI.E;NTj.c;)f;J~E;V.i;NU1;: W tax.illinois.gov

1 800 732-8866 217 782-3336

April 15, 2019 TDD 1 800 544-5304

l~~llll~lllllllll~~lll~l~ll~llllmilll~l!lll!~ll~llll~~il~II Letter ID: CN.XXXX4282177121

Account ID: 00611-27648 Date of purchase: Apr 27, 2017





Liability Eayments/Credit Unr1aid Balance

Audit Tax 6,229.00 0.00 6,229.00 Audit Late Payment Penalty 311.45 0.00 311.45 Late Payment Penalty Increase 934.00 0.00 934.00

Late FIiing Penalty Increase 125.00 0.00 125.00 Interest 534.43 0.00 534.43 Assessment Total $8,133.88 $0.00 $8,133.88


IDOR-2P-BILL (R-06/14)

P-000076

A-6

Final Notice of Tax Due for Form ST-44. Illinois Use Tax Return

#BWNKMGV #CNXX X15X 1959 5369# SAMARITAN DISPLAY GROUP INC 1230 REMINGTON RD SCHAUMBURG IL 60173-4812

I ,I I II II 11111 ii 11, 11 I,, 111, I,, 11, ,111,, II, ,I 1l,1ll, I I, 111 l, I, l

STATE OF

Iii no is DE ARTMENT.:Of,'REVENUE· W tax.illinois.gov

., 1 800 732-8866 217 782-3336

April 15, 2019 TDD 1800544-5304

llllm\~~\llllllll~l~lll~lll~~llllllll~ll~llll~l~llllllll~~III Letter ID: CNXXX15X19595369

Account ID: 00611-27648 Date of purchase: May 19, 2017

The Notice of Tax Liability issued on January 28, 2019 is final. Any correspondence and/or amended figures received for this llablllty have been processed.


To avoid cost of collectlon fees, additional penalties and interest for this assessment, you must pay on or before May 15, 2019.

Please use the voucher on the enclosed·Taxpayer Statement to make your payment.

Liability Pa~ments/Credit UnQaid Balance Audit Tax 4,409.00 0.00 4.409.00 Audit Late Payment Penalty 220.45 0.00 220.45 Late Payment Penalty Increase 661.00 0.00 661.00

Late Filing Penalty Increase 88.00 0.00 88.00 Interest 363.79 0.00 363.79 Assessment Total $5,742.24 $0.00 $5,742.24


IDOR•2P•BILL (R-06114)

P-000077

A-7

Final Notice ·of Tax Due for Form ST-44, llllnois Use Tax Return

#BWNKMGV #CNXX XX96 5X88 6247# SAMARITAN DISPLAY GROUP INC 1230 REMINGTON RD SCHAUMBURG IL 60173-4812

STATE OF

llinois DE~ARTMENT(Q!tR!=YENOE: 'tf/ tax.illinois.gov

1800 732-88ti6 217 782-3336

April 15, 2019 TDD 1 800 544-5304

· lll~lll~llllll~lll~llll~l~llllillll~l~~l~lllllllillllllillllll~~ll Letter ID: CNXXXX965X886247

Account ID: 00611-27648 Date of purchase: Jun 12, 2017





Liability Payments/Credit Ungaid Balance Audit Tax 1,459.00 0.00 1,459.00 Audit Late Payment Penalty 72.95 0.00 72.95 Late Payment Penalty Increase 219.00 0.00 219.00 Late Filing Penalty Increase 29.00 0.00 29.00 Interest 115.38 0.00 115.38 Assessment Total $1,895.33 $0.00 $1,895.33


1DOR.:2P-BILL (R•06lt4)

l>-000078

A-8

{) iilinois Department of Revenue

EDA-94 Auditor-prepared Use Tax Report (ST-44) Rev 02 Form 022 Station 448 -

Step 1: Identify the purchaser. 1 Owning entity: SAMARITAN DISPLAY GROUP INC 4 Account ID: 00611-27648 ----------2 Name: SAMARITAN DISPLAY GROUP INC 5 0 SSN or (B:]FEIN: 36--4417799

3 Address: PO BOX 1349 6 Project Code: _9_31_4 _______ _ 1Stn1G1'1P'P<OBO.

DEERFIELD IL 60015-6005 7 Examination period: January 11, 2017 Slate ZIP

8 Earliest statute date; June 30, 2023

9 Interest through date:December 10, 2018

Step 2: Figure Illinois use tax.

1 O Write the total cost of general merchandise purchased outside of lllinois for use in Illinois.

11 Multiply Line 10 by6,2S % (.0625).

10 ____ 1_3_;3''--02_1_.o_o

11 ____ _;s.'--3_14_.o_o

12 Write the total cost of qualifying food, drugs, and medical appliances, purchased outside of Illinois to use in Illinois. 12 ______ o_.o_o

13 Multiply Line 12 by 1 % (.01). 13 ______ o_.o_o 14 Add Lines 11 and 13. This is the Illinois use tax on purchases. 15 Credit

15a Write the amount of sales tax paid to another state (not to another country) on the items included on Lines 10 and 12.

15 0 00 State of: _____ a ______ ._ 15b Write the amount of tax paid on original Form ST -44 return. 15b ______ o ._O_O

16 Add Lines 15a and 15b. 17 Subtract Line 16 from Line 14. This is the amount of tax due.

Step 3: Figure total amount due. 18 Penalty:

18a Late filing 18b Late-payment 18c Negligence 18d Fraud

19 Add lines 18a through 18d. 20 Interest on tax.

18a 166.00 ------18b ____ 1....:.,_24_7_.o_o 18c 0.00 -------18d 0.00 ------

21 Add Lines 17, 19, and 20, This is the total amount due by: January 9,2019.

Step 4: Read and sign below.

14 8,314.00 ---

16 0.00 --------17 8,314.00 ----------

19 1,413.00 --------,---,--20 629.00 21-----,-1-0,-:-35--=6-.0-0

Under penalties of perjury, I state that l have examined this report and, to the best of my knowledge, it is true, correct, and complete.

Taxpaye(s Signature

Auditor's Signature

Total audit payments: Remittance amount: EDA•94 (R-09/13) IDOR-8-ROTCU(R-09/131

Tille Telephone number Date

Dale

Official Use Only. Do not write below this line. Audit ID: AL EL NF MAAD ---------Date received:

A-9

Illinois Department of Revenue

EDA-94 Auditor-prepared Use Tax Report (ST-44) Rev 02 Form 022 Station 448

Step 1: Identify the purchaser. 1 Owning entity: SAMARITAN DISPLAY GROUP INC 4 Account 10: 00611-27648 ...;._~----~---2 Name: SAMARITAN DISPLAY GROl)P INC 5 □ SSN or IB)FEIN: 36-4417799

3 Address: PO BOX 1349 6 Project Code: ..;.93..;_1_4 _______ _

DEERFIELD IL 60015-6005 7 Examination period: March 30, 2017 City State ZIP

8 Earliest statute date: June 30, 2023



1 O Write the total cost of general merchandise purchased outside of Illinois for use in Illinois.

11 Multiply Line 1 o by 6.25 % (,0625). 12 Write the total cost of qualifying food, drugs, and medical

appliances, purchased outside of Illinois to use in Illinois.

10 1,986.00 11 124.00

12 0.00 0.00 13 Multiply Line 12 by 1 % (,01). 13 _____ _

14 Add Lines 11 and 13. This is the Illinois use tax on purchases. 15 Credit:


15 State of: __ ..,....__ a _____ _ 0.00 0.00 15b Write the amount of tax paid on original Form ST -44 return. 15b ____ _





18a 2.00 18b -----1.....,.9-.0-0

18c 0.00 ------18d 0.00

21 Add Lines 17, 19, and 20. This ls the total amount due by: January 9,2019.


14 124.00

16 0.00 17 124.00

19 21.00 ---------,---20 4.00 21-------:-,4--:-:gc-c_o=o

Under penalties of perjury, I state that I have examined this report and, to the best of my knowledge, it is true, correct, and complete.

I a'kpayer':. S'9nalure

Total audit payments: Remittance amount: EDA-94 (R-09/13) IDOR·8•ROTCUIR-09/13)

TIiie le1ephone number bate

Date

Official Use Only. Do not wrlte below this line. Audit ID: AL EL NF MAAD ---------Date received: __ / __ /. __ _

A-10 P-000116

{J Illinois Department of Revenue

EDA-94 Auditor-prepared Use Tax Report (ST-44) Rev 02 Fenn 022 Station 446

Step 1: Identify the purchaser. 1 Owning entity: SAMARITAN DISPLAY GROUP INC 4 Account ID: 00611-27648 ----------2 Name: SAMARITAN DISPLAY GROUP INC 5 0ssN or [E]FEIN: 36-4417799

3 Address: PO BOX 1349 6 Project Code: _93~1_4 _______ _

DEERFIELD IL 60015-6005 7 Examination period: April 27, 2017 City State ZIP


9 Interest through date: December 10, 2018


1 0 Write the total cost of general merchandise purchased 10 outside of Illinois for use in Illinois. ____ 9_9_,6_6_Z_.O_O 11 Multiply Line 10 by6.25 % (.0625). 11 6,229.00 12 Write the total cost of qualifying food, drugs, and medical

appliances, purchased outside of Illinois to use in Illinois. 12 ___ ~ ___ O_.O_O 13 Multiply Line 12 by 1 % (.01). 13 ______ 0_.0_0 14 Add Lines 11 and 13. This is the Illinois use tax on purchases. 15 Credit:

15a Write the amount of sales tax paid to another state {not to another country) on the items Included on Lines 10 and 12. 11:a o 00 State of: "' ------·-'-

15b Write the amount of tax paid on origfnal Form ST-44 return. 15b _____ o_.o_o 16 Add Lines 15a and 15b. 17 Subtract Line 16 from Line 14. This is the amount of tax due.




18a 125.00 18b -----9-3-4.-0-0

-------18c 0.00 -------18d 0.00

21 Add Lines 17, 19, and 20. This is the total amount due by: January 9,2019.


14 6,229.00

16 0.00 --------17 6,229.00 ----------

19 1,059.00 20 ____ 409.00

-------------,:-:-21 7,697.00

Under penalties of perjury, I state that I have examined this report and, to the best of my knowledge, it is true, correct, and complete.

Ta•P•vet• Signatur&

Audilol's Signalure

Total audit payments: Remittance amount:

EDA-94 (R-09/13) IDOR·B·ROTCUCR-09/13)

Thie telephone number Cale

Dote

Official Use Only. Do not write below this line. Audit ID: AL EL NFMAAD -.,.--~-----Date received: __ / __ / __ _

1'-000170 A-11

e1J ritinois Department of Revenue

\J EDA-94 Auditor-prepared Use Tax Report (ST-44) Rev 02 Fonn 022 Sta1ion 448

Step 1: Identify the purchaser. 1 Owning entity: SAMARITAN DISPLAY GROUP INC 4 Account ID: 00611-27648 -----------2 Name: SAMARITAN DISPLAY GROUP INC 5 0 SSN or IB)FEIN: 36-4417799

3 Address: PO BOX 1349 6 Project Code: _9_31_4 _______ _

DEERFIELD IL 60015-6005 7 Examination period: May 19, 2017 City Stato ZIP


g Interest through date:December to, 2018


10 Write the total cost of general merchandise purchased outside of Illinois for use in Illinois.

11 Multiply Line 10 by 6.25 % (.0625}. 12 Write the total cost of qualifying food, drugs, and medical

appliances, purchased outside of Illinois to use in Illinois.

10 70,544.00 11 4,409.00

12 0.00 0.00 13 Multiply Line 12 by 1 % (.01). 13 _____ _

14 Add Lines 11 and 13. This is the lllinols use tax on purchases. 15 Credit:

15a Write the amount of sales tax paid to another state (not to another country) on the Items included on Lines 10 and 12.

15 State of: --~-- a ____ _ 0.00 0.00 15b Write the amount of tax paid on original Form ST-44 return. 15b ____ _

16 Add Lines 15a and 1 Sb. 17 Subtract Line 16 from Line 14. This is the amount of tax due.


1 Ba Late filing 18b Late-payment 18c Negligence 18d Fraud


18a 88.00 18b 661.00 -------18c o~o -----.,....,.....,.. 18d 0.00



14 4,409.00

16 0.00 17 4,409.00

19 749.00 20-----~27~5'."":.o=o

21 5,433.00 --------

Under penalties of perjury, I state that I have examined this report and, to the best of my knowledge, It is true, correct, and complete.

f axpaye?s Sigl'\Bture

Audito?o signature


EDA-94 (R-09/13) IOOR-8-RO'rCUIR•09/13J

THle Teraphone number date

Oat&

Official Use Only. Do not write below this line. Audit ID: ALEL NF MAAD ---------O ate received: /

P-000180

A-12

~ lllinois Department of Revenue

\J EDA-94 Auditor-prepared Use Tax Report (ST-44) Rev 02 Form 022 Stalion 448

Step 1: Identify the purchaser. 1 Owning entity: SAMARITAN DISPLAY GROUP INC 4 Account ID: 00611-27648 ----------2 Name: SAMARITAN DISPLAY GROUP INC 5 □ssN or [R]FEIN: 36-4417799

3 Address: PO BOX 1349

DEERFIELD

6 Project Code: _9_31_4 _______ _

IL 60015-6005 7 Examination period: June 12, 2017 City State




1 O Write the total cost of general merchandise purchased outside of Illinois for use In llllnols.

11 Multiply Line 10 by 6.25 % {.0625}.

10 23,350.00 ------~ 11 1,459.00 -------

12 Write the total cost of qualifying food, drugs, and medical appliances, purchased outside of Illinois to use in Illinois. 12 0.00

13 Multiply Line 12 by 1 % (.01). 13 ______ 0_.o_o 14 Add Lines 11 and 13. This is the Illinois use tax on purchases, 15 Credit:


15 0 00 State of: _____ a ______ . _ 15b Write the amount of tax paid on original Form ST-44 return_ 15b ______ 0_.0_0





18a 29.00 18b ____ 2_1_9-.0-0

18c 18d

0.00 0.00 -------



14 1,459.00 -------=---

16 0.00 --------17 1,459.00 -------'---

19 248.00 --------20 86.00 21-----1,--79~3,......0c--O

Under penalties of perjury, I state that I have examined this report and, to the best of my knowledge, it fs true, correct, and complete.

Taxpayers Signet1Jte

Aud~ors Signature


EOA-94 (R-09/13) IDOR-S·ROTCUrR--09/13}

Tille Tetephcne numtier Date

Date

Official Use Only. Do not write below this line. Audit ID: AL EL NF MAAD Date recei'""ve_d_: _____ 1:::::~

1?•000182

A-13

EXHIBIT B

Illinois Department of Revenue OFFICE OF ADMINISTRATIVE HEARINGS

Willard Ice Building 101 West Jefferson Street- Level SSW

Springfield, IL 62702 (217)782-699 5

July 16, 2021

John R. Simpson Sorling Northrup 1 North Old State Capitol Plaza, Suite 200 P.O. Box 5131 Springfield, IL 62705

Re: Late Discretionary Hearing Granted - Tribunal Jurisdiction Samaritan Display Group Inc. Account ID: 00611-27648 (5) Notice of Tax Liability, dated January 28, 2019 Letter IDs: CNXX:Xl 14X2691684, CNXXXXX665273449, CNXXX21133476963

CNXXX1X396X58721, CNXXX15764767849 Dear Mr. Simpson:

The office of Administrative Hearings of the Illinois Department of Revenue received your request for a late discretionary hearing on behalf of Samaritan Display Group Inc. regarding the above (5) Notices of Tax Liability. Based on the information provided in your request, I believe that it is appropriate to grant your request on behalf of Samaritan Display Group Inc. for a late discretionary hearing for the above (5) Notices of Tax Liability.

The amount ofliability at issue for this protest exceeds the statutory amount for which the Department has jurisdiction. For late discretionary hearings that are granted and that exceed the statutory amount, jurisdiction is vested solely in the Illinois Independent Tax Tribunal (Tax Tribunal). See 35 ILCS I 010/1-1 et seq.

The Tax Tribunal's rules provide that when a late discretionary hearing is granted and the protest meets the statutory amount, the taxpayer shall file a petition with the Tax Tribunal within 60 .days and shall attach a copy of the letter granting the late discretionary hearing.

I recommend that you review the information provided on the Tax Tribunal's website and contact them if you have any questions.

SincereJ.¥,

f.:th~ TDC Chief Administrative Law Judge

u 1--m -:c >< Ill

fRANSACTION A Shipping Summary

SCRUB UNIT (2) OUTRIGGERS INCLUOm

SHOE UNIT STARTER ASSEMBLY

SHOE UNIT ADD-ON ASSEMBLY

SMALL 4--WAV RACK ASSEMBLY

LARGE 4-WAY RACK ASSEMBLY

SIGN HOLDER WELDMENT/FIXTURES (6) PER PRE•PACKED CART

SMALL SALESMAN RACK ASSEt.'IBLY

LARGE SALESMAN RACK ASSEIJIBLY

WINDOW GRID ASSEMBLY

SIGN HOWER WELDMENT /SHOE WALL 121 PER PRE-PACKED CARTON

REVERSIBLE SHOE BRACKET ASSEMBLY (35) PER PRE-PACKED Cl

SIGN HOLDER PEDESTAL (15) PER PRE-PACKED CARTON

NESTING TABLES

METAL BENCH FRAME (ASSEMBLY COST IS INCLUDED)

GO BACK RACK

Large Hanger Bars

Extr.i Hardware B.igs

$ Way Round Tube

QTY Invoiced Transferred

QTY lmpo.l ·----■ ----·--■ -.-.......... , ............... , ~ ...... I -.-.., ......... , I I I I I .in~Qc.l 4rutnl .llll44al 4/14c:nl 4n41<-,I """"' I 405961 406461 40797 40495 Total Billed toAMD

8

11

34

57

83

180

7

4

7

30

705

120

11

18

1

5

1

1

2

3

2

9

10

2

so s

6

1

1

l 1 1

2 1 2

3 3 2

s 4

13 s 12

12 12

4 l

2

2 3

2 2 2

40 40 40

8 6 9

1 1

2 1

1 5

2 9

3 14

2 13

9 48

11 45

2 7

2 4

2 7

2 10

50 225

7 36

l 1 l 6

1 6

3

20

44

35

135

0

0

0

20

480

84

5

12

0

5

0

'I"' I u

Samaritan Display Group, lnc.

1230 Remington Rd. Schaumburg, IL 60173

Mail To:

Scmbs Steve Such 12969 Manchester Road St. Louis, MO 63131

P.O. Number

SB100-02

Item Code

Terms

Net 30Days

Description

Due Date

2/17/2017

Billable Ship ... Shipping Charge to deliver Scrnbs Fi'Ctures to: Scrubs and Beyond Store # 100 4083 Veterans Memorial Parkway St Peters, MO. 63376

Billable War ... Warehousing & Storage Fee per Store Customer Se ... Assembly & Blanket Wrap Pallet Fec-0 ... Pallet Fee-Oversized 100 x 60 Pallet Fee.St ... Pallet Fee-Standard 48 x 40

TOTAL :FIXTURE COST FOR STORE 100 - $7,231.57

Phone# Fax#

(847) 882-7214 (84 7) 882-7360

P.O. Date

1/18/2017

Rep

Invoiced

C-2

Invoice Date Invoice#

1/18/2017 40395

Scrubs Steve Such 12969 Manchester Road St. Louis, MO 63131

Via Project Account#

DCD 790-17 Fulfillment

RM store# ! ._I __ 10_0 _ _,

Prev. lnvoic ... Ordered Price Each Amount

1 862.50 862.50

1 575.00 575.00 I 379.49 379.49 1 30.00 30.00 1 10.00 I0.00

I Total $1,856.99

scruli>s &beyond

IN STORE DATE: 1/17/2017

STORE# 100

SHIP TO: !Scrubs and Beyond #100

ITEM#

3'ii9-io70-01

'4083 Veterans Memorial PKWY St. Pete,s, MO. 63376 xxxx

Attention: Gary Vogt 314-581-3200

:UEt:::;::.·~:-1~~~;::J~tJNi•:~.;;••. ~-.,~•;!.'

SCRUB UNIT {Z) OUTRIGGERS INO.UDED

3129-1060-01 )SHOE UNITSTARTER ASSEMBLY

3U9-1060-02 )SHOE UNIT ADD-ON ASSEMBLY

3129-10S0-01 !SMALL 4-WAY RACK ASSEMBLY

3129-1040-01 )LARGE 4WAY RACK ASSEMBLY

3129-108-01 !SIGN HOLDER WELDMENT/AXTURES (6) PER PRE-PACKED CARTON

3129·103Q.01 )SMALL SALESMAN RACK ASSEMBLY

3129-1020-01 )LARGE SALESMAN RACK ASSEMBLY

3129-1010-01 )WINDOW GRID ASSEMBLY

3129-137..01 !SIGN HOLDER WELOMENT/SHOE WALL (2) PER PRE.PACKED CARTON

3ll9-520-01 !REVERSIBLE SHOE BRACKET ASSEMBLY (35) PER PRE-PACKED CARTON

3129-135-01 )SIGN HOLDER PEOEST~ (15)_ PER PRE-PACKED CARTON

3129-2000-0l NESTING TABLES

3129-1000-02 METAL BENCH FRAME (ASSEMBLY COST IS INCLUDED)

3129-1035-01 IGO BACK RACK

COMMENTS:

This order has to be combined with fixtures on 2017 order

Fixture delivery to be direct to store- (No Miilwork pick-up)

2016 ORDER FORM

PO #58100-02

Issued Date: 12/27/2016

POPUIATE

THtSCOLUMN

.IF ASSEMBLY IS REQUIRED PlACE ANUMBER 1, IN THE NEl,cr CELL

ONLY 1 1 FORMULA I FORMULA , r FORMULA ASSEM!ij.Y REQUIREMENTS

~~::~t _; .. ~ · -~ .\}.. · \fl1!~1~~1tt · .... ·· ~ ·, t;,,2· -1,;~•J~

NEEOEO ,,_!•tr:' .. : ; i;':, . STORECOST .:~i~'t:.~ UNITCO~PER .;~~~<w· ,j IN EACHES ,UNr,'CO~:e~~ PER UNIT ,~t,'!~; . ASSEMBLY P~~B!,Y

1 $1.4n.so $1,412.so "l!·'{;ttl<P'E& $26.84 _ $26.14

2 $174.67 $349.34 _11,!UST ~SS_!:MBLE IN STORE

3 $148.75 $446.25 MU:ST·ASSEMBLE IN STORE

0 $266.00 $0.00 I o ,,, ·• $21.48 $0.00

9 $305.00 $2,145.00 I , . :s, $24.16 i217A4

10 $5.86 $58.60 MUST ASSEMBLE IN STORE

2 $113.00 $226.00 ;2 $8.05 $16.10

2 $1~3.00 $286.00 'al c, •~' $8,05 $16.10

$115.63 $0.00 'o·: $5.37 $0.00

0 $9.48 $0.00 MUST ASSEMBLE IN STORE

0 $6.36 $0.00 MUST ~EMBLE IN STORE

6 i5.90 $3S.40 MUST ASSEMBLE IN STORE

1 $515.00 $515.00 "1' $42.95 $42.!15

1 $106.24 1106.24 1"·<'<•,' $9.05 $9.05

0 $95.24 $0.00 ,,o.; ,,.: ~-05 ~.00

l

POPULATE ABOVE o:t.l

IF ASS£1Wll Y IS NEEDED

FORMULA

llft7ilil5 Tl'JfAl' STORE COST PER

UNIT

$1,499.34

$349.34

$446.25

$0.00

$2,962.44 I $58.60

,!242.10

~02.10

10.00

10.00

J:o.oo .!35.40

!557.95

!!15.29

$0.00

ri;",;68.81

' <iRANDTOTAL '":.' TPTA\:;~~"1!£•:~'f $6,240.33 [ ~J, \:'. 'I TOTALASSEMBLYI =,za,48 C ~-~-, CJ:)ST ~E{t~Rf. , COST PER STORE

C") I u

scrulYs &beyond

INSTOREDATE: 1/1712017

STORE# 100

SHIP TO: )iclllba and Ba¥DJ1d 81 oo

l4083 Ve1erana Memorial PKWY ~ Pdal'8, MO. D3T8 nu

IT1lMII trl1~-~~}f;ititffl~1::i~it:;irilt:;~illl 3129-1070-01 SCRUB UNIT 121 OUTRIGGERS INCUIDEI)

312!!-106IJ.41 SHOE UNff STAll11:R ASSEMBLY

3l2!1-106CM2 SHOE UNff ADD.()N ASSEMBLY

3129-10$0-01 SMALL4-WAY !!ACK ASSEMBLY

3129-1040,01 LARGE 4-WAV RACK ASSEMBLY

fl2.9-10IMJ1 SIGN IIOlDER WELDMENT/flXTURES (6) PER PRE•PACKED CARTON

3129-1Q30.01 SMAil SALESMAN RACK ASSEMBLY

l:129-102CHl1 LARGE SALESMAN RACK ASSEMBLY

3129-1010-01 WINDOW GRID ASSEMBLY

3129-137-411 SIGN HOLDER WELDMENT/SHOE WAU (2) PER PRE.PACKe~ CAATDN

312!1-S20-01 REVERSIBLE SHOE BRACKIIT ASSEMBLY (35) PEIi PRE-PACKED CARTON

312!1-135-01 SIGN HOLDER PECESTAL (lS) PER PRE·PACKfD CARTON

3129-2000-ol NESTING TABlES

a129-1000-02 METAL BENCH FRIIIME (ASSEMBLY COST IS INaUDED)

3129-1035-01 GOBACKRAa

r~~-ENtS:

This order has to De combined with fiXtures on 2016 order

Fhcture delivery to be direct to store• (NO Millwork plck~up)

POPU1ATI

TfilSCOWMN

ONLY'

Qn NEEDED

INEAcms

0

0

O,

2

0

0

()'

0

0

2

so

u

0

0

1

2017{)ROJ;_R FORM

PO #58100-02

Issued Date: 12127/2016

I If ~EMBLY IS REQUIRED PlAC£ A NUMllER ! IN THE NEXT CE:U I 1

PGPUlATEABO'l.'t(Etl

lf A!ISEMBLY LS NE£m:D

I FORMULA FORMULA I I FORMULA FORMULA , · ASSEMBLY,REQ.UIIIEMENlS

~=i~;i~ Iii ~~ktilt? STORE COST .U!lff COSTPBI :. STORE COST PER .PEIIUNIT ' ASSEMBLY ··UNIT

$1.518.lJII $0.00 ·-*~.t.Gi:YS• .. , $26.84 $0.IJO $0.00

$1SZ.9G $11.00 MUST ASSEMBlE IN STORE $0.00 I

$127A2 $11.00 MUST ASSEMBLE IN'SlORE $0.00

$274.23 $548.46 2, $21.48 $42.96 $591.42

$314.43 $0.00 f.:·~ .'Ci'.'\:•'.i;, $24.16 $0.00 $0.00

$6.04 $0.00 · MUST ASSEMBLE IN STORE $0.00

$115.49 $0.00 ri~~c.~to~ iif: $8.05 $0.00 $0.00

$147A2 $0.00 .:~· -J:'c;i~:.1•.~ $8.05 $0.00 $0.00

$119,21 $0.00 .~:.!.~~t~:~tt; $5.37 $0.00 $0.00

$9.77 $19.S4 MUST ASSEMBLE IN STORE $19.54

$6.56 $328.00 MU,T ASSEMBLE IN STORE $328,00 I

$6.08 $0.00 MUST ASScMBLE ,IN STORE $0.00

$530,93 $11.00 .t•~-~;_1t~~; $42.95 $0.00 $0.00

$1116,24 $0.00 ~c"~~~i":...;~ $!I.OS $0.00 SD.DO

$9$.24 $95.24 ·-~~~·_,;,; $8.0S $8.0S $103.29

;: T..Q!'Al-fll']\IJ\i ,' $991.24 \"'... ·,,: ,,: TOTAI.ASSEMIILI' ,, ;,$5~01 s:· $1,042.25 :mnP£ilswiiE., C:OStl'EIISTQRE GRAND TOTA!.·

, u

------- -----•------

Samaritan Display Group, Inc.


Mail To:

Scmbs Steve Such 12969 Manchester Road St Louis, MO 63131

P.O. Number

SBl0S-11

Item Code

Terms

Net 30Days

Description

Due Date

2/22/2017

Billable Ship ... Shipping Charge to deliver Scrubs Fixtures to: Scrubs and Beyond Store # 105 Perris Plai.a 12310 Chenal Parkway, Ste #101 Little Rock. AR 72211

PalletFee-0 ... Pallet Fee-Oversized 60 x 45

TOTAL FIXTIJRE COST FOR STORE 105-$128.04

Phone# Fax#

(847) 882-7214 (847) 882-7360

P.O. Date

]/23/2017

Rep

Invoiced

C-5


1/23/2017 40423

Scrubs steve Such 12969 Manchester Road St. Louis, MO 63131


Custom 790-17 Fulfillment

RM Store# ll .... __ 1o_s __


1 162.48 162.48

1 30.00 30.00

I Total $192.48

scrut?>S &beyond


STORE# 105

SHIP TO: !Scrubs and Beyond

Perris Plaza 12310 Chenal Parkway, Suite #101 Little Reck, AR. 72211

Attn: Store Manager Kendra Gilliam {501)644-1394 POPULATe

THIS COLUMN

O>ILY

ORDE_R_FORM

PO# S8105-11


IF ASSEMBLY IS REQUIRED PLACE·A NUMBER l lN THE NEXT·CELL

FORMULA I FORMULA I I FORMULA . ASSEMBLY REQUIREMENTS

POPULATE AS0\11: CEll

If ASSfMBlY IS NEEtliD

FORMULA

ITEM#

3129-1070-01

\t~J~'./"r--~~~N\f}<~}-i!;rrlif 1t~ :=~ ~-✓.~kjki~~; ST:Eu~T :it~~~ u~c::Li · !\J;!l;{ STOREuFrrs/::R {2) OUTRIGGERS INCLUDED 0 $1,518..04 $0.00 · '.q. ·•·+ $26.84 $0.00 $0.00

3129-1060-01 !SHOE UNIT STARTER ASSEMBLY I 0 I !152.90 $0,00 MUST ASSEMBLE IN STORE $0.00

3129-1060·02 SHOE UNIT ADD-ON ASSEMBLY 0 $127AZ $0.00 MUST'ASSEMBLE IN STORE _$0.00

3129-1050-01 SMALL4-WAY RACK ASSEMBLY 0 $274.23 so.oo I- · '..c) •. · t $21.48 $0.00 $0.00

3129-1040-01 LARGE 4-WAY RACK ASSEMBLY 0 $314.43 so.oo I"' ,o:.", $24.16 $0.00 $0.01)_

3129-108--01 !SIGN HOLDER WELDMENT/FIXTURES (6) PER PRE-PACl<ED CARTON -0 $6.04 $0.00 MUSTASSEMBlE IN STORE $0.00

3129·1030-01 SMALL SALESMAN RACK ASSEMBLY 0 $116,49 $0.oo I ' ·o , ,J $8.05 $0.00 _$0.00

3129-1020-01 LARGE SALESMAN RACK ASSEMBLY 0 $147.42 so.oo I; .. ;: :10::;; J $8.05 $0.00 $0.00

3129-1010-01 WINDOW GRID ASSEMBLY 0 $119.21 $0.00 I:': '.O· .,. ?, $5.37 $0.00 $0.00

3129-137--01 SIGN HOLDER WELOMENT/SHOE WALL (21 PER PRE•PAO<ED CARTON 0 $9.77 $0,00 MUST ASSEMJ!LE IN ·sTORE · $0.00

3129·520-01 REVERSIBLE SHOE BRACKET ASSEMBLY 135) PER PRE-PACKED CARTON s $6.56 $32.80 MUST ASSEMBLE IN STORE $32.80

3129-135--01 !SIGN HOLDER PEDESTAL (15) PER PRE-PACKED CARTON 0 $6.08 $0.00 MUST.ASSEMBLE IN STORE !0,00

3129-2000-01 !NESTINGTABLES 0 $530.93 so.oo I :· -. o.~ ·1 $42.!15 $0.00 _$0.()0_

3129-1000-02 !METAL BENCH FRAME (ASSEMBLY_ COST IS INCLUDED) 0 $106.24 so.oo 1 ·,~fo_·. ,,, $9.05 $0.()()_ $0.00

, u



Mail To:


P.O. Number

8B022-02

Item Code

Terms

Net 30Days

Description

Due Date

3/1/2017

Billable Ship ... Shipping Charge to deliver (2) Small Salesman Racks to: Scrubs and Beyond Store #I 22 1515 Town East Blvd Suite#l36 Mesquite, TX 75150

Pallet Fee-0 ... Pallet Fee-Oversized 60 x 45

TOTAL FIXTURE COST FOR STORE 22 -$232.98

Phone# Fax#

(847) 882-7214 (847) 882-7360

P.O. Date

1/30/2017

Rep

Invoiced

C-7

l


1/30/2017 40449




RM Store# l l._ __ 22 _ __,


156.98 156.98

I 30.00 30.00

I Total $186.98

scbru~s & eyond.

IN STORla DATE: 1/20/2017 STORE# 22

SHIP TO: Stl\lb& and Beyond

161&Town EastBlvd. Sulte#138 Mesquite, TX. 76150

Altn: Ston, Man19er LaNechla Gebllardt (972) 2711-3186

·ITEMt ·:;·:,;::.i~z~i;1. :·:--.!:::··•;:J~~ ~~r:•;!-~;~{/':~': -~::<, . :

312~107D-01 SCRUilUNIT (2l OurlllGGEAS INCLUD£D

3129-1060-01 SHOE UNITSJAR1ERA5SEMBLY

312~1ll&O-D2 SIIOE UNIT ADO-ON ASSEMBLY

312HOSO-Ol SMAll4-WAY RIO(ASSEMBLY

3129-10-0-01 IARGE4-WAY RACK A5Sl:MBLY

31!9-UIS.(Jl SIGN HOUJER WELDMENT/FIXTURES (6) PER PRE•PACKED CARTON

3129-lOJD-Ol SMALi. SAtESMAll RACK ASSEMBLY

3129-1021M1l LARGE SALESMAN RACKASSEMBLY

3129-1010-01 WINIIOW GRID ASSEMBLY

3129-137-01 SIGN HOLDER WllDMENT/SHOE WALi. (21 PER PR•.PACKfD CARTON

3!D-521M11 REV£1\SIBLE SHO! BRACKET ASSEMBLY (351 PER PRE-PACKED CARTON

3129-135-01 SIGN HOLDER P~SJAL (15) PEIi PRE-PACKED CARTON

3129-2000-01 NESTING TABLES

3129-100D-02 METAL BENCH FRIIME (ASSEMBLY COST IS INCLUDEDI

31l9-103>01 GOBACICAACI(

~-MENTS:

POPlJlATE

THISCDLUMR

ONLY

.... NEEDED

tNEACHES

0

0

0

0

0

D

2

0

0

0

0

0

0

0

0

0---8D ER_f ORM


If ASSEMBLY IS_lll;Q.UJRED PIJ\CE A NUMBER 1 IN THE NElCT CELI. I POPUtAU ~vE CILL

tf AS5iMllLl' IS NEEDED

I FORMUIA FORMUIA I I FORMUIA FORMUIA · ASSEMBLY REQUIREMEN1S

,-~.,fl'-~! ~J~.f :", '-1:..'-\:j(, ~t;~~~~l"i~: v-"D1u1Al

STORE COST ;~~, UNIT~PER· STORE COST PER ~uiir\:i:iiiiiti~·{ PER UNIT , •• <' •• ,_; ASSEMBLY -~.!!i.i, .UNIT

$1.518.04 $0.00 ~ ,o,v, $26.84 $0.00 $0.00

$152.90 $0.00 MUST ASSl:MBLE IN STORf $o..oO

$127.42 $0.QO MUSTASSEMBLE IN STORE $0.00

$274.23 SO.DO B~. ;.o,~·~ ... ~~: $21.48 $0.00 $0.00 :

$314,43 $0,00 .·• .o,~ $2•1.16 $0.00 $0.00

$6.04 $0.00 MUST ASSEMBLE.IN STORE $0.00 GO u

$116.49 ~2.98 i.St.t;t:f;.:.,., $8.05 $0,00 $232.98

$147.42 $0.00 .,,::-,::;;;,~~·:? $8.05 $0.00 $0.00 I

$119.21 $0.00 '";;!_Jd;~ .')_":. $5.37 $0.00 $0.00

$9.77 $0.00 MUST ASSEMBLE IN STORE $0,00 I

$6.56 $0.00 MUST ASSEMBLE IN STORE $0.0D I

$6.0S $0.00 'MUSTASSEMBLE'INSTORE $0.00

$530.93 SO.DO , ->o·,>.•·: $42.95 $0,00 $0.00

$106.24 $0.00 .. . :o-, $9.05 $0,00 $0.00 I

$95.24 $0.00 . '-0 '.: $8.05 $0.00 $0.00

':11r-JL~£q $232.911 ., , ~._- .. ' .:,: lOTALAmMIIU' ;:.;~~:·:} $232.!II!, COST PEIi STORE GRANDTOTAL·



Mail To:


P.O. Number

SB033-02

Item Code

Terms

Net 30Days

Description

Due Date

3/1/2017

Billable Ship ... Shipping Charge to deliver ( 1) Small Salesman Rack to: Scrubs and Beyond Store# 33 9494 W Northern Ave. Suite#) 12 Peoria, AZ 85305

Pallet Fee-O ... Pallet Fee-Oversized 60 x 45

TOTAL FIXTIJRE COST FOR STORE 33 • $116.49

Phone# Fax#

(847) 882-7214 (847) 882-7360

P.O. Date

1/30/2017

Rep

Invoiced

C-9

1

1


l/30/2017 40450

Scrubs Steve Such 12969 Manchester Road St Louis, MO 63131



RM store# ! ._I __ 3_3 _ __,,


179.22 179.22

30.00 30.00

I Total $209.22

scruG>s &beyond

IN STORE DATE: 1/20/2017 STORE# 33

SHIP TO: Scrubs and Seyontl

9494 w. Northem Ave. Sulte#112 Peoria, AZ.. 85305

Attn: Store l!lanoger Charlene Picard (&%3) 872-2989

·, :f ''~?f( ,_\C: :::,;'. .'·\f:::.\•:};'i. . ,.•. J. {·. c. •' ·'/f,',.c• \,:·,···', •, :.: ~. '" ,·~~,,.··: ..

ITEM'# . .c<-' ,,. • . . . • '' :~-., :o~QN'' . . ... ., ,, -~. ,. 3U!J.1070-01 SCRUB UNIT (2) OUTRIGGERS INCLUDED

3129-1060-01 SHOE UNIT STARTER ASSEMBLY

3U!J.106IM)2 SHOE UNIT ADO-ON ASSEMBLY

3129-1050-01 SMALL 4-WAr RACK ASSEMBLY

3U9-1040-01 LARGE 4-WAY RACKASSEMBLV

312!1-1118-01 SIGN HOLDER WELDMENT/FIXTURES (6) PER PRE.PACKED CARTON

JU!J.1030-01 SMALL SALESMAN RACK ASSEMBLY

3129-1020-01 LARGE SALESMAN RACK ASSEMBLY

3129-1010.01 WINDOW GRID ASSEMBLY

31Z!J.l37-01 SIGN HOLDER WELDMENT/5HOE WALL (2) PER PRE·PACKEO CARTON

1

3129-520-01 REVERSIBLE SHOE BRACKET ASSEMBLY j3S) PER PRE-PACKED CARTON

3129-135..01 SIGN HOLDER PEDESfAL (15) PER PRE-PACKED CARTON

3U!J.Z000.01 NESTING TABLES

3129-1000-02 METAL BENOf FRAME (ASSEMBLY COST IS INCLUDED)

3U9-1.035-01 GO BACK RACK

COMMENTS:

POPULATE

THl$COlUMN

ONLY

QTY NEEDED

INEACHES

0

0

0

0

G

G

1

G

0

0

0

0

G

0

0

ORDER FORM


IF ASSEMBLY IS REQUIREPPLACE A NUMBER! IN'THE NEXT CELL

POPULATE ABOVE CElL

If ASSEMBI.Y IS fllEOEO

FORMULA FORMULA I I FORMULA FORMULA ASSEMBLYREQUIREMENTS .•

'" •;,; JC ,,~" - ' "'• ,I • • :~;~;;r,~; GRAND TOTAL

;t .... '.,,' ·< J; :"1 ... ~i--:·~;. STORECOST -~'ari:ro,,' UNIT COST PER . STORE COST PER \U~.~~~ET· PEIIUNIT ·#$£MifE ASSEMBLY ~BLY. UNIT

$1,518.04 $0.00 O' $26,84 $0.W $0.00

$152.90 $0.00 MUST ASSEMBLE·IN STORE $OJ)O

$U7AZ $0.00 MUST ASSEMBLE·IN STORE $0.00

$274.23 $0.00 ~t·r.;·ot";~(f .; $21.48 $0.00 $0.oo

$314.4:1 $0.00 ~ .. E~.b;~ .::"i,! $24.16 $0.0D $0.00

$6.04 $0.00 MUST ASSEMBLE IN STORE $0.00

$116.49 $116.49 l[ ' 0 .•. $8.05 $0.0D $116A9

$147AZ $0.00 f·r·o._ $8.0S $0.00 $0.00

$119.21 $0.00 . ' 0 '.' $5.37 $0.00 $0.00

$9.77 $0.00 MUST ASSEMBLE IN STORE . $0.00

$6.56 $0.00 MUST.ASSEMBI:£ IN STORE· $0,00

$6.D& $0.00 MUST ASSEMBLEJN STORE'· $0,00

$530.93 $0.00 ·rf ·•· $42.95 $0.00 $0.00

$106.24 $0.00 " ~ 0: $9.05 $0.00 $0.00

$95.24 $0.00 ·o';-:, $a.OS $0.00 $0.00

,: Jg;T1'.' l:l)IWII!! :'. $116.49· , }-',,, l'OTAL ASSEfl'IBLY , .$0,00 $U6.49 JCQ$1'1!£R STQI\E·, COST PER STORE ~DTDTAL

0 'I"'

u



Mail To:


P.O. Number

SB306-02

Item Code

Terms

Net 30Days

Description

Due Date

3/23/2017

Billable Ship ... Shipping Charge to deliver Scrubs Fixtures to: Scrubs and Beyond Store #306 Colonies Crossroads 1271 E. 19th Street Upland, CA 91784

Billable Ship ... Shipping Charge for (15) Reversible Brackets via Fed Ex 2-day

Billable War ... Warehousing & Storage Fee Per Store Customer Se ... Assembly & Blanket Wrap Pallet Fee-0 ... Pallet Fee•Oversized 100 x 60 Pallet Fee-St. .. Pallet Fee-Standard 48 x 40

TOTAL FIXTURE COST FOR STORE 306 - $8937.61

Phone# Fax#

(847) 882-7214 (847) 882-7360

P.O. Date

2/10/2017

Rep

Invoiced

C-11

1


2/21/2017 40467

Scrubs Steve Such 12969 Manchester Road st. Louis, MO 63131


Artur Express 790-17 Fulfillment

RM Store# l! -__ 3_06 _ __,


5,916.83 5,916.83

I 45.00 45.00

l 575.00 575.00 1 425.13 425.13 I 30.00 30.00 I I0.00 10.00

I Total $7,001.96

scru~ &beyond.

INSTOREDATE: 2/7/2017 STORE# 306

SHIP TO:\SGrub..and Boyand Colonies Croo&roada 1271 E. 19th Streat U_e_land, Ca. 91784

Attention: Mil<& McBAlh (708) 654-8204 POP-U:.ATE

TtfiSCOWMN

OM.Y

ORDER FORM

PO# 58306--02

Issued Date: 111212017 revised 1123/2017

IF ASSEMBLY IS REQUIRED PLACE A NUMBER !.IN THE NEXT cm

I FORMULA I FORMULA I I FORMULA ASSEMBLY REClUIREMENlS

PO'PULATE ABOV£ tEU.

If ASS!:MBi.Y IS Ntmf:D

FORMULA

ITEMII ,. :;.: ;\ :·; :._;,•,:'.f" .:· ,rt(\'}:{'.'.:} '.,I N=ED r·:. ·:,:,::} ~+TORECOST1~~-~~\·11 UNITUJSTPER

, .. ;:< ,1 ;, .. s•~·~.-~IPTION ;;,'~) .' .,:;.,·,-··.·,p •;,,,tNEACHES :·Ut;IJ.C:QSt!'£3SE1> PERUNIT •l\$,S~ll!l.· ASSEMBLY. ~,r~~•;;R

312!H071Ml1 SCRUBUNIT (2JOUTIUGG£RSINO.UDED I O I $1,518.04 I $0JJO_~L~~-O -~ ;1 ~2~ $0.00 _l_ $0.00

il.29-1060-01 !SHOE UNITSTARTcRASSEMBtV

312!1-lll60-02 !SHOE UNIT ADO-ON ASSEMBLY

312!1-W50·U1 !SMALL 4-WAY IIACK ASSEMBLY

3129-J040-ll1 ILARGE4-WAYRACKASSEMBLY

3129-108-01 jSIGN HOLDER IVELOMENT/FIXTURES (6) PER PRE-PACKED CAIITON

3129-1030-01 !SMALL SALESMAN RACK ASSEMBLY

3129·10:ZO-Ol !LARGE SALESMAN RACK ASSEMBLY

3129-1010-01 !WINDOW GRID ASSEMBLY

3129-llNll _ !SIGN HOLDER IVELDMENT/SHOE WALL j2_1 PER PRE·PACKED CARTON

3129-520-01 )REVERSIBLE SHOE BRACKET ASSEMBLY (35) PER PRE-PACKED CARTON

3129-135-ol ISIGN HOLDER PEDESTAL (m_?ER PRE-PACKED CARTON

3129-2000-01 !NESTING TABLES

3129-WOO-O.Z I METAL BENC:H FRAME (ASSEMBLY COST IS INCLUDED)

i1129-W35-G1 JGO BACK RACK

Thi• ,hippmen1 to be cooridnated with Millwork delivery from Fixture

Contracting

Verify ,pace on truck for fixtures.

0

u

2

D

D

0

0

0

2

40

0

0

D

!152.90

$127.42

$274.U

$314.43

$6.04

1116.49

$147..42

$119,21

$9.n

$6.56

$6.08

$530.93

$106.24

$95.24

$0.00

?!_.00

$:548.46 1 . . , 2 .

~.00 r ,. ·O ·•

$0.00

~.00 0

$0.00 , o·-

~.00 .·,o~:-. ,-,

$19.54

$262.40

$0.00

$0.00 t-<:;,--_:-J.97~ •. '.,_.;

$0.00 _}ll'.,;~{':~·-;

195.24 I,, •·1--

TOTAlflXJYRC f $925.64' '~cosrriER$fOJ!i:;'

MUST ASSEMBLE IN $TORE S0,01)

MUST ASSEMBLE IN STORE $0.00

$2l.4B $42.96 $~91,"2

$24,:16 $_0.~ $D.00

MUST ASSEMBLE IN STORE $0.0lt

18,DS $0_-!JD_ ~-00

$8.0S ~.!1_0_ $0.00

$5.37 $0.00 $0.Dl)_

MUST ASSEMBLE IN STORE $19._54

. MUST ASSEMBLE IN'STORE $262.40

. MUST ASSEMJII.E IM STORE ~-00

$4Z.95 ~OD ~-00

~.OS ~-00 $0.00

$8.05 $8.0S 1!_03.29

TOTAl ASSEMIILY 1'_;']$l_f.,01' (XJ5TP.ER STORE

$976.65 . GRANDTOTAL

N ... u

scru®s &beyond

IN STORE DAT£: 2/7/2017 STORE# 306

SHIPTO: Scrubs and Beyond

Colonies Crossroads 1211 E. 19th Street Upland, Ca. 91784

Attention: Mike MCBAth (708) 654-8204

,,.,, :·t "'' \ .. , '

,·,:,,'.'• c "_t :~··-)~-~;i} < · ... >: ::, . i :,: :, ,'·• .. \'': -~; ITEM# . >,

3129•1070-01 SCRUB UNIT (2) OUTRIGGERS INCLUDED

3129-1060-01 SHOE UNIT Sf ARTER ASSEMBLY

3129-1060-02 SHOE UNIT ADD-ON ASSEMBLY

3129-1050-01 SMALL 4-WAY RACK ASSEMBLY

3129-1040-01 LARGE 4-WAV RACK ASSEMBLY

3129-108-01 SIGN HOLDER WELOMENT/FIXTURES (6) PER PRE·PACl{ED CARTON

3129-103o-01 SMALL SALESMAN RACK ASSEMBLY

312!1-1020-01 LARGE SALESMAN RACK ASSEMBLY


3129-137-01 SIGN HOLDER WELDMENT/SHOE WALL (2) PER PRE.PAO<ED CARTON

3129-520-01 REVERSIBLE SHOE BRACKET ASSEMBLY (35} PER PRE-PACKED CARTON

3129-135-01 SIGN HOLDfR PEDESTAL {1S) PER PRE-PACKED CARTON

3129-2000-01 NESTING TABLES

3129-1000-02 MET AL BENCH FRAME (ASSEMBLY COST IS INCWDEO)

3129-1035-01 GOBACJ<RACK

CQ!Y.!MEl'll!S:

This·shippment to be caoridnated with Millwork delivery from Fixture

Contracting

Verify space on truck for fixt_ures.

POPULATE

TIIISCOLUMIII

ONLY

.... NEEDED

INEACHES

1

2

3

0

13

12

z

l

4

0

0

8

1

1

0

ORO_EB.FORM

PO# SB306-02

Issued Date: 1/12/2017 revised 1/23/2017

IF ASSEMBLY IS REQUIRED PLACE A NUMBE~ ! IN T_HE NEXT CELL 1

PD•UlATE ABOVE CELL

IF ASSEMBLY IS NEEDED

I FORMULA FORMULA FORMULA FORMULA . ASSEMBLY REQUIREMENTS

:;u~~~,E,~~~'. >, ~

~~~ . "'·-··- 1-•-.

STORECOST Q'Nm>·,'. UNIT.COST PER STORE COST PER PER.UNJT ~EIY1ei.£; ASSEMBLY UNIT·

$1,472.50 $1,472.50 ':21' $26.84 $26.84 $1,499.34

$174.li7 $349.34 MUST ASSEMBLE IN STORE $349.34 I


$266.00 $0.00 ~~::~}llf;;i~;f: $21.48 $0.00 $0.00

$305.00 $3,965.00 ,'1 .. ::~::.,;,·.·, $24.16 $314-08 $4,279.08


$113.00 $226,00 " ,2. : $8.05 $16.10 $242.10

$143.00 $281i.DO :·~ .'-,·12 :, t - < $8.05 $16.10 $302.10

$115.li:i $462.52 4 < $5.37 $21.48 $484.00


$1i.36 $0.oo MIJSJ AsSEMBLE IN STORE $0.00

$5.90 $47.20 MUST·ASSEMBLE IN STORE. $47.20

$515.00 $515.00 · l. $42.95 $42.95 $557.95

$106.24 $106.24 1 $9.05 $9.05 $115.29

$95.24 $0.00 ·o. , ·-" $8.05 $0.00 $0.00

.' ··;rpTALflXIUBfc: "· $7,946,37 '

>. TOTAi.ASSEMBLY- $446.~0,' $8,392.97 :·.ttost'l'Etis,6RE , COST PER SJQRE GRANDTOTAL

C') ... u


1230 Remington Rd. Schaumburg, IL. 60173

Mail To:


P.O. Number

SB361-02

Item Code

Terms

Net 30Days

Description

Due Date

4/9/2017

Billable Ship ... Shippng Charge to deliver Scmbs Fixtures to: Scrubs and Beyond Store #361 Easton Square 3864 Morse Road Colwnbus, OH 43230

Billable War ... Warehousing-Billable Customer Se, .. Assembly and Blanket Wrap Pallet Fee-O ... Pallet Fee-Oversized 100 x 60 Pallet Fee-St.. Pallet Fee-Standard 48 x 40

TOTAL FIXTURE COST FOR STORE 361 - $6,346.89

Phone# Fax#

(847) 882-7214 (847) 882-7360

P.O. Date

3/10/2017

Rep

Invoiced

C-14


3/10/2017 40531



CH Robinson 790-17 Fulfillment

RM Store# ll.....__36_1 _ _,


l 1,448.00 1,448.00

1 0.00 0.00 I 323.13 323.13 I 30.00 30.00 1 10.00 10.00

I Total $1,81).13

:?; 'C !'?

'? :. ::, i:: ::r Ill ~ ("J 0 3 0 a. ! :0 a> 0 (I}

~-() 0

~ !\)

~ 0 II ..,, w a, ;; ~ 0

~ 00

' "' p g_ ~ ;;;-7" 0:, N

~ 0) ., ::::;! lj c,_ Cl)

-l'> <I)

0 ...., i,,, ..... ;;; :>

"' ., ~ o· ::?. 0 !!. "' ,:,. ..., in 0 IX> w ,,.

" ;:::; ..e

"U !::! .,. (0 ....,

., "' Nf.,,) 0...., _..., "'s::

scru@s &beyond.

IN STORE DAT£: 3/10/2017 STORE# 361

SHIP TO:IEaston Square 3864 Morse Rd. Columbus, OH. 43230 xxxx

POPULATE

THIS COLUMN

ONLY

ORDERF_ORM


IF ASSEMBLY IS REQUIRED PLACE A NUMBER 1 IN THE NEXT CELL

FORMULA I FORMULA I I FORMULA . ~MBL'fREQUIREMENTS .

1

POPULATE ABOVE CELL

IF ASSEMBLY 15 NE£0ED

FORMULA

ITEM# p ... ri: rJ~:., :DESciu~/·t .,.:_,:,, . ,· \\,'.':_,': ,,STORECOS'J'.1•,~c:~Jo:S, ''UNffC9Si-'P-ERSET .• PERUNIT • ~El',/IBLE'.

'/,- . ,, ... ,,. . ;d IOIU\AU IUUU.

u::l~R -~~-~ STOR~~PER

3129-1070-01 (SCRUB UNIT (2) OUTRIGGERS INCLUDED

3129-1060-01 fSHOE UNIT STARTER ASSEMBLY

3129-1068-02 (SHOE UNIT ADD-ON ASSEMBLY

3129·1058-01 !SMALL 4-WAY RACK ASSEMBLY

3129-1040-01 I LARGE 4-WAY RACK ASSEMBLY

312!1-108-01 (SIGN HOLDER WELOMENT/FIXTURES (6} PER PRE-PACKED CARTON

3129-1030-01 )SMALL SALESMAN RACK ASSEMBLY

3l2!H020-01 !LARGE SALESMAN RACK ASSEMBLY

3129-1010-01 I WINDOW GRID ASSEMBLY

3129-137-01 JSIGN HOLOER WELOMENT/SHOE WAU (Z) PER PRE·PACKEO CARTON

3129•520-01 JREVERSISLE SHOE BRACKET ASSE_r,IIBLY (35) PER PRE-PACKED CARTON

3129•135-01 !SIGN HOL_O~R_l'EDESTAL (15JPE_R_PRE•PACKED CARTON

3129-2000-01 !NESTING TABLES

3129-1000-02 I METAL BENCH FRAME (ASSEMBLY COST IS INaUDED)

3129-1035•01 IGO BACK RACK

!COMMENTS:

Shippment to be sent directly to the store. (This Is NOT a combined shipping with millwork fixtures)

Location is a temporary Life Uniform space in same center as existing just a

few doors away

1

1

3

0

s

0

2

2

2

0

0

6

0

1

$1,472.50 ~1~412.soi:~i,·a:-~ $26,84 ! $26.84 _l__ j_l,499.34



$266.00 $0.00 .o .. $21.48 $0.00 $0,00

$~5.00 $1,S2S.OO 5.· $24.16 ilZ0,S0 $1,645.80

$S.86 $0.00 MUST.ASSEMBLE IN STORE $0.00

$113.00 $22&.oo r~·-·.,i,it~~t $8.()! H&.10 1242.10

$143.00 }za~._ool.-:%.dlt~f,,:, $8.05 $16.10 $302.10

$11S.63 ~21_1.2& f::;$·.-:-yf $537 $10.74 $242.00

$9.48 $0.00 MUST ASSEMBU: IN STORE $0.00

$6.36 $11.00 MUST-ASSEMBLE IN STORE $0.00

$5.90 $3SAO MUST ASSEMBLE IN STORE $35.40

$515.00 $0.00 :o $42.95 $0.00 $0.00

$106.24 $106.24 ... ,. . '1 $9.115 $9.05 $115.29

$9S.24 $95.24 1. j8.05_ $8._05 tt_03.29

:: TOTA~.flXJURf.' J $.4,598.56 1 , ' COSJ PB'{ $TOBE :

•• , TOTALASSEMIILY r . $207,68, 1

$4,806.~4 1 cosr ~ERSTORE GRAND.TG>TAL

.,, "I"' u

scru@s &beyond


ORDER FORM

Issued Date: 2/?7/2017

SHIP TO:IEaston Square IF ASSEMBLY IS REQUIRED PLACE A NUMBER! IN THE NEXT CELL

3864 Morse Rd. Columbus, OH. 43230 XXIUI

,, >7~.t:\:: ~~- :: . -~ ~. ,, ' llEM/1 ':':_iiliQllPJION · .. · ·,

312!1-1071Hl1 SCRUB UNIT 12) OUTRIGGEIIS INCWDED

3U9-1060-01 ISHOE UNIT STARTER ASSEMBLY

3129-1060-02 !SHOE UNIT ADO-ON ASSEMBLY

3129-1050-01 )SMALL 4-WAV llACK ASSEMBLY

3U9,1040-D1 IIARGE 4•WAV RACK ASSEMBLY

3129-108-01 ISIGN H010ER WELDMENT/£1lCTURES (6) PER PRE-PACKED_ CARTON

31Z!H031>-01 ISMALLSALESMAN RAO( ASSEMBLY

312!>-10211--0l !LARGE SALESMAN RACk ASSEMBLY

Jl2.9-101o-01 !WINDOW GRIDASSEMBLY

3129-137·01 !SIGN HOLDER WELDMENT/SHOE WALL (2) PER PRE-PACKEDCARlON

3129-520-01 !REVERSIBLE SliOE BRACKET ASSEMBLY (35) PER PRE-PACKED CARTON

3129·1:IS-Gl !SIGN HOLDER PEDESTAL {1S) PER PRE-PACICEI) CAR_!g_r-J_

3129·20~ )NESTINGTAIILES

3129-1000-02 !METAL BENCH FRAME lASSEMB_I._Y CQST IS INCLUDEOI

3129-1035-01 IGO BAC:I< RACk

POPU\ATE

nuSCOLIJMN

OHLY

-~'.J N:0£D •:;· .;_ ', : . ;/ >, ;.,:4 IN EAOIES ,u,,micost ,i11S£T

o I 1!,5_18.114

0 $152.911_

0 $127.42

5 !274.23

0. $314.43

0 M-04

0 $116.49

0 $_147.42

0 $119.21_

2 $9._n

40 $6.~

0 $6.08

0 $5~.93

0 $106.24

!95.24

I FORMULA I FORMUIA I I FORMULA AS$EMl!LY R£t2UIREMEN1S

,II..~.;,. f ,, - ~ ,; • .f.:'t:~·:.:::;t

~~u~:,~~:;: ~';~~L~R~ ,~~~ ~OD f' ~- ( $26.84 .---$0.IMI_

~.IID MUST ASSEMBU: IN ~ORE

I $0.011 MUST ASSEMBLE IN STORE

$1,111.15 I .'' ·5 $21.~ f107AO

$0.0D I'• 0 $24.16 $0.DO

!D,00 MUST ASSEMBLE 1.N STOJIE

~.OD b~~;Jp);'-...,:i $8.05 $0.00

so.oo r.r~:-,'ai:.t:::: $11.~ $11.~

i~oo 1-;Li..:~40_:~ !_5.37 f0.00

$19.54 MUST ASSEMBLE IN STORE

$2G2AO MUST ASSEMBLE IN STORE

$0.00 · MUST ASSEMBLE IN STORE

$D,!III D J $42.95 $0.00 I

$0.IJO 0. l $9.05 $0.00

~95_.24 1 _.'j ~ $8.05

POf'\JI.AT£ ABOVE CEll

IF ASSfMBLV" 15- NEEDED

FORMULA

GRANbTOTAi 'STORE c:osT PER

UNIT

~.00

~.00

$0.00

$1.!.478.55

~-OD

$0.oo

~ !_D.00

Jo.oo jj9.54

E:62.40

10.00

!O.OO

jo.oo

ji:03.29

~lm.; ii863.78 l>KAN"'""";;"wfAL

l.•~-::~::~rri.748~3H~({;~~'c,;1::.:::1~,$.~.-4S=rJ=-=~~ Shippment to be sent directly to the store. (This is NOT a combined shipping with millwo,k fixtures)

Location Is a temporary Life Uniform space in same center as exiSting Just a

few doors away

co 'I"'

u

Samaritan Displa4



MailTo:


P.O. Number

SB374-02

Item Code

Terms

Net30 Days

Description

Due Date

S/14/2017

Billabe Ship ... Shipping Charge to deliver Scrubs Fixtures to: Scrubs and Beyond Store #374 Academy Square 1112 Lancaster Square Salem, OR 97301

Warehousing ... Warehousing & Storage Fee per Store Customer Ser ... Assembly and Blanket Wrap Pallet Fee-O ... Pallet Fee-Oversized I 00 x 60 Pallet Fee-St... Pallet Fee-Standard 48 x 40

TOTAL FIXTURE COST FOR STORE 374 • $9188.33

Phone# Fax#

(847) 882-7214 (847) 882-7360

P.O. Date

4/14/2017

Rep

Invoiced

C-17

]

J I I I


4/14/2017 40596

Bill To:

Scrubs Steve Such 12969 Manchester Road St Louis, MO 63131


CH Robinson 790-17 Fulfillment

RM Store# ! ._l __ 37_4 _ _.


7,686.38 7,686.38

380.36 380.36 502.99 S02.99

30.00 30.00 10.00 10.00

I Total $8,609.73

scruli>s &beyond

IN STORE DATE: 4/411/

STORE# 374

SHIP TO:,Scrubs and Beyond :Academy SqLIBre 1112 Lancaster Square !Salem, OR. 97301

Attn: Mike Mebath (708) &54-11204 POPUlATI:

TlllSCOLUMN

ONLY

ORDEREORM

PO #58374-02


IF.ASSEMBlY.IS REQUIRED l'IACE A NUMBER! IN THE NEXT CELL

FORMULA I FORMULA f FORMULA . A,§EMBLY REQUIREMENTS· .

P0PULATEA8,0VE C£U

IF ASSEMBLY lS NEE:DEO

FORMULA

?~-;~f(?<r,:,i~~~·~:i:S/>t,r-:\fC NEEDED • ,, ,:.,. - • ,.,,• STORHOST' ~19; UNITCOSTl'ER {~111 ;;;;;~;·~ . mM11. .c,;;'.,,{.J .,::,,,;.,-.·. ·.£-,o~IPIION.:.." :·:· 1NEAotes .llN1t-W~·,E~-sET· -PERuNrr ~sJt ~Lv !i.~~@lr:::: uNrr

J129-1071M>1 SCRUB UNIT (2) OUTRIGGERS INCLUDED _ 0 _ _ $1,518,04 $0.00 .o · $26.84 $0.00 $0.00

3129-1060-01 !SHOE UNIT STi\RTER ASSEMBLY $152.90

3129-1060-02 (SHOE UNIT ADD-0111 ASSEMBLY $0.00

3129·105CMl1 I SMALL 4-WAY RACK ASSEMBLY ll.096.92

MUST ASSEMBLE IN STORE.

I MUST ASSEMBLE IN STORE

I 4. I !21.48 $85.92

1 I !152.90

0 I !'!z7A2

4 I ~74.23

$152.90

$0.00

$1,182.84

3129-1ll40-01 I LARGE 4-WAY RACK ASSEMBLY $0.00

3129-108-01 ISIGN HOLDER WELDMENT/AXTURES (6) PER PRE-PACKED CARTON ~-~

3129-1030-01 !SMALL SALESMAN RACK ASSEMBLY $0.00

o · I $24.16 I $0.00

MUST ASSEMBLE IN STORE

I It" I $8.05 $0.00

0 I $314.43

1 I $6.04

0 I !116A9

$0.00

~ ~00

3U9-1020-01 IIARGE SALESMAN RACK ASSEMBLY $0.00

3129-1010-01 fWIN0OW GRID ASSEMBLY $0.0D

.. • 1 I

$8.05 $0.00

,O•:. $5.37 $0.00

0 I !147.42

0 I $119.21

~00

jo.oo

3129-137-01 !SIGN HOLDER WELOMENT/SHOE WALL (2) PER PRE•PACKEO CARlON 2 I !!_.77 $19.54 MUST·ASSEMBLE IN STORE. jl9.54

3129-520-01 I REVERSIBLE SHOE BRACKET ASSEMBLY (35) PER PRE-PACKED CARTON 40 I £6,56 $262.40 MUST ASSfMBl.f IN STORE .E_62.40

3129-135-01 !SIGN HOLDER PEDESTAL (15) PER PRE-PACKED CARTON 0 I js.oa $0.00 MUST. ASSEMBLE IN STOJIE J:o.oo

3129-2000--01 !NESTING TABLES 1 I fs30.93 $530.93 I •0 ··1 $42.95 $42.95 ~73.88

3129-1000-02 !METAL BENCH FRA~E {ASSEMBLY COST IS INCLUDED) 1 I $106.24 $106.24 I ·:1 $9.05 $9.05 !115.29 3129-1035-01 IGO BACK RACK 1 I $95.24 $95,24 I ·•· • 1· . $8.05 $8.05 $103.29

COMMlNl'S:. ~ ,i-.,,..; .. ;, 1.:.. i..--... " ....... ·---r-......... r __ :-s'n.;:'?i:,: """; · TOTAL ASSEMBLY]. 'C'•iits.9?'·-:--,l -$2 .. 16.10 ==~~:-;.;...; __ ....,....._..:.:,;;,;...;;a,i COSJPERSTORE _GRANDTOT~l

Order to be coordinated to plck up Millwork fixtures from Fixture Contracting

00 'I"'

I u

scru0s &beyond.


SHIP T0:1scrubsandBeyond Ac:adem:, Squ81'8

ITEM#

3129-1070-01

1112 Lancaster Square 5alem, OR. 97:S01

Attn: Mike Mcbath (708) 654-8204

F~'~:-it;:5'..'_: \r\:]\~i~jJ:::;-x}~t :·.{~ SCRUB UNIT (2} OUTRIGGERS INCLUDED

3129·1060-01 !SHOE UNIT STARTER ASSEMBLY

3129-1060-02 ISHOE UNIT AOD-ON ASSEMBLY

3129-1050-01 fSMALL 4-WAY RACK ASSEMBLY

3129-104ll-01 I LARGE 4-WAY RACK ASSEMBLY

3129-108·01 !SIGN HOLDERINELOMEN'T/FIXTt.l_RES (6) PER PRE.PACKEI> CARTON

3129-1030-0l !SMALL SALESMAN RACK ASSEMBLY

31Z9-1020-01 !LARGE SP.LESMAN RACK ASSEMBLY

3129-1010-0l !WINDOW GRID ASSEMBLY

3129-137-01 !SIGN HOLDER WELDMENT/SHOE WALL (21 PER PRE-PACKED CARTO!I

3129-520-01 I REVERSIBLE SHOE BRACKET ASSEMBLY {35) PER PRE-PACKED CARTON

3129-135-01 !SIGN HOLDER PEDESTAL (15} PER PRE-PACKED CARTON

3129-2000-0l !NESTING TABLES

3U9-1000-02 I METAL BENCH FRAME (ASSEMBLY COST IS INCLUDED)

3129-1035-01 !GO BACK RACK

!COMMENTS;

POPULATE

lHISCOWMN

ONLY

ORDERFQRM

PO #SB374-02


IF ASSEMBLY IS:REQUIREO PLACE A NUMBER _1 IN THE NEXT CELL 1

FORMULA I FORMULA f FOAMUlA . -ASSEMBLY REQUIREMENTS

POPIJlATE ABOVE CEU

If AS$EMSW IS NEEOED

FORMULA

'· ;·/ NEEDED -, :,:,, , .. ~;, ', STORE COST t'.m:Y,TO _•. U.lilrrCOSTPER :~ ~:·i'•~t '-UT 1• ,- ,. •~¼,~-·, l~- ·:1·ccs;,_:~-. :·_ c··--- --~i•:-;.:>

yr_ INEACHES H~f'fC:!)5Il1~,m PERUNIT - ,~au~ --ASS£M_B_LY !~!'f· ·-i~,;1 _;:;~~~:;;R 1'1--d UNIT

1 I $1,412.so I s:1,412.50 lt~- i1 ' I $26..84 $26.84 f $1,499.34

1 $174.67 $174.67 MUST ASSEMBLE IN STORE $174.67

2 $148.75 $297.50 MUST ASSEMBLE lN STORE $297.SO

0 $266.00 $0.00 0 $21.48 $0.00 $0.00

12 $305.00 $3,660.00 :U,: $24.16 !289.92 $3,949.92

11 $5.86 $64.46 MUST ASSEMBLE IN STORE $64.46

1 $113.00 $1~.00 1,-;t:.1.·f;.''>i $8.05 $8.05 $121.05

z $143.00 $286.00 It,,[!~~~ $8.05 $16.10 $302.10

3 $115.63 $346.89 t:1::-::;,3:pJ\1 $5.37 $16.11 $363.00

0 $9.48 $0.00 MUST ASSEMBLE-IN STORE $0.00

0 $6.36 $0.00 MUS"I' ASSEMBLE 1111 STORE $0.00

9 $5,90 $53.10 MUST.ASSEMBLE IN STORE $~_3.11)_

0 $515.00 $0.00 0 $42.95 $0.00 $0.00

0 $106.24 $0.00 o~" $9.05 $_0.00 ~-00

0 $95.24 $0.00 0 $8.05 $0.00 $0.00

_'. 19:rAt.·F_.oo'~~-~ ·: I $6,468.12 l' '-. ·,/roTALASSEMBLY,,. ~s1.02:,= -.$6;82S.l4 CO~l'ER'~otll; ·, COSTPERSTORE GIWIQTOTAl

Order to be coordinated to pick up Millwork fixtures from Fixture Contracting

~ 'I"' u



Mail To:

Scmbs Steve Such 12969 Manchester Road St. Louis, MO 6313 I

P.O. Number

8B361-12

Item Cade

Terms

Net 30Days

Description

Due Date

6n/2017

Billable Ship ... RUSH Shipping Charge to deliver ( 1) set ofNesting Tables(ltem #3129-2000-01) Ship to: Scrubs and Beyond Store 11361 Easton Square 3 864 MOrse Road Columbus, OH 43230

Return of ( J) Shoe Unit Add-On Assembly (Item #3129-1060-02) Return was deliver to: Samaritan Display Group 1230 Remington Road SchaUlllburg, JL. 60173

Billable War ... Warehousing & Storage Fee per Store Customer Se ... Disposable Blanket Cost


Phone# Fax#

(847) 882-7214 (847) 882-7360

P.O. Date

5/8/2017

Rep

Invoiced

Page 1

C-20


5/8/2017 40646



UPS Next Day ... 790-17 Fulfillment

RM Store# I._! __ 36_1 _ _,


1 984.50 984.50

1 37.00 37.00 3 4.22 12.66

0.00 0.00

l Total

scrul'i>s &beyond

IN STORE DATE: 514/2017 STORE# 361

SHIP TO; ISGtubs and eoyond

Easton Squara 3864 Morse Rd. Columbus, OH, 43230

Attn: Stare Manager Traci Whits (614) 47J.333 i'OPUlATI

TIUSCOWMN

DHLY

ORDER FORM

PO #5B361·12

Issued Date: 51312017

IF ASSEMBL:V IS REQUIRED.PLACE A NUMBER,! IN THE NElCT CELL

I FORMULA I FORMULA I I FORMULA ~BLY RE(lUIREMEH'JS ."

P0$1UlA1l ABOVEQU

U:ASSEMSLY ISNEED£0

FOJIMUlA

ITEM# b:,:'v{''i't f.if~;,1~,itiii:~ ,/_\:'. '.:<{:.f .. : .\ ~~::i: :G.~:J{i~: ~~:;r ~~~ U:S:;L7 iii{ -· GRAND TOTAL STORE COST PER

UNIT 312!H070-01 !SCRUB UNIT {2IOUTRIGGERS INCLUDED 0 $1,518.114 $0.00 ,,~ $26.84 $0.00 so.iiii

3129•1060-01 fSHOE UNIT STARTER ASSEMBLY 0 $152,9D $0.00 MUST ASSEMBLE IN STORE !0,00

3129-1061).1)2 !SHOE UNIT ADD-ON ASSEMBLY 0 $127.42 $0.00 MUST ASSEMBLE IN STORE !D.00

3129-1050-01 ISMALL4-WAY IIACl< ASSEMIILV 0 $274.23 $0.00 ,,~:;,-'1-, ~1.~ 10.00

312!"1040-ol !LARGE 4-WAY RACK ASSEMB,i.Y 0 $314.43 $0.00 h~;:~o:cc:'J.·1 ~4.16 $0.00

$0.00

~ 3129·108-01 !SIGl\l HOL!)ER llfEUlMENT/FlXTURES {6) PER PRE-PACKED CARTON 0 S&.04 $.1)._00 MUST ASSEMBLE IN STORE $0.00

312!H03D-01 !SMALL SALESMAN RACK ASSEMBLY 0 !116,49 10.00 r a,_ $8.05 $0.00 ~-00

3129-1020-01 !LARGE SALESMAN RACK ASSEMBLY 0 114!,42 $0.00 ~ ~ill\':1.o'{ '','~i ~8.05 $0.00 ~-00

3129-1010-01 !WINDOW GRID ASSEMBLY 0 $119.21 $0.00 I :, o $5.37 $0.00 io.oo

3129-137-01 fSIGN HOLDER WELOMENT/SHOE WALL_(Zl P"'PR£·PACK<O.<AATO_N 0 ~-77 $0.00 MUST ASSEMBLE IN STORE ~.OD

3129•5:ZO.Ol !REVERSIBLE SHOE BRACKET ASSEMBLY (35) PER PRE-PACKED CARTON 0 $6.56 $0.00 MUST ASSEMB[E IN STORE ~.oo

3129·135-01 !SIGN HOLDER PEDESTAL (1S) PER PRE-PACKED CARTON 0 $_6..0! $0.00 MUST ASSEMBlE IN STORE ..fo.oo 3129•2000-01 IN~TING TABLfS 1 $530.93 $530.93 j'~' $42.95 ~2.9S ~73.88

312!H0IIO-o2 !METAL BENCH•RAME !_ASSEMBLY COST IS INCLUDED) D i!OG,24 $0.00 -J2-:]~i\, 19,05 $0.00 j_O.GO

3129·1Da5-o1 !GO BACK RACK o. $95.24 $0.011 t.x ;.o,D''.J ~.cis. i_0.00 $0.GO

COMMENTS: ,~::1r~:.~~ :1 $530:93 ,., c- r::p::::r/~:~;;•1 ~:~:Al, TO BE IN STORE THURSDAY 5/4/17

'I"' N

I

CJ



Mail To:

Scrnbs Steve Such 12969 Manchester Road St. Louis, M06313I

P.O. Number

SB344--02

Item Code

Terms

Net 30Days

Description

Due Date

7/21/2017

Billable Ship ... Shipping Charge to deliver (1) Set of Nesting Tables to the following address: Scrubs and Beyond Store #344 8873 Hall Road Utica, Ml 48317

Billable War ... Warehousing & Storage Fee per Store


Phone# Fax#

(847) 882-7214 (847) 882-7360

P.O. Date

6/21/2017

Rep

Invoiced

C-22


6/21/2017 40797



FedEx 790-I 7 Fulfillment

RM Store# ! ... I __ 344 _ ___.


1 121.37 121.37

l 31.00 31.00

I Total $152.37

scrut®s &beyond

IN STORE DATE: 6120/2017 5TORE# 344

SHIP TO:ISCrubs and Beyond ,8873 Hall Road Utica, Ml 48317

Attn: Store Ma111ger Pamela Pardo (&B6l 323-3364 POPUlAH

lt:liSCOlUMN

Ol'fLY

r

ORDER FORM

PO #SB344-0Z


IF ASSEMBLY IS REQUIRED PLAct" A NUMBER! IN Tt1E MXT CEU

I FORMUIA I FOllM\JlA I r FORMUIA .ASSl:MBLY REQUIREMENTS

POPUIATE ABDV£ CW.

!F ASS£r.tlU.Y ts N£EDED

FDRMUIA

ITEM#, .. ·,;,!:.•.,;:o~~lsr:u1°rr5T ii\:; u:s~=L~R· !ri~f: ;~~•;~ 3129-1070-01 1 $0.00 :.r;:.:-~;;1!!;.;.: $26.84 $0.00 _ _ _ $0.00

"2&-14Ml0-C1 !SHOE UNIT STARlERASSEMBLY I 0 $15:t.llO $0.00 MUST ASSEMBLE·IN"STORE $0.00

I I 3129-1060-02 lSHOE UNIT ADO-ONASSEMBI.Y l 0 $127.42 $0.00 MUST ASSEMBLE IN STORE S0.00

Ul!l-1050-Cl SMAU4-WAYRACKASSEMBI.Y 0 $274.23 $0.00 . 0. ·' $21.48 $0.00 $0.00

3129-1040-01 UIRGE4-WAY RACK ASSEMBLY Q $314.43 $0.00 ,.-:lr ~:::. .. $24.16 $0.00 $0.00

3129-UlB-01 SIGN HOLDER WELDMENT/RXTURES (6} PER PRE·PACKED CARTON Q S6.o4 $0.00 MUST ASSEMBLE IN STORE $0.00

3119--1030-01 SMALLSAI.ESM.Afl IIACKASSEMBLY 0 $116.49 $0.00 .f;".:}>Jt~-,:-;..: ... ~ $8.0S $0.00 $0.00 I

3129--1021>-0l LARGE SJ\LESM.Afl RACl< ASSEMBLY 0 $147.42 $0.00 a.., $8.05 $0.00 so.oo

' 3129-1010-01 WINDOW GRID ASSEMBLY 0 $119.21 $0.00 O• $$.37 $0.00 $0,00

3129-137-01 ISIGN HOlDER WILDM£NT/SHOE WALL (2} PfR PRHACKf0CARfON Q $9.77 $0.00 ·MUST ASSEMBLE IN STORE so.DO I I

!l129-520-ol [REVERSIBLE SHOE BRACl(ff ASSEMBLY (3S) PER PRE,PACKED CARTON 0 $6.56 $0.00 .MUST ASSEM.8LE IN STORE $0.00 I

3129-135-01 )SIGN HOIDER PED£STAl (15) PER PRE-PACKED CARTON 0 $6.08 $0.00 MUST ASSl:MBLE IN STORE $0.00 l

3129-ZO(J(M)l lNESrlNG TABLES 1 $530.93 $530.93 1-~•,-..:-i0~ •• /· 1 $42.95 $0.00 $530.!13

Sl29•1000-Q2 METAL BENCH FRAME (ASSEMBLY COST IS INCWDEDI 0 $106.24 $0.00 ~~f,::i::-;:{!t,; .. $9.05 $0.00 $0.00

3129-Ulis-41 GO BACK RACK D $95.24 $0.00 ' . o·:· $8.05 $0.00 $0.00

rnMMENTS: c , TOTAL ffl('f(JRE ' $530.93 •· • ! . TOTAL ASSEMBLY ~-:~:'$11;~:.:··, -$5ao.93 :•cosr'patsi'PRi. COST PER'5TOBE GRAND TOTA\.

ORDER TO BE SHIPPED llOXED, UNASSEMBLED

CW) N u



Mail To:

Scmbs Steve Such 12969 Manchester Road St. Louis, MO 63131

P.O. Number

8B263-02

Item Code

Terms

Net30Days

Description

Due Date

4/5/20]7

Billable Ship ... Shipping Charge to deliver Scrubs Fixtures to: Scrubs and Beyond Store #263 The Commons at Magnolia 2861 DavidH Mcleod Blvd Florence, SC 29501

Billable War ... Warehousing & Storage Fee per Store Customer Se ... Assembly and Blanket Wrap Pallet Fee-0 ... Pal1et Fee-Oversized 100 x 60 Pallet Fee-St. .. Pallet Fee-Slaudard 48 x 40

TOTAL FIXTURE COST FOR STORE 263 - $7,465.58

Phone# Fax#

(847) 882-7214 (847) 882-7360

P.O. Date

3/6/2017

Rep

Invoiced

C-24


3/6/2017 40495



Landstar 790-17 Fulfillment

RM Store# I .... I __ 26_3 _ _,


I 3,850.00 3,850.00

1 575.00 575.00 1 400.97 400.97 1 30.00 30.00 I IO.OD IO.OD

I Total $4,865.97

scru~s &beyond.


STORE# 283

SHIP TO: Scrubs and Beyot1d

Tile Commons At. Magnolia 2881 David H. Mcleod Bvld.

Aonmce, SC.19601

Dellvery Contlct: Tom Wright (706) 254-7033

ITEM#

' :(;:\if5} .. ·.t·',:\:?i',,:~'t \ •. ,., ·.; ,: ,.

1

} •./ ~;v'esi:iumON . · •·· ~ • Jv, ,.;, · .,,.. ,., 3129-1070-01 SCRUB UNIT 121 OUTRIGGERS INQJJDED

3129-1060-01 SHOE UNIT STAITTERASSEMBLY

3129-106(1.02 SHOE UNIT ADO•ON ASSEMBLY

3129-lOS~l SMALL 4-WAV <ACK ASSEMBLY

3129-104(H)1 LARGE 4-WAV .\ACK ASSEMBLY

3129-11111-01 SIGN HOLDER \YELDMENT/FIXTURES (6) PER PRE-PACKED CARTON

3129-1030-01 SMALL SALESMAN RACK ASSEMBLY

3129•1020-01 LARGE SALESMAN RACK ASSEMBLY


3129-137-01 SIGN HOLDER 1\/ELDMENT/SHOE WALL(>) PER PIU!.PACKEO CARTON

312!1-S20-01 REVERSIBLE SHOE eRAOOT ASSEMBLY (351 PER PRE-PACKED CARTON

3:129-135-01 SIGN HOLDER PEDESTAL (15) PER PRE·PAc«ED CARTON

3129·2000-01 NESTINGTABUS

3129-lOll0-4!2 METAL BENCH FRAME (ASSEMBLY COST IS INCLUDED)

3129-1035-01 GO BACK RACK

COMMEN~,

Order to be coordinated to pick up Millwork a'. Fixture contracting

POPIJ1AT£

THJSCOLUMN

ONLY

~ .. NEEDED

IN£ACHES

0

0

0

2

0

D

0

0

0

2

50

0

0

0

1

ORDER FORM

PO# S9263-02


IF ASSEMBLY IS REQUIRED PLACE A NUMBER_! IN THE NEXT CELL 1

POPULATE ABOVE CElL

JFAS§EMW,.Y ISNUDED

I FORMUlA FORMUIA I FORMULA FORMULA ASSEMBI.Y REQUIREMENT;S

~t~\{i~~ :i~ it~ STORE COST UNIT COST PER . ~Olll: COST PER PERUNlT AS51iMBLY UNIT

$1,SlB.04 $0.0D ~.: '-:~!O~~;,:,~J. $26.84 $0.00 $0,00

$152.90 $0.0l) MUST ASSEMBLE IN STORE $0.00

$127.42 $0,00 MUST ASSEMBLE IN STORE $0.00

$Z74.23 $548.46 ·2· ... $21.48 $42.96 $591.42

$314.43 $0.GO '.o· $24.16 $0.00 $0.00

$6.04 $0.00 Musn,ssEMBLE JN STORE $0.llO

$116.49 $0.GO "·•· "1.·o • ... - $8.0S $0.00 $0.00

$147A2 $0.00 -· ·o $8.05 $0.00 $0.00

$119.21 $0.0D 0 •.. $5.37 $0.00 $0.00

$9.77 $19.54 MUST.ASSEM8LE IN STORE· $19.54

: $6.56 $J2B.OO MUST ASSEMBtE IN STORE $318,00

$6.08 $0.GO MUST ASSEMBtE IN STORE $0.00

$530.93 $0.00 . ·.o 542.95 $0.00 $0.00

$106.24 $0.00 o·: .. $9.0S $0.00 $0.00

$9S.24 $95.24 ,. 1.•,. "• $8.05 $8.05 $103.29

· .. T!ll-"~~•:·· $99LZ4 - . TOTl>tASHMBLY .,,,{$.~l $1;042.25 . ·COST PEll~Qfllt;. COSJPERSJ011£ GRANDTOTAL

an ~ u

S~[~~§. IN STOR£ DATE: 3/212017

STORE# 263

SHIP TO:scrubs and lleJond Conanoas At Magnolia

t David H. Mdeod Bvld.

Florence, SC. 29501 __ _

Delivery Contact: Tom Wright (708) 254-7033 POt'UlAT.E

THlSCOl.llMN

ONL'f

ORDER FORM

PO# 5B263-02


If ASSEMBL!'5 IIEQ.LJIREO Pl.A~ A NlJ_MBER_! IN THE NEXT CELL 1

PCIPtilATi ABOVC C£U

IF ASS£M~D

I FORMULA I FORMULA I FORMULA FORMiiiA'"' ASSEMBLY REQUIREMENTS

ITEM# 3lzi'iii711-0l

;~,.;L~·: (f ·:~k;:~~;,J{?:·;:,,l --. ··1 Qrr f :·:;~r,~;.1:;_}tt :~~-~\f·, · . ..~:s.~"~tf~~l ;;~;~~;~:: ~~?~?:-~ • . NEEDED ·>:<1,,;!';•'°" ;1>c:~1:t:f'i SfORECOST ,-.,"9:{Y~-~ UNIT·COSTPER, ~~~" :: :; :, IN EAO!ES ~~i,jr-,$§i'j PER UHIT ~J,M:@f,t~ ASSEMBLY - ~Affl~~

&iWJi> TOl STORE COST.PER

UNIT SCRUB UNIT (2)0UTIUGGERS INCLUD!D l _!l,472.50 $.l,47.Z.50 ,··,t,;:l-,.".-:''.:· $26.84 $26.84 $.1_499.34

312'-1060-ol SHOE UNIT STARTER ASSEMBLY 2 $174.fi7 $349.34 I I MUST ASSEMBLE IN STORE $349.34

312!H060-02 SHOE UNIT AOD-ONASSEMBLY 3 $:IAll.75 $446.25 MUST·ASSEMBLE IN STORE $446.25

3129-I0SO-Ol SMAU4-WAi RACK ASSEMBLY 0 $266.00 $0.00 :?,::ii:;,;:: $21AB $0,00 $0.00

3129-1040-01 LARGE 4-WAY RACk ASSEMBLY ' $305.00 $2,745.00 t?;.~:.il:,. 9.s~i $24.16_j $217.44 $2,962.44

3129-108-01 SIGN HOLOERWELOMENT/FIXTURES (61 PER PRE-PACKED CARTON 11 $5.16 $64.46 MUST ASSEMBL£ IN-STORE $64.46

3129-1030-01 SMALLSALESMAN RACK ASSEMBLY 2 $113,CIO $226.00 ,, ' 2 $8.0S $16.10 $242.10

3129-10211-0l LARGE SALESMAN RACK ASSEMBLY .z $143.00 $286.00 .·- ,. f - $8.05 $16.10 $302.10

3129-1010-01 WINDOW GRIO ASSEMBLY 2 $115.63 $231.26 :z $5.37 $10.74 _g42.0D

3129-137-01 ~IGN HOLDER WELOMENT/SHOE WALL (2) PER PRE·PACK£D CARTON I 0 $9.48 $0.00 MUST ASSEMBLE IN STORE ~ 3129-520-Gl IREVERSIBLf SHOE BRACKET ASSEMBLY (35) PER PRE-PACKED CARTON 0 $6.36 $0.00 MUST ASSEMBLE IN STORE J!l.00

3129-135•01 SIGN HOLDERPEOESTAL(lS) PER PRE-PACKED CARTON I 7 $5.90 $4UO MUST ASSEMBLE IN.STORE $41.30 i

3129-2000-01 NESTING TABLES J 1 $515.00 $SIS.DO ,; 1 $42.9S $42.95 $557.95

3129-1000-0Z METAL BENCH FRAME !ASSEMBLY COST IS INCLUDED)

I 1

3129-1035-Gl 160 BACK RAC< 0

CO!!!!fl!!~tffl•

$106.24 $106.24 1 · -· $9.05 $9.0S

$95.24 ~_.Ill)_ ... ··o·,: , .• $8.05 -

_jo.oo

t:~'11---~RE.d $6,~.3S·t.,

$115.29

$0.00 I

• -CO$T,PU STORE _ •• TOTAl.~LY

1 ,~y .. ir~ $6,822.57

COSU£RSTOllE . GRAND,TOTAL · I Order to be coordinated to pick up Millwork al Fixture contracting

co N

I u

E)(HIBIT D

Toal Pldauprr.te Ncl.upDllta ...... ,..,_ _,_

tnmlc.ta - - fJp - Pollolt,/ o,....,.. Contlnontal c..,. l/25/ffl17 842809473 1/27/2017 1/30/2017 4500S. Third St. LouisvlDe KV 40214 (502) 361-1057

3

* 1/25/2017 842809464 1/27/2017 1/30/2017 2700Fern Vaflev Rd. Louisville KV 40213 (502) 966-8919 3

1/25/'l017 842809482 1/27/2017 l/M/2017 3909 Highway 31E darksvllte IN 47130 (812)283-7881

' IS

lnstaHOn)v product elriea~ at 1/31)/2017 1335 Hurstbourne Lanie Louisvllle KV 40223

station ' '•\;,;"• 1/26/'l017 1/30/2017 1/31no11 401 w. Court Ave. Je~nonvll~ IN 47130 ltRUI 284-4796 •

I 1/26/2017 1/30/2017 1/31/2017 202 East 10th Street Jeffersonvllte IN 47130 (812) 283-4650 3

1/26/2017 I/W/2017 1/31/2017 4136CaneRunRd, loulsvllle KV 40216 (502)448-7426

' ~ 1/26/2017 1/30/2017 1/31/2017 4520 Dl11!! Hlghwav Loulsvllle KY 40216 (502)448-1DSO

' 1/27/2017 1/31/2017 2/1/2017 1401 State Ro11te 111 New Albany IN 47150 (812) 542-1081

3

1/27/2017 1/31/2017 2/1/2017 ll700S. Dixie Hwy. LOUISVIiie KY 402n (502) 933·2083 3

... " 1/27/2017 1/31/2017 2/1/2017 8400 Db111!! Hflhway Loulwllle KY 40258 (501)933,.S:344

3

1/27/2017 1/31/2017 2/1/2017 9200 Preston Highway Loul5Vnle KV 40229 (502) 969-2273 3

I 2111,017 2n12011 3255 Bardstown Road loulnllle KV 40205 502 479-6072 3

2/1/2017 2/2/2017 8405 National Tumptke Loulsvllle KV 40214 1502)37'-5"9 3

2/1/2017 2/2/2017 4154 Bardstown Rd. loubivllle KV 4021B (SOl) 499-0439 3 ... 2/1/2017 2/2/2017 7920 Bardstown Rd. loulsvllle KV 40291 (502) 231·6319 3

I I

~~ 2n12011 l/3/2017 1830 Midland Tr all Rd. Shelbvvllle KY 40065 (502) 633-9415

' '"J./2/2017 2/3/2017 3300 Bardstown Ad. oulsvllle KV 40218 (502) 451-9467 • 2/2/2017 213/2017 3726 T,11ylorwUle Rd. Loul$vllle KV 40220 (502)47!>-0067

4 2nn017 21312017 7515 Shtlbwllle rd louisvme KV 40222 (502132&-1407 3 _, __

212 12017 2/3/2017 214/2017 Z4144 West Eames Street Channahon IL 60410 (815. 521~3220 4 - 2/2/2017 2/3/2017 2/4/2017 2798W.Jefferscm St. Joliet IL 60435 (815) 773-9344 4

~~" 2/3/2017 2/4/2017 605 Lyndon Ln. LoulsvDle KY 40222 (502) 327-6460 • ~::. 2/3/2017 2/4/2017 1804 New Blankenbaker loulsvHle KY 40299 (502) 266-5098 4 ..

2"'2017 2,3,.,....7 21c.no17 Z609 Famsworth Ave Aurora II 6050S 1630) 820-2075 4

2/2/2017 2/3/2017 2/5/2017 418 S. Uncoln Way N.Aurora II 60542 1630) 906-1114 • 2/3/2017 2/5/2017 13314 Shefbyvlle Ad Loulsvale KV 40223 (S02) 24!'.-5180

3

~ 2/3/2.017 2/5/2D17 14101 ShelbyvfUe Rd. Loutsvnll! KY 40245 (502)253-0050 5 - 2/2/2017 2/3/2017 l/6/2017 100 East Dundee Ave EastOundee IL 6011B (847)428--3217 s

i 2/2/2017 2 31'1017 2/6/2017 27905 West Highway l 7fi Island lake IL 60042 1847) S26-7568 s

2/3/2017 2/6/2017 12412 La Grange Rd, Loulsvllle KY 40245 (S02) 241-4720 s 2/3/2017 2/6/2017 10320 Westport Rd. loutsvllle KV 40241 (502)33~8639

'

I 2 2/2017 2J6nn17 2nno11 11 N. Route 12 Fo11Lake II 60020 1847) ~7-0554 . 2/Z/2017 2/6/2017 2/7/2017 180 E. RoOlns Rd Round lake Beach IL 60073 (847) 740-8021 s

21&no11 2/7/2017 9400Westport loulsvllle KY 40241 (502)425-3200 3

2/6/2017 ,n12011 13302 W. Hwy. 42 ··- KV 40059 1502) 228--0350 4

- 2n}2017 2'"'~17 2 81'0]7 601 Route 83 Bensonville II

1

60106r~:-0602 s ·- 2/2/2017 3233 Grand Ave Waukegan II )336-0730 5 ··~ 2/112017 2/8/2017 3196 W. Gblbtelth Rd. Cincinnati OH 521-1523 ' 2n.~011 2/8/2017 1550Griind8f.id Hiimllton OH 737•1198 • - 2/2/2017 2/812017 2/9/2017 476 North York Rd Elmhurst II 6012.6 (630)415-3001 •

l.:J~ 2/2/2017 '2/8/2017 2/9/2017 !19<XJS. Harlem Ave. summit IL 60501 1708) 458·3227 3 ·- 2'8/2017 219"017 12185 Prlnteton p:lke s-,•--·dale OH 45246 513) 671-0102 3

,n 2/2/2017 2/9/2017 2/10/2017 2330127'" Street Bfuelsland IL 60406 1708)23~'17 4 ,nnm1

t~ 2/10/2017 2/11/2017 813 N. St. Joseph Evansville IN 47712 (812)425--0035 • 161

w ~ -m -:c >< w

DROP SHEET FOR TOWN PUMP

S,o,. Reforonco

# Stora Untt

7/2812021

I of lndhidual S.curtty Cages I of Stores R■oetved

IC) Town Pump- 30 Sta,. tnsa:11 Schedut.7-1D-17

Blore I I Large Cage wl I Small Cage wt (31 • &n.t ~FutlPari.tc.ae (3).,_lvn •h■lvu I lnstallatiandatH

45 :!ij

WEEK1 startJ>n6•27-1J

--'-==--==

Week 2 Start after the 4th July week 7·10-17

OU!door Morehand151ng Cagos

Om• Olma I WJe•hta

Piek up date

9wt I &tfmated Service Shipping deUwry R■commtnd■d

C* I Cap, I D-13-17 dat. I lnatall Data

Page 1

u. 1--m -:c >< w

···••u<;E A 1·1 S'i'MBOL TOREltEVE INVl:1111( ·····vse AH-;YMHOL. ro RUlf\lE !NvEr. ····•uSIAHSYMBOL l

T liJffl!Clf<A L_~ ±.L 'J1~•1 ~~ ____ tu~ - ~'ta-~

J DAJEPO ~-- DMd~ I -., ~-••- '"•~- a~ =• ~Cod• _. ,,__,U<pDatt ,.,..., •-•••TE ..... :..T:~7.::..J =-- ,- ~-I RECEIVED Code -~~~'""----~:f~;d _~ .:. ::

I I I I I 001~11 10 /Hi 16 Coluriiut ~er OH O1-s.J \ IJJi'lfiJlb 0CJ9UMOO 10 l J6 620 kin Soo n. Grand Junction CO 8IS03 l-10192016 ~~~!:~: I : OOl!tlatS\ l 16 620 ICJntlS ~~==~- G,111111isM _Q) 81230 4-10192016 _lO/)l./?016 ~~ _ (!3/j__ 16 Z4 lour,,'l'l!ll> ™- f --~ 6'JOOBmlst11WnRoad ~1!!....____.,_,.p_ -~__l_ ,±!_~~ C:Ol'lCJ4&<l 1 J/Ui z.4 Lo11h.Ville ]60 6900e..drt<Mn Ftd lo11i!.'l'llle- kY 40291 1·1032016

1~6 40272 10 li 16 40273

i,XU!U):tU 10 l 16 lO<JeVtl!e 39S l(r 200 ~ Alblln Pk N- Alb IN 47150 2-10192016 11/1/2016 40275 0019111451 10{17 16 620 klr> Soo rl 4Z5 Cl' Mirbts 569 32 !load Gm1d Junction CO 81504 S.1.01920]6 1 16 40274 D0190Jl71 10104/16 ZS Deft• __ !l_lL ~<!!!.~~~- ze 2380MoontPlu1.111tRd H~n8!ldo MS --~_J 2--1062016 ~-- ~~ D01151'n l lti I Dallz. 6-8162016 1ons 16 40m D01&500l1 08 15 16 Mid Atlintlt Kr tr l-816l016 10 1 16 40278 D0192Dl51 l 16 16 Colun-iboi; 2-102l2016 10/31/2016 40181 ~9B4fi6 1 24 16 16 Columbo.r.l 1:_l,92_~2016

.,,., DOlHffll A1iama ,; l'J!>/b 1-102/Zolb 11 '/ .!016 40260 b019UOH Mich n Ml 49202 -4-10122016 1 ! 16 40289 D0Ul759t1 A1!.1ITT.a GA 31410 5-!n32Q16 .!!/1-4_______l1Q_1__L_ - -~~ 001U.11fl5 A1bn•a CA 10011 1-11102016

!!?,19411015 A1Lmt:1 GA ~74 2-11102016 11/l'l2_1V6 _ _l 40301 D019U011 10""116 l8 I Mkhl:wn 711 ICr- '7084MlllerRo.ad <--m1Crtti Ml 48473 S.10l22016 11'15/2016 I 40305 DOl912D:ZS 1 16 18 M. n 651 Kr- 5990:S..shabaw 011rbton Ml 48341:, IH0l210l6 U/15 1016 «l304 D0190514 11 U 16 24 lo111wir.@ 350 11:rornr SSi33NewCittR.oxl Louisllflle r!i 40h4 t-1llA2016 Utt.8/2016 40W 0019'623 U/lAll6 11 ,'lll.in1a ◄11 Kr,.,,,.,. U:Ul..awnN?cwllleSuwanH Sll-lN' GA XI024 1·11182016 11 16 40E D01350411 11n.1,1G 14 0!1(tnn;ni/D--Oll 933 ~,- 1934~dtn11<eRoad r,.......... OH 45'114 2·1lll2016 lllll/2016 40.UO

UJ'l(:Ulf.

~ _1lf_ll2Q_t~ !YJ/.1.016 ltf'l,2016

U/9(2016

~ 1.!~ Uty'2016 Ul1/201G

l1M016 1:&lO~G: U/'912016

11/15'1016 u111no16

~ ll/11/1016

~ ~ ~

~

D01M9510 11,19 1& tilO i ltl''-"S--n 75 Ki-m~rs l~SParlo:.erf\Nd Parter co 80134 1•11212016 11/230016 1 «JJU I 11~16 D0196ZIS9 11/l.•7116 615 Dllon 49 OlllnMMari:et datt 10222W2htSTN Wichita 1<S 071(11; 1-12720lti 12119!2016 40338 12 ("i'"°.nni'& D0191&71i! 12/H/16 11 Albnta 354 ltrA- 12.32:SH;rmtonRo.ld SloMMountaln GA JOCM 1-122:72016 ________J£◄ '2011 Pd\ould.beSOG I/S/2(111

fitS D!lon XJfOl KS 67SOl 2-152017 1 017 l A0366 I 2017

16 Co!tlfflbul 938 OH 43616 1·11:132016 12 1 16 40~ ~•~./2017 610 Jbt ~ 19 CO 8J227 l·l?U2015 12 1~ 16 40353 2017

620 kl Soui:sn S9 =-==== co ~-~ 2-121sio1s 12/19(2016 AO~ v~m11 0019:11153 OliMJ17 620 Kln,1Srnm,on, '10 m..Markat 42SSM~S1 Mo~ VT 84532 I 142017,1 l L'l1jJOl7- 40371 ].112017 = :'~!; 6:: wk3°!t:mrc ~ :~ :~!::~s~r;iw -~~- ! = ~::~::;-1 ~i~~j t .. ::! _j ;;~~;_-1 D0200SZ8J 01 '2'"17 24 Loui:Nl!le Xl«Xl7 MidwuthR&S U23Gilk:ooo, IJeffcnorituwn ,:y 40m DOlOU710 01,31}17 14 CnclnnaWD...,"IGn 909 Jr,_, 147-1Man iltooFllthmosid Himill:on OH 45i01l D02015Zl0 0~107/17 1S Oefta 490 11:•·-r 6145S5tw,..ll~oacl 9,.,..,. MS 3917.2 D020llbl 021:ii1.J)1 19 MldAllaml:t 782 ltr~r li 7thJ'Ve-W H11n1fnnon WV 25701 0020164n 02.m:r11 Delta 04 Kr,,,..,.r jll0K· I I ~

~ D02!lJ9HJ 02 1 7 N.1$hvlle ICrc:;er 26001

0020210& 02."ln.'11 laukv!Jlt 4027 Frallklln ?rtr:e 22S7 Horth US 127 Llb(,.tu i IK'I' T .(12S39 002026515 1)2r13,,7 fiC, Dillon 3l.5 Bi,ken; l!lSOWM1pleRoad Om.ih~ NI: 66164 00202592 OJIU/17 1a<; ~" 31,;, ~~ !fiSOW"1!!f!!R~ !~ih:! 00Z03tl02J Q2riS 17 Delta C68 ~ 3~WVlllvffllt _....._ TN 38305

D020l02U 02.'15;17 Dehl •1& ICr-eller 951 HI 51N Covti.ie!Ofl TN 38019 002030:!81 o:i}1r,f17 34 WIOM5ion 138 Kt=rMn.elplace 22030Mark.tPl«.O."'-" ,-..c;.,..,,,.. TX 77357 001163S17 08/?fi 16 35 Dalla 530 Kr,_, 1653 BasSalOOd Blwl Fon Warth TX 16131

1-ll62017 l-ill017 1-232017

~ 1·'62017 W2017 i"iiioi7 ~ !-2!~Zt'1? 1·Zl5i011

!:~::; 4-9162016

4/~ 011 z

..ll:Jllllli_

~ _21J__Q00_!7

,017 ]E_l/2017

..... '"''" ~ -.;.., .,.., ~ '°'n ~ M"..!~

'"'" = 40553 00205IZ66 0 7 34 'SW OM.ion 14 Kr oar Millkel UK15 1-45 N WIiiis TI( 7731! j Wa!Un fur Stev•n lo ttOII~ «>567

J!v/2017

~ ~l'!, 1Jl4'2017

""''°" ;114n011 2/11/JQlJ

112'1"°17 iJqi'im, ~i1J•l?PP

~15262 (!}./rn/11 '20 12S Kln~s""""'n SS44Promenadl!,hft,,wa,, CatleRIWC CO 80U~ 2132017 .:I nnnt7 40568 / lf31.n017 DOHmJ!i 01/06,117 n A11.!n111 441 - --Kita,- 2300Holco,nbA-;. .. R~ fl0wdl GA 300T6 lr192017 ili912011 ~-- ~l:.Ol2011 D01!J~l 1 6 14 OIIClnf\l!.:0~~on 960 KrrrHMarket~ 5400Cofrwst011eNcrth Bl'wf Ceitteivile OH 45440 t-10192016 405M 4/IC!f2017

.!!

-• 7i

c!

.z ·l

cl

0020466l7 03(01/17 26 ~It> 619 l:fOHI 237EMa111Slreet _ Htndtr50fflille TN 37075 1·3Z2017 ~17 40589 4/12/201} ... D0191.S941 HJ.118116 1◄ One~ on 960 Krp·•••<"Marketkj;. 540)eo,MJ~~N,gf1h Btwd Center-die Ot-t 45440 1·30192016 - ~--- C0612 --4"1 J011 001998177 Ol no11 7 J6 M3$hvil!c 628 1(1.,,..tr 1820 Ro:inl! SUlle I"'" !Qrrlman n,i 31748 1-1202011 3,27/2017 40609 ~ 1 -4

OOZOJ.1831 0210.'17 3' SWOividon 39.\ lk.,._ 1010Cn1mt1 C1>anRd Lai:e<h.wL!,i; lA 708)5 1.nmm1 • tm7111' '1li:1' • Jli/Mnl :;-0020"355 02-.... 7 620 r.-~~-B___ µ3_ i;~Soo1•n 10405EM.artlnltn.lN!fltlll JtBlvd DflltJet c:o 80238 2-222-01.7 l/21'7017__ 40618 4_f1JJ]Y}..1_ =i 00210600Z Lt7 35 165l8n5W00:1Blwl FortWorth ! 1X 75131 2-4212017 ~ 17 ◄0624 4 DOZ102UC 04119/17 81.◄ Mill!ISI MIiford OH 45150 • 7 40649 ',JU/l017 002102902 OA/19/17 U OOOl'lnat Ul1WKffllPQ'Proad 0.11r.lnniai:i OH 45240 17 4QtSO S/U/2011 00203520 CD.ilO 7 706 689NonhRedwoodRaad Sar.a< a 11, UT 8'045 2-202017 4 0017 "°651 VU/2011

DO~ZSl ~11._ ll 36l8tr 1111.SE Sl:oci1Jrld~ CA ~J_ 1-125201.7 4 1 "M' _40?9~ Vl_l/~l DOlllt!.Z14 oifiiiit1 11·- Allanl.;1 25 l(rnn,r -~11 Mu1t•!blnlv\ .5C Z9576 .,_23Z017 4/lo/201' il0737 ~2011 DmlDlSZJI 7 11 Atlann lM ICr-r S6otCttJSStownD1M' P,:a.:htrtt!O. GA 30269 4-232017 ,,t 1 40133 3 1 D02Dlll01 Ol/CE.-'17 70R FoodHes~ 9.i3 Food 4lll'SS ll150SP<tbsHRoad Als}p 11 60802 l.272017 ( l(l/2011 407#1 ~.t:11f2011 D020Zll8Z Q2lfWIJJ7 )()!;001. Ol!IMI XX001 Dillons 2700 E.ttbAve- Hll:chinson KS 6'50$ 1-282017 .f. '10/2017 ,W7J4 1:t3Jnt1l7 ... D020Bll'2 m 'J.:;,1) :z, MldAlllrlllt 305 Kr~, 6300Crffd1T1001'RdSII! ISO ff~,.-.. NC 276U 2-2132017 . 4 l7 2017 40735 'J/3112017 .. DO:IO~ OJ./10/17 29 MldAl'bntlc _J 765 rn:,,,e, 1'3Red0ak:!.Shn Cenler Ronceverte _j WY 2"970 1·2132017 ~~1 40736 5/31/2017 002021$63 ci:;2,it,.fiJ7 104 foad4lt:-tt 7 SD I S:OM'SCO 74UWStoddonBlwl S.Xramtnl<'l ~ CA 95823 3"2142017 .tl1iriiii"1 ol07J2 5'31/2017 D02JU161 ou10:::111 620 K!n.,S<-=-rs 91 K!.....,St•",_~ nBAw.ae-Road t..tloPntls co 80108 1-2112011 •12 1 40105 5/31/7017 0020B162 aii16: 17 620 Kin 132 Kl...,S....,._n; iSONll~~ castll!'Rock I CO 80104 2-ll72017 4{24/1011 40706 l,f,31Hm7 DOllllll6J 02 16/17 620 t<llHl ~ ' 6 r. ..... s-n. 1750WUlruliSt CobadoS '.I~, W eo'J04 3--Z172017 '/l4/2011 40708 ~n.)/'Z011 002032164 02 'tt-117 620 Kin•S.--rs 102 Ki-Soq-r; 1611~51 t ! CO 80504 4-Zl72017 4.7.u,n,7 40701 '\/31 2017 002D4&125 /H U Atl.inta 356 u Kt .. ,,,., 36000.0a H:IPRSW Mintttl GA D>64 U-3Z2017 "'24J2017 40722 "'.U/2011 002D4G.12& 03/01./1..L, ...........!I ~ . Atl.lld:• 369 kr..-:.!r 3618 Hi"'-n 1.38 SE Stod:br!dfl • CA 31'.»81 ~o.~220p WM:lOJ.7 40703 U 1011 CIOZl'.M8121 03 r:11./17 11 Atlanll 455 w ....... , !l!x:OWhltlod:AwNW Marll!nl • GA ~ 11•32'°17 4/24(2017 407011 5/31/2017 002046128 0l ll]Jl7 11 Al:Wlta 458 Kr<;n-r 136SWWalnutAw!. oilon GA 307Z0 11•3'Z2017 • 1 40738 V31 2017 ocnc.ta 03 fJl/17 11 Atl~ 2-4S. r 34JSW"~lmboro Road AutuVa • M 30909 1.!j.ll2017 '4:1'24!2017 40720 '-131/2017

a! cl

., ~

•! .. - !

.. :.-

·l

..

-=: ::~:: !! :~ :!: :;:~ :~:=:o;:.oad ::~, ~: = 11~~33::~ ~=! :! ~:~:; +-~'--+--~-+---+---+ -+---·--·-+---D021MG-13Z 03'fli'17 t1 Atl.lU 247 Kr,•nr 45501011nb:ir0Road U11lon•11 GA 30291 9-.322(117 7 40144 "'/3!.2017 -1 D0204fit@._ 03/0J."17 U Allantil JOl r 3479Memo,Jlll0,lui Dec.a...,. GA 30032 7-322017 4/24!2011 '°731 VJS:!2017 ~ =: ::'!! !! :::: : :~~; i~SNMmlMAd ;O~OUlllilm ~ :: ~=~ ~~~:; :;:: ~:;::-

1 =- --~~~; :~ 01;::~ ~~ :o:w =~t.-N~:~: ::h ~ :: :::; 4/24/::: -"~~ -e--z~:: D020ll6U:9 03/01/17 11 Atbilrtil ◄11 Kro:;11" 14628Presldt1111il"~ Macon -GA 31206 2-322017 4n4.'1m7 40740 \nl/2017. D020461111 03/01 '17 l1 Atlint.a 694 Kr- 2809NColumbiaStfffi Ml~ .. <Nille GA 31()61 3".mm7 ,i/24.'2017 40726 '- 31/2017 D02054Zll OJ'OB!l7 u .Atbinta J74 Krom 2100RlversidaP~~ uwreneevm, GA 30043 1•382m7 4''211 2011 40730 S/3U20U_ D020757t7 Olr271t7 1l Atl.lnta _ 619 ~ 1S24M>rl 16W~ G,_lffm _ _ _ GA 30223_ +J212017 -1/"lB/_2017 4072'1 5/.llllQ!!.

... I

II.

00"""'21 ~:~~~~~ t· -~! -- ~- AUanla "' t:rOP."r :!H'.ITho Elrid~Ro.,d -·· GA .,.,. 1•3272017 ,v28/20l7 «Jill 513!/~lJ -0020,..,. lo111si.ilh! '" i::r-r 4101T.it~Crttti.c:entte lt'Un.,,(lfl KT 40~l7 2-3111017 !,,,'12l017 """ 5/31/,'01' 00...,, .. 04lll1t7 .,. 11'.1<1.~Soo irn ... ,n Marl<et: 16400STow!'IHnd A.~ Montro,.e co 81401 4n,zo17 <Oll4 Y3H20l7 002083187 Od/0117 620 k!n~s .. , a-.Milrk,,.t /t28STa.wM!ffidA~ -- co """ 24U017 """°'' «ma S,'31/2017 D02087191 04:05. 17 11 Alttn1a .. , ,,- 600lC~mm· .. GA lOStl: •◄~2017 5 2011 ~1l6 'i/312017 D01089275 04ta;111 )Os vFoodC«ltffl ,so Qul:111,,fl)l)Qc:,mttr Z28llBoth:llEw1ettl1<,o,-.. """"' WA 98021 1--46Z011 5 ZfJJ7 40111 5131nm1

DO- 04/11/17 ,. lovisville ,.. l(r • ...-.er 20l4Sll 5l '"' '""" 1-4112011 5 1017 .,,,. 5/31/2017 -+-·~ -l)OlQQSt'QI OI 12 17 " ..... l,~ •er 1:mA2WinchastarRoad ~..t,iJ TN ,.,, 2-4Ul017 Ml r,o17 ,,ms ' , IJOU04499 (141,0/17 Co:ibiml:lin ,,. trOJlet 33Cl1Mall.zrreAY@ o,- CH 4~616 2-4201011 Sil 017 40117 ,:;,3i/m1 ., DOll055lll 0411117 ,. loul'lvil"' 110 i:,...._"Pt 'Z~USHwhwa 227 ~rQ!lton "' 41000! 1-4212017 ~,212o11 40727 '°" oonama ot1'Cl'l7 11 Atl.inta '" K,,..-.... M.-m..tau ,461SColumbl;iAVl! Rinoon GA il1326 1-4242017 s,mnon 40712 S(rnr.=> 0011082S> 041.!5'17 16 Columbus "' Ir""'"' 1996Tiff,nAve R~~ OH 45840 i.AlS:1017 Sll/2011 U,]~7 S/i'l/2011 DOll08ZS4 04nsf17 16 ColumbUl 878 ic,,.,,., 'tl$itNMslnS1 RaiN!IMGr- OH 43431 1-4151017 o::1nnou .. , .. ',,')J/1017

0011= 0Sltl3{17 .,.. tcrour ... K101er 1 35Wunhle1sttPb,, •=·- ,. '"'"' 3-~3l0l/ ';i/rJ/2011 "'"' S/31(1017 00m, ... ,,,- ' " Columllm "'•=< '833V/Afe•isRd Tolrdo OH 4Uil.4 z.~,2011 S/ 1 "'"' 5131no11

D0l126730 ()Sin; 17 16 Columbus ''" Kro:,\er 100 5alnl Thomai ~iff W11il'l'on WV '""" 1-S92017 <40745 v31r.m11 002126111 05/09 17 16 ColumhUl '" "'"""'' 55aa~Road ~ Winci-i:..,. OH 43110 J.59}017 017 .,,., \,,JIJ201)

00211&331 0511.0 7 " Michi:,.m .,, ,,- 460H~ l1l:eOrlon Ml 48'02 1-5112017 ';i/5/2017 <070l 101/ ., DOZ132180 =~ !!._ l1 Atlanla 435 Kraner 5341Hl..:..:.:.;-a 205 CaYin •on GA l00l6 i-5152017 ; , ,.,......_ 4071] 5131/2017 -1 DOll.3'187 17 ,--.. .. 400 .,.~ 4003 Pru,lif Lcvri II~ '""""" KY 40l13 1-5162011 S/23/2017 -40715 S/31/2011

D02136101 OS/1717 II ., .. u 424 kmr:er 147S&furdDriwe lawrer,ce,,i:lle GA 30043 l•S172017 §1312011 «mo VJl'jn,7

002142341: 05 .z, 17 " ..... ,._, U30NHoustonlevNllnad C.Ordo¥a TN Wll8 2-5142017 '};i/2017 40761 1 0011 ..... OS.114 17 LDtdwllle "' """' 3040 Dolrtim Oriwe El~trtown KY 4U01 4-'522017 "11121}17 -40759 v3J2017 DO.,,.... 041211 Centr.ol ,.,

' KP::t!f 200lNM!clttta1St Pl1moulh M' '6563 l-412io17 ... ,n;2017 .,, .. \.3112011 ·1 DO_,.. 03117 17 34 W/Dlvi$,on 121 •~-· !J&OEi~lonR~ '" "'

,,.,. 13172017 4 6/l017 "'"' ..,,-.unou ., -1 . DOU, .... ~.24 louiwllle T66 ICtMt1r 200 E Brannon Rd Nld!obwlll@ "' '°"' 1-525201? 4:0176 6/111.017 •l oozi48271 '"r'Mt;O/l.l r- 14 011Cllln~f/D.11;u:,n 4'1 Kr$~r 3-120TDWrtt!Blvd MldllletDWn OH 45005 1•5302017 Jl".11117 40111 r:.J7W17

DOU26soZ ()5/tl9/17 620 ~ ICJn-JSoo>ttr.. 7915 ccns1l11Uon Ave Colorado5cri"fn,; co "'351 4-592017 1017 '0118 n/7f2017

D011"""' OS/l0117 " M~All,ntlc .l30 ,_, :J61E~rt~Rlld VA 241'i3 1·5312017 7 2017 ..,, .. i.,'8/2017

00l11:7«1'.J rF.,/10/11 Columbus "" Kror,,,, •2l6lltkinR~ Columbus OH 43223 2-5112017 " .,,., 6/1312017

OOUJ'7-«IO os,,n,11 " CDlllrnl,,,.. ,,. Kr,-.. i9'6510ef.f.vSI Ndsoowillt- OH 4S?64 2-!iU2011 """'" """ fill ~7017

DODl7.COO 05/10/17 ,. Columbut .,. h,>f'cer 1425Worthb<mon~e,DrlvE' WonhiM!on OM 43085 2-!il12011 =1 40791 ..-1VXl17

00Zl56159 , ..... .,_, 2939§Hl;rjawaul7 M11rrieOsJn!et "' 29576 3-652011 •'l l 40792 1017

DOU6CM93 " " 5W DMs!on 748 kfnt11r 1001oc,newtroOdOrive """'"" lX 77070 Z-&1011 6/1 ioJ.7 407" 'W14/2017

~DOU~, -~?L!?_ N~hvU1 6'8 "'""' 1820 Rcu1m~Sta111 - - TN 31748 t-&,011 6(1 ffl17 40794 61l4/2017 r- - ----j """"""' 01nn~1 3S °""' 8,0 Kr<'l:>f!r 3)70BcltLh>QRo~ Addbcn "' 7S00l l-13L2017 """ SIZ720t7

002016B9G !\'2717 706 Smtm,fQCd&Oru 271 Srnb:MM2rkot1 111?WeU400SOurh l._.,flll<!"nltl UT .... , l-3272017 • !29 2017 4ml!O <,;2712017

00ll7""8 ..-.iJ!UJ7 .. ,.,.. 679 Kr1..-er 475:IAtlantaHw'I. l,.lrunwHle GA """' ~6212017 , .,,.,,, ~,-.,,;,,JJ.1 --DOU""60 Clndnna1.~'D. "' Kwr,er 10101~dir.tW~ Mlirrusbur OH 45342 4-6212017 f,/28/2017 '°""' "'1'17.2017

0027.51362 lhl15,t7 " ci .. onna1 "' .,_, 130-Rnilion p~,....., on "' 41011 l•GZU017 7 """" 6/27201.7

!·-~ii= ~1s11, 16 Columbvs '" l(rr,n,r 9!i5_f'~arSt ...,_., OH 467611 2-6212017 6/2.3/1.017 """" 6/77/l.017 .. " 615 """"

,.. °""m 700NMaiSt EIOor300 kS G?OU 7-&212017 n1l1011 40804 (IJ27o'l017

OOU66813 117 Co!ombt!i .. , Kr•""'r ~5!)Qnln,,..,lload Wei;lenlllle OH 43081 l·bl4mtr """" ~Zl.2011

DOD64744 13 7 CllldMld1,10-.0l'I 441 "'·~ 3420T~8!wd MsddlttOWll OH 45005 2-6132017 ...., f.d.71017 00216 .... '" """""" ~

.,, Kf,.,.,,r 2n&EMilmSI Smln.rtitld OH """ 3-692011 """ •>'271017

D0116Z14J 7 16 Cobr,hus .. , ,._, 4S33Manrao>Strtt'1 Tall!do OH 43613 1-691011 1 7 40812 272017

"°"""'" " " Z4 louh.'ti!~ ,,. •=• 4501 Outer too~ loub¥11Jt "' 40219 1-3292017 1 ''"' ""'' ?7 2017

D01117'77S """'" "'" Smith's m Smilh'sMarb>t.,W::e 565 Sotrl h MIii Dnve ..,,,,. UT .. ,.,, 1-522017 19/2017 <0116 .il!J:2017 DOn7Q:D 06/'JJ/17 11 ,..,.... ... "'~- U\141trM,;11~v, North A1lrmt1 SC "''" 8-6212017 2017 40846 " -1

DOl1'61 .. 1J',"'2ll17 It '"'"" .. , .,,_ 1295Towt1elake~ Woodu"" GA 30189 t-6211017 '""" _,

0017 •1

=- «.t.:1111 11 ""'"'' "" 16850ldPerdMMaHRttad Jtffcinon GA 30549 9-6212017 lVW2017 """ ,017 D0200'M7i 01 11' 17 " °""' 8,0 Kr ... ---er 37708M Une Road Addison "' 7'001 2•HH011 f./[9'2017 .... , Jll>'.2017 ., ocm"""' 17 ,. 'SNCIW!SKJrt "' K,..,....rM.-tdPbQ i01611ba!itrttl Mom=m1i, lX 77356 2-652017 " '""

_, 715/2017 ' ~

D02Wal5 04/03/17 Cflnlral ... ..... , 8130huSoulhDOJtR~ l..clia.wDOI~ IN ..,,, 3-<43201} Z017 .... , .>017 .z D02D'7172 "" " "'""

·-.,. ltro>M,Mario:«,..,.,.e 46'50W'1f.t ,._,ff lX ''"8 1,3132017 (,/ 2017 40871 ]TU Ql)"

00?!!:~~ !!6.-'re'17 " .,..,n~-...._ 13/ ;;;;s..,;,s; 3731 ;; .... r- ---• ft •• ~ Sfrf,..,,_ Tl\ i•.366 l-01220H Ji?) ~Ui/ """ l!HilOtl ., ..

DO:U9Z150 07/fK,/17 6ZO Kin SooPH'S m ICinit 5,oo.-,, 7SONRid,,..R!).id C.ulleRo<k 00 8<>!04 71 201.7 408T] 7•17/2017 ., 4 00H9Z1«J 07/Ui,JJ7 620 ., .. liti:-,~~ UIEi7Shl!ridanB!vd lln~mtreld 00 """" 71 2017 '"'"" 7 2112017 -4

DOUH161> 07P-~J7 6lO kln :soo-rs ,.,. ,.. n 7915ConstlMianAve Cobr.adoS, 00 80951 1•772017 ,on '"'" 7/21./2017 l 0021,.m 17 21 Centrat 71 .._. 21115 wash~n -- , . ""'' 4-752017 717/"1017 """' 7/Z4/'1Dl7 -1

0021 .. 521 Ct1111.~ ""' !Cr,,,..., tiOSNCm:ooROid icot.omo ,. ..,.,, >152011 71112017 40901 7h4/2017 •1

""""""' 17 21 Cenlral [00 Krc_, 7U)lEIC1hSI t~larwu:.:i!l'5 "' ..,,, 6-'152011 717Xlt7 40902 7/2412017

0021"'756 05 12/17 " ., .. ... K,,-, 41Stimebroot"'-e J;Kban TN 38305 2-S.Ul0l7 7!18/20J7 """ ]},s/2017 ., 0021'1"" 05,2'117 "" 1Un11Soa.-n. 71 200 351:hAw G,_, 00 """ l-5242017 72.t2017 .,.,. 7 2U2017 -1 -4 0021,_ OJRR 17 610 Km Soo,.,,.,,. ""' 0h1MBketl 508EMalnS1 "'"" 00 81321 2-710Xll7 11nn011 .,.,. 7 311201

0021 ..... 06 30" Om.ral '°' K,= 5aJOE7UtST Jr,dla~i,,,!15 ,. 46Z20 7-752017 7/242017 4(l'J24 ? 3112017

0021""'5Z 01 /17 " °""' 484 '"'"' 775Plcbn:k51 Savannah ,.. 38."1 14--752017 "7/201' "'930 """' DO<IJ9J603 07 117 6'0 !':in SIXl'Vn 403 O• Marki'h 128ST end An M°"'= "' 81'40l S-7n017 7 3J!2017 '"''·" Dm151241 " ,. MdAllan!it '"" 11:rn,,a,r Z23TheCrOl. .,,,_ WV ''"" 1-662017 1 o>Ml 2017

DOZl<J7551' ., " 14 CmdnnatVO~ton 4'4 ,._ 9001USK1.rtr,w,1,42 "'""'

.., 410i1 >1111017 ,V3H10t7 -· Z Z017 .z l><>209t2Z3 04 17 17 Cffilr~ .. , "'"- ~11 Madison Ave tnd,;in-•Us '" .. ,,, 1-4172017 1 ,...,, g a/2017 .z oozm,az ffl 11 " ""a ... -~ 2200fM~ Mlilolhlan TX

_, 1-8152017 9,U,'2017 ,...., 'JI Z017 ..

DOm6692 61' ..... "' ,....,, 505N lS5thPIL °"'"'' .. '""' 9/11/2017 Ui866l 9}10/'2017

0021Jffl3 '" °'' "" QJr~liti, Food Cf!ntpars 851 O.Uo11hh· Food c .. n1•r 22828 UXllhAwW S!ruoo.t, WA 98020 S.6212017 .,~,,017 1"""' 9,-1rul()t7

00l117"" 17 ,. NashYOe "" '"'"' 44COltbanan Pike Hermit~• TN 37076 6-6232017 91112017 , ... ,. 929'7017 -4 0021,.,., ~ l ', 25 o,h, ,.. «- 6S60 F,iula, A,ern.111 Memrf115 TN 38138 l•S122017 9/l8/l017 16861? 9 !8/2017 ., 0021!1164Z 07Ul7 ., ... Dilons 8&28.Wt~SIN

_ .. " 67:212 t-713W17 &nnru1 ...... g Ja.,zo11

D0119!fl!IO 07 l7 .,. Olb .. Ollo~ 6UlW61hSI Juattlonot .. 66441 2•7132017 "" "'"'' 9 111,2017 -1

DOZZ0093' 07 1417 620 ~~I'!; " • .... 50'.>EBromh-,lane Briarhton co "''°' 3-7112017 8/7no11 1 ..... 9 ~l:1017 ·1 DOZ!,_ "' " lot11$Vd!e ""' (romr SGa e~, .. ,H Road Brandenbur KY 40Ul8 7/2l.'!i2017 7119!2017 1 .... , g~rZOl 00,:,40G6 0!1 Ul t7 " Mlr.hl-r,m ,,. 8StlSMonroe51 -·~ W1 43161 l-8122011 9118/2017 Ui8688 9'29/2017

"""""" ~1 " "' M1tt>i..a11 ... l(ro,.-, 1000Mgn,011Blvd , .. ~ M, 48180 1-a22:Kll7 918/J0l7 1li8688 9 29' 2011 -1 IIOZ,""45 06 18t17 "' Mlr:hm..ri ,,. ,, 16450 26 Mile Road Mattmh Ml ""'' l-8J210U 9,]111017 1"683 9129no11 -1

~ 08 IK/17 18 MJchl",111 Kr n 22t0 E" 11 MIio Road RoalO# Ml .,.,., l-a:221011 911112017 1 ..... 917'11.tal] -1

D0Z24006 Oil 1Nl7 18 Mlch'-Qn "' " ''945N[uclidAwe ..,o., Ml 48700 1-&21201' 9 lS/2017 1""'8 9'29!2011 ·• IIOZ24064S 08 IK/1] 18 P,h:hr~illl .,, Kt<" r 2910CfflterAve Essex.ville Ml ... ,., 1-8422017 918 2017 , ..... . -1 ---- -,,.,,,....,. GI 18/17 " Mith~n 738 ,, 4612St.iteSt -.. - M, """' 1-8222017 9 t8">Ul7 1 ..... 91241'2()17

DOZ1tl8511 06iv.J 11 34 !.WD!VIMcn "" 2150 ~D1M studln« ~Jll11tfl TX ,,,.. 1·612017 8302017 ,...., 10 , DOZ186100 QG .. "'1il7 ,. MldA!lantk "' "~ llOOFledder,ohnftoad Chan...,~ WV 253l4 2•71j2017 91 2017 168707 10,lll/20i7

D0>2017M 0118-/17 620 ICUttrSOOl"t'~ 4S ~ .. 0 123SOW64thAve .,,.,. co .,,,.,. 1-7192011 81 017 1G8706 10/11/2017

DOZ219519 ()l!l,()!•t7 14 unt:in~\ID.-11n 833 2001ett.eAve <irP.-en,,,,!J,i. OH 4~331 1.a12011 . "'" 168703 lfl/1212017

== :::,~~~j'"~ r- ~1~. Round,"sCb~ .. , MB1illno's 345WROOH'i!!llJwe Lombard n 001'11 2·912016 10/6/2017 1Ei87l0 10J12nfll7 -1

DilllA '" ,,_ 2Ul9Hilrwood~ Bedford Ill 7fl0210 2-a25Z017 ?~-wlllacMse 16&117 10116/2017 .. -2 "6"--

DOZ194751 07 10 17 CelltTd: '" ,,_ 9799£ U61:hSr """" '"

..,,., 1-7102017 104nn17 1(,8716 101',[2i;,17 ., -.. , 0011/17 la1,1lsvltlf! ,,. "'~' 12SOlstielmtleAoad Mldd~owr,_ "' .40243 lfl3l"2017 168741 w,.o nrm]7 .7 -· 06'3tM7 Ccntnil .,. ••= 444S ElOl.hSt tndianai,ult:; IN . .,.,. &-75Z017 WJ1Sll011 16874~ " 0021ama C6 30 11 Central .,, Kr'-'"1!r 4~025East5t 1111!~-.::tlis " 46W ~752017 1nr2Snn11 16874] lO'lO!l017 ·1 D02186789 06130•11 " Central .. , Kr~r 10450 E Wa,h:n«"!on 51 lndAna~ll5 "

...,,. 10-752017 168741 " ·1 IIOZllS107 (l!./15/17 ,. louisvi!"° T05 1Crf;\\'!IM.arir.t11,lace 8901llchrnoridPl.iu '"""""' KY .,.,. mn•smn1 ,..,., 10/.31/2017 -1 00 ...... , 09!11117 ,.. ....,.. JSG kl""'1'f 12S01Shet .,.. Mldd!Hc.,,n "' 40743 2"9112011 '""l 2017 168"8 IQ/31'2017

OOZl ..... /17 )1)8 Smith's 706 Smith~ 600E'201h5l Faminrflon NM 81401 l-751017 to'25/l017 1687&3 l0/31fl017

oou .... ~ 00>1E806 ooumu! D022G111J f 09,13 1' 00,.,.,.,, D91317 00,,.,.,, 09,n,11 DOU618H 09jUIH

00.u,1°" Clln8h7 0013116!17 09.,..317 OOU1168& 09h317 DO,.,...., 09113117 OOU61506 1ll'J817 002261007 09..m/17 00l3""2J 11/06117 •

0023""1 U.105'1.7 00"7SJ11 l2-'TT4'17 DO,,_ 11/06/17

t DOl.U6i84 I 1t/06J17 DOZ33eM 11"" .. .,

DOllJ6004 11/06/17 001''69111 11,ry11

00"""" 1 7 I 001.336991 Jllnl./17 ! OOU17151 rs.113/17 D0lll7J8D UJ/13/11 DOZ32!1m 10/31/17

00- 11n11 00 .... lll> 11/1817

00"°"°' om111 DODumn mn•11 0012ZS815 00/04/17 001225819 17 OOZ3""9l Jl/06/17 .Q9~ - J2M711;7

OOZ3S"'50 U/18/U ~-D0~~11'90 0,/1:1/17

DOZ:Jl11V2 09 1!117 • DOU!I0970 1 ,,

00......,,. 00/27/17 -0024- 0118/18 oou,a;a ,.,. 002452562 l . oou,_ ' . 001514'40 18 00, ...... 3/>0lll 001511683 . DO ....... " ' D024U76Z 1119/2019

-~-~ _l/_39/2D1~

Mk~n

''"'"" ~ Mlchl ,m

[email protected]

MldAlllntlt

" MldAll.111111:t

" Mlcl,1Ulall1k. ,. MidAILlntlc

" M.ldAtlanlk 620 IO 35 O.Uz 35 o,o.. 35 o,u..

" Ot't1 620 "'' -= " Mll,-Albnlk 21 Cent,ad '1 Centr'11

" MG-A!~lk ,. M!d-Allaiillt

" Mld•Allarttk 29

~ ,., m m .. , m ,., IM

lJ~----~~!!M.~Road ~l_!f~ __ _j_._~ l-- 48076 -l,..J.:.w1~11_j Jl/6f!0..1_7_ L. __ 1~773 tr< r lJ85EM;ifnSI D;irwi!le IN 46122 12•~2011

970NMortonStnet l'l".-,Hln IN 4:6131 ll-75:Ml17

l",o,,;er _lf,11'.l'iFortllStrft't. :;o...i:h.11,11~ 4819'> 1.-10162017

~~; ·~=~A- ~i:~: _::V ~: 11-752011 tOJll/:~ l ~=: I ~J=~ ll'rfJr'(:t 111Milttltlllll.erll:m J161vd ~h!W KT 41Wl - ilJ31/")(l17 168780 Jl/JU10l7 Kls...-111r 302 Great,,..,.... Blvd Stott D<-1'<.f WV :nsso 10 11!2017 168780 11:~ '2017

328 1 l(r.,;;mo, 166tE Stene Oroive lCinr<r.nt1 Tl4 31660 1 2Ql7 16878:0 11' 'MOITT7

400 JCro,,:s, 614 Bnndon /w<e SW __ Roanoic. _ V~~ 2,fQtS • • _ __ ~ _ 10(11/2017 168780 11 7 1 II'#• SOo•,en. 5125Wflor1daA11e Oen_. CO 80Zl9 2-8222011 ~·18/2o11 168785 1,IK/2011

sn ICN?fi!• '1001,~m;eP•-L_Plano__ _ TX __ 7502S ________ T80 t688ttl 1112'~17

824 l(rO)!<~r \Ul20Nloylnt'fl~ Sh@fflUHI TX _ 7S090 --- -- 1filL__ _ 1~: 11/?9/'2017 490 ICrartet '205USHtfi-.ya-v19S !Henderson Tl( f 156511 TBD t&aa ., 624 ICl'l!f':fl IOO'lWM.lln5t R1rt.w!MIIP AA 71AOI 1-JU92fl17 1Ul1 :>017 11ill

lO IClnnSoo= 3400Y-our>meld SI Whei!tftidr.e co f !,OCBJ 11 n11zu17 1688£0 T U'lt 2011 325 ltr,-.r SOSO!tutll4!n.Av• Ro1110ke VA 2-COll l.6886S n1um11

OU~ M .. e.-.o1,mc:nt~t132.f1Narth5hado?l.am! I~:,,;,!~ IN 462M 168812 11113 Ml11,

!9l~_td1M:l!t'!MlltW-hou-iil.d!NorthSh~lano:I rncianu,.,lrs. 'N....L. 467~_ 1"871 _!_J..!_O_/1017

~ _ [ !!burn / VA j 24502 168866 J '11/Yl1$}!_7 ~v ••Vffl!' 12716JefftrwnDMS~ Ch~ter VA 23831 168866 12..:.!}.8(l......Q_

ICrq;er t&H~rkRoitd Sales VA 2.4153 L6B8f,6 1.f'l.Jt'1017

,§

_, :,

Md-Atl.srtic

" 'P.12 1 t::rciar 2.627SthAvt- HunU,,:ttOl"I Wi 2S'°2. --+--- 1.61186& 12/ 17

29 Mid-AtlaJllit 399 t t::rco,r SOW<$14eR~ Ha.r~ VA 2U01 1&8:866 12 t3 Z017 1 T -7

i--

<: -:;

29

" MICl..,.,._lil{)llt - MidAllinlk : ::: •:::=:::na~ :~~ ~: !:!~ 1-1002011 ~= !~:,:~; .i .i l .i .1 j .1 i " o,u,,,

" o,i.,

" ColumbllS ,. lrJtliMUt

" """"" " COiumbus.

" Columbm.

'10 l(iM~r,

" l(j,,,.-=:r.=n

" Md-N.i..ic

580 ...:it

51.2_

ICR:li.f'r ;4&51 lt ,_,, Dt fl'-ltm TX 7!;0M TOD 161sS8£ 1?_119/2.017_

IID{ier

KrOfl!rM~la~

_!!!5!!._ ~--~~.,

l:rlllfler

2011Littlq£lm~ .. 226£PefkJnsAi.e

18a1AleranlffiaD111#e

~~!~Ift~il03

Lilli• £Im r,: 1~ TIID 16S887 1 i.t 5.andm.t' OH 4487() t-1122011 17 • 168904 U/2&/2017 leiln ,on KY 40504 1•1122•2017 U 17 168922 --.,-,

!Charles.lOWll IN 47111 2·12191017 1689:M U/29 2.017

46335\zderAve Toledo _ _OH ~~-2.:P.1()P ~1 CANCEU_EO CAN_g__!,_LEO --OH- 43228 7,1242011 1".ANClllrD CANO:UE0

KlntS~,t;B ~==~~_____QL_ 8052.l 2-eno11 (Atl_(I_!_l_(0 ~lLE0 B 36COTablo!!MesaDrlfto Bouldet

~~~-- .,..___ 190IEmmetSTN " ---~~ ,, MliAt~tk 29 MliAt~tk 1S2 l P.irkermur

29 Mic1At11111k 35 ! """' 35 o.a..

"' SW°""""" 106 ,.,.., 35 O,b, .. ..,,.....,. " .......... Z4 lo .......

14 ......... "' Mid ...... ,. .. ~-14 andnnat!i~ Z4 '°"""'" .,.

,. __

I 730 Elli:lns 536 FortWorth

- fr 136 Conroe - --------1-1032.017 '" ,..,,. 3~_ ~

592 950 m7 "'° I ...-,.. iii Fo m_.~ 137 1_ 1(1

1600Nllith5t

~ 4009 Pllpt.r'-:!Roed 4009 Po@- I.ewe! Roal

1DEil'tl.Grwwsir.t 7805Tlrnberl,bbd l491Northa.-ridRo.ad J715E10th5t U967G.ndaln~

-.. IArU~ :an~

1~~Sll!!IJe I: Lou!~

' .,,, ~---rvi"

:,m~Ue t ':: -· co

MmOV

76017 J.119201B ,mo 2SOS3 -- _ 1-29201~

«JZll-1523 1•362018

-taZU.1525 1.J62018

:ZSZ71 1·Z521J1.8 24502 l·UIZ018 45:!!Jg

mio 80Cl05 1 1-..ua

ia

l/l_W9Is

j/i9/Z018 iiiiiiiii 3J5/l018 ~ .t/Jn017

~ 111_11~a

168969 :;.;:.;;.; ~ imia man 1,.,.. 16iiii rniii iiii'i9 16illO 'iiii46 169147

L,ij72018 Jn/MIUI

,ii Jl}.7/ZOl.8

Y..Z:!1.Z01JJ

~--t-- -7

~ ~

-1

';i

~

j

_, -=i

C")

al.

f o <lf C:OuQ...-r JJrvD /(/l,;6 !.e S"°VMM~Rf

IMPORT tMNSACTIONS 8,G;H,l,J r•= ;PO Number r

I Full Pallet Security Cages /319S-1060

!small Security , Kroger HD \Kroger HD \Kroger Pallet )kroger I Kroger 11 x 1? ,Large Security Cages 3195- \sidewalk Nesting 3493, Pallet 3493- cage 3308- \Nesting Cage !'Slgnholder 2959-

jcage ~~~-1020_:_1000 1Secur1tycages _ 1000 ~000 1060-01 13309-1000-02 521

Import Trans B JPurchase Import Trans H iPurchase

Import Trans J _ ;purchase _ Import Trans I Purchase Import Trans G \Purchase TOTAL IMPORTS

lEZIDONE 1sss2\ 801 !Xlamen King ~964· !XlainenKlng 1 1S96_5 ... I ----

~E21D0NE -115946/1584?/15948; IE21DONE

j _I

80

b,es ,::lAJ✓o I~ £$ .

75,

jf

IClrcieK llNV40608 .-------· 41

~Tc>wn~Ur:r!L 11'4V~66_ ;__ , 1s! -~· ;TO!ln_!u111p~ ~t:"'_4()_875 __

1 ____ lS_j 131

:Jackson'sF~~s\lNV~9 __ ,; 2] __ 1 Kroger 40701 i

--· 40704i - __ , ---· 40705\· ______ ,___

40706;

40707\

~08[ ------i --

·---- - -, :~:\ - _____ .,.... ___ _ 4071li

-, -~21 : 40713i i- --4<>.±W

______ , ___ [

: ____ 40715[

. --· ~~~t · ----~:1_1~;r-- ----·---

-----· ~407191

1--

·---- - :~~ ---1 -----·--___ 40722t-· _ .

40723

1--- --·l ·----+-----· 407241·. 40725 40726:--

i . 40721 1---- ----

_____ .;._ ____ ! -4iins1 ·---

- --- -:~~i\ ~73~

-------1

i---

40732i

-,m.mL 1--·

40734!

t-

isl I ---

- !L_ ·-•

~L 105 --,

-- i I "'i30 .

4 --20:

lS

20

101

2

-··2

2

2

1001 --·100

=E'___ 1' . -•

----1

125, 125

400

400

14 29 3B

_ __ -_1: ______ 1

1' 1 ----,r· ··- ·- - -~-

2L

,--

---,-------~- 2

j

2 2 21 2 --,

1:

l, ---ii

l 1 __ , ___ _ l

-

,---·----2 1 2

---· ---·

-I

2 -----. -----___ 2: l'

1 l.

21

--r _, ______ _

=t-- 2' -

1 1 1

-L-------1

~ .. 11 ±= -~;

1: 1, •·-1~-- __ , - ---11

1

1 l

1

., If,,

4013s\ __ L I 40736 --- I ' -+-

=1= 1 _ ~mC ---4----- L. -· ------ '.. --- 1 l _____ ,

---·--;

2

2 I

401381 I ___ 1 _ · ----+-------!---40139 --- I -'-------1--------

1 ' - ----«i~~\ -- _), _____ · --~------ Fi_-. ---\

-~ _ _--1 -----.\---- 40741 I ·--- _ __]_ ___ _

. 40742\ + i \ 1' _,.__ -

1-- I ----. _4;?7431 l ------'------ 40744 ... _____ _

'---~745\ -·

~746 ---~ ·- -40747

· --· 407481

---·--. - ---=--·; __!!I. --- -· ------, - 407~1--

' --- --- 407631

------ ----- 407641

1,

1: 1\ 4( 11"

4;_ -- ' ------1 ---1- 4~-

.. - \--- - 4· '·- -1~--- : _,j __ - 1\ . - : ~;-===t----.t-=-:..--7 -~~ :1 _;

,- l 407751 ---- _3 __ _ l __ 40~m.J_------ __ _ . 407781 ------ -

40784 - - -- ----!-----

-- i -- . ''!"' ---~L-

·•----£=--5_ -r -)~ , - } -- J~-~ --i

-------4- 1 -~ =---±==i1

k·- --2 . . ,- ___ ,._ f

: 1 I ____ ti ~-- 2

,_

___ _ - 40~93\ ----, - _ 407941 -----

' 40803,

}-I ] ·---------..----- -- !~~I I 40808;

________ L 1---1~:~l ______ J ·--=---~-- 408l_3J

-- , 40842,

--- 408441 40846

-7 --40!S47r---

40853; ---- I 40871,

----·-- =E -_ -_j --- ~:;'.---- ·I•

-a897. . ....._ ____ ---40898\ _____ - __ , 11------;--- 409061

I -40913! ----' 409141

-ri-

---i

I _, ___ 2!

--, ' -- ·- -----1 - -----, --t-------- ·- 4 - 1 -~ l---- ------ 1 __

I , 1 l ------- 1• 2 - -- -----~:,~ -- ,t . - 1}

·=:__----=:t___ ----- I -· -=-._ ____ ±_,

2 2 ----~

-----------2 - .- l; ~ - _...:.,. ___ 2 . - ~,- - ; i;

. --- ,1 -------1 .. ---l----1 2

T ,1 - .--2: - ------- ---, . ' 2~ 2 ----

-

1

i _ 2, - .. --I ---~-----I

! ----c--· _____ , 31

-----L---------- I ---··----~,._ ___ 2_1 --- 2

2 ------· ---2r 2----i 2 1 2 2

u, I ...

r

! ___ _ i

AMD ASSET PURCHASE

TOTAL SOLD 7--

409301 4093-1\ 40942i

!------- ---- 39f=-==s2'. ---~1-78 .. 74 129

101

. :.i 20

2,

2

_1 __

2,

2

2' 2 ---- , __ ·----2: 7f .1- •

I 100

-3..r _____ 2

45_,

li4

214

376

Cf ...

-!

EJICHIBIT G

ASSETPURC~SEAGREEMENT

This Asset Purchase Agreement (the "A enf') is made and entered into this ~day of August, 2017 (the "Effective Date'i by and

RECITALS

A. Samaritan Display Group, Inc. ("Samaritan") is engaged in the business of designing, manufacturing and seJJing point-of-purchase display and retail merchandising solutions (the ''Business").

s: Samarlt:an assigned aJJ of its sissets 'to Seller, as Assignee/frustee, under that c.ertain Trust Agreement and Assignment of As.sets for the Benefit of Creditors of Samaritan Display Group. Inc~, dated Au~29,2017.

C. Seller desires to sell to Buyer, imd Buyer desires to purchase from Seller, substantially all of the assets, properties and rights used in the (>peration of the Business on and subject to the tenns and conditions set furth in dlis Agreement

NOW 1HEREFORE, in consideration of the promises hereinafter made, and o1her good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties agree as follows:

1. Purchase and Sale of Asset11. On the terms and subject to the conditions set forth in this Agreement, Seller hereby sells, assigrui, convey~ transfers and delivers to Buyer, and Buyer hereby purchases from Seller, all right, title .and interest of Seller in and to the following assets that are used or useful in the Business ( collectively the "Assets"), free ·and clear of any liens, claims, security interests, encmnbrances or other n~trictions of any nature whatsoever ("Liens"): (a) all · computer equipment, software and accessotjes, office furniture, equipment, to.ols and toolin& molds, dies, prototypes, supplies, the trade show booth and related materials and other tangible personal property that is used or useful in the operatfon of the Business (collectively, ''Tangible Property'1; (b) all finished goods, work-in-process, raw material and other inventories of Seller, including the Kroger, Forecourt and Office Depot inventories (collectively, the."lnventory"); (c) all sales and marketin~ materials, brochure designs, mailers and photography; (d) the contracts with Kroger Company and Office Depot, the open purchase orders listed on Exhibit A and any other contracts of Seller specifically elected to be assumed by ]Buyer ( collectively, the" Assumed Contracts"); ( e) all rights of Samaritan under any confidentiality, non-competition and/or non-solicitation or similar agreements (including rights with respect to similar provisions in any employment agreeµtents) with any employee of S~tan; (±) all Intellectual Property used in connection with the Business and all goodwill associated therewith, including all patents aµd patent applications, websites and domain names, designs and engineering drawings; (g) all prepaid expenses (including any trade show entzy fees), security deposits and other deposits that are attributable to the Busi~; (h) all business records, including, design files; production tiles, customer and vendor, database information and other records. documents and books of accol.UlLt relating to the Business, including all lists of present, funner and prospective customers and vendors, pricing infon:nation and sales records; however, Seller shall be granted reasonable access to si:dd business records for a period of twenty-four (24) months after the Closing, upon reasonable ~otice, for proper pUtposes such as administration and

G-1

a·

BILL OF :gALE AND ASSIGNMENT

Thi$ BJ~ OF SALB AND ASSJGNMENT (''Agreement•~ is made and delivered effective le~.ie,t, \ \.-~.2017 (the "Eft'~ve Date'), by Tailwind Services, LLC ("Seller''), to and fo:r t · . nt.r11. of AMO lndus1ries. Inc. ('"Buyer''), purs.,Htffl if;, and subject to the tenns of, that certain Asset Purchase Agreement dated.August 29, 2017 between Buye, and Seller (the "Purchase Agreement"). The capitalized tenns used but not defined herein shall have the meanings ascribed to them in the Purch11~ Agreement

To carry out the intent and pu~pose of the Purchase Agreement, Buyer and Seller are executing and delivering this instrumentt evidencing the vesting in Buyer of all ofSeJJer•s right, 1itle and jnterest in and to the Ass!ts on the terms and conditions set forth in the Purchase Agreement.

NOW, TiiEREFORE, subject to Md in accordance with the terms and conditions of the Purchase Agreement and for good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties agree as follows:

1. Assets to be Transferml. Subject to the tenns and conditions of the Purchase Agreement, Seller hereby sells, assigns,, conveys, 1ransfers · and delivers to Buyer, and Buyer hereby purchases and aecep1s, all ofSeJh:,r's rights, dtJe and interest in and to the Assets, ftee and clear of any and all Llens.

2. Purchase Agreement Co111tro1Hng. Notw:ithstanding any other provision in this Agreement to the contrary, nothing contained herein shall in any way supersede, modify, replace, amend, change.- rescind, waive, exceed, 1mlarge or in any way affect the provisions. incJuding warranties, covenants, agreements, ~nditions, representations or, in general, any of the rights and remedies, or any of the obligations, oif Buyer or Self er set forth in the PurclJaSe Agreement This Agreement is subject to and controlle1d by the terms of the.Purchase Agreement.

3. Counterparts; FaeslmHe.s. This Agreement may be executed in counterparts, each of which shall be deemed to be an i:>1iginaJ. b1.1t all of which together shall constitute one and the same lnstl"tlment, and shall become effective when one or more counteiparts have been signed by each of the parties and deliVimd to the other party. The signature page to this Agreement may be delivered by facsimile or other electronic transmission and the signatures thereor:i shall be deemed effective upon receipt by the intended receiving party.

4. MJsceUaneous. SeJler co1fenants and agrees that it wiU, upon the request of Buyer, do. execute. acknowledge and deliver, or cause to be done, executed, acknowledged and delivered, all such further acts and docUllll~nts as may &e reasollably requested by Buyer for the purpose of completing and confttming allJ assignments and transfers made here1.1nder. This Agreement shall inure to the benefrt of Buyer. its legal representatives, succeSS01'$ and assigns, and shall be binding upon SeJJer and its res1~ectfve legal representatives, successors eno .assigns.

[Signature Page Follows)

G-2

IN WITNESS WHEREOF. Buyer and Seller have executed this BiJI of Sale and Assignment on the date or dates Indicated below, effective as of the Effective Date.

SELLER:

Date; -----iilll~IZi: ~: L..-:.\'),,~)i>,.,;:.:_l '3::::.s.._· -__ _

AMO Industries, lnc.

··~.!~ , ~ ,i .. Qi- J By. r._ .Y ~ .. David E. Allen. President/CEO

Date:-~" /,~l...;;..'1-.,_/...:...i'-..;;;.b .... l 7"--. ___ _

r1

DMS 10774871 vi

2

G-3

Item II 1020201 1020202 1020203

1020205 1020207 1020208 1020209 1020213 1020214 1020215 1020216 1020217 1020218 1020219 1020220 1020221 1020222 1020223 1020225 1020226 1020227 1020229 1020230 1020231 1020232 1020233 1020234 1020235 1020236 1020237 1020238 1020239 1020240 2360-551·552SL 2360-6000CHB 2368-530T 2368HBS 2368HBT

IJJ),T / '7'°v-1 5 Sot... D ( f"/

.I.J5Sf,' Pv e c (,-l.,d5'i- !JG, e 1£€.#1~

Description KROGER INVENTORY

~ge#7_ -~ Auto SnaclCCa6'inet #8

Nestl11g Cap ll .. __ RIM

Canopy

Bollard

Corner Graphic Kit

Rplcmt Shelves RIM

Rplcmt RIM Hooks

Rplcmt RIM Large Side Sign

Rplcmt RIM Commodity Signs

Rplcmt RIM Shelf liners

Rplcmt RIM Under-cabinet lock Only

Rplcmt RIM Under-cabinet Key Only

Rplcmt RIM Slide Lock Door lever

Pallet Cage Door Set

Rplcmt Pallet Cage Feet

Pallet Cage Plexiglass Sign Cover

Rplcmt Nesting Cage Wheels+CAPS, 4 each of 2 diff. per set Nesting Cage Doors

Rplcmt Auto Snack Cabinet Shelf 10" Gen 3 Replacement Doors

Mouse Protection

Rplcmt Nesting Cage Door Brackets 2 per set

Rplcmt Auto Snack Door Glide & Hinge

Nesting Cage Small Liners

Nesting Cage large Liners _

PalleVNestln~ TOJ? Mount Sltm Holder, ~

=Paltef/Nesting Cage Side Mount Sign Holder

Rplcmt Auto Snack cabinet Gen 5, left and right

Rplcmt 12" Auto/Snack Cabinet Shelf, 1 per carton, GEN 5

Additional metal wire shelves and liners for nesting cage gen 2

Rplcmt llx7 plexiglass clear inserts for nening/pallet cage

Window wire rack shelf liners kit for 20" and 30" black

Nesting cage hardware bag

Pallet cage clear graphic holder, tan

Pallet cage hardware bag, silver

Pallet cage hardware bag, tan

Total Kroger Inventory

Onhond Value/Ea Total Value 7 $421.40 $2,949.80

so~- S341.25 s11,062.so 45 $307.36 $13,831.20

0 _, $4,807.00 $0.00 1 $3,467.72 $3,467.72

20 $60.81 $1,216.20 14 $81.22 $1,137.08 1}'. $21.89 $240.79

201 8

$7.91 $1,589.91 $0.00 so.co

i 8 6

s 4 g

11 80 19

4: 81 21

0, 99' 25

112·

176

~!~-=-' 145

10. 38 84 70 15

1 19

8

?.1.

$0.00 $0.00 $35.02 $280.16

$0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

$96.68 $2,030.28 $73.SO $0.00

$0.00 $0.00 $26.22 $655.50 $25.49 $2,854.88 $26.15 $4,602.40 $14.80 $3,167.20 $13.45 $1,950.25

$147.00 $1,470.00 $0.00 $0.00

$64.86 $5,448.24 $4.49 $314.30 $0.00 $0.00 so.oo $0.00 so.oo $0.00 $0.00 $0.00 $0.00 $0.00

$64,268.41

APA Sale Prlce Sale Price : EHtended

$421.00 $2,947.00 $128.00 $6,400.00 $307.00 $13,815.00

$0.00 $0.00 $0.00 : $0.00

$60.00 · $1,200.00 $41.00 : $574.00 1 $21.00 , $231.00

$1.00 $1A07.00 $0.00 $0.00·; $0.00 , $0.00 i

$35.00 : $280.00 $0.00 : $0:00 I

$0.00 . $0,00

$0.00 $D.00. $0.00 $0.00 ' $0.00 $0,00 . $0.00 $0.00 $0.00 $0.00 $0,00 I $0.QO I

$0.00 , $0.00 : $0.00 : $0.00 $0.00 i $0.00 ; $0.00 $0.00

$13.00 : $325.00 : $8.00 ; $896.00 ' $8.00 i $1,408.00 $7.40 \ $1,583.60' $6.00 $870.00 .

$49.00 . $490.00 ; $0.00 : $0.00 ·

$16.00 : $1,344.00 . $4.49 $314.30 . $0.00 i· $0.00 ' so.oo · so.rio $0.00 • $0.00

$0.00 $8.00 $0.00 $D.00

~34~:9_0

,. C,

FORECOURT MARGINS AND INVENTORY ( Pve~ u.o~ P)

Part No

3195100001A 3195100001B 3195100001A 3195100001B 3195102001A 31951020018 3195105001A 3195105001B 3195106001A 3195106001B 31951060HOW 319550001S 319551001L

rnADt..tr-f"'\A Uf'V'\Dl'tUV-,

Description

~!'itjJt~ui:ity Cage.~ . ,~ •-~~ ... ~••◄~.•~: :•: •.l" • •. ' -• ~, _f• ..

~~!!lr~~~,~ge~~~?- _,. ,t.

~~~0.$eJ;~~f■r··;·~ i , •• ,,J)O, ~,~. , "O~ - •• C · ;,:r,. •\:, '••. ·f : {$'ID.iJ!tS.ecur~g~-. . ., <- j

ti~_:,~~u~itv-~'k1~1ibfFf ,.. . ~u~·=~a,¢""~;•~~·· · ~--~ .·-,,. cA.;q;_,. ·-·~· 1 ''.;;.:Mfge-'Seturify.£ag~. · "n--2· ·

Full Pallet Security Cage Heavy Carton 1

Full Pallet Security Cage Heavy Carton 2

~~11;:.~~llart~~ , ~ "-~"-~' ~:::~Dia(r~t!~n i~·~: ; j Hardware Bag Full Pallet Security Cage

Small Cage Cart Assembly

Large Cage Cart Assembly

(.;r;:ih and Go 4" Unit

GRABNG08 Grab and Go 8 11 Unit

3569-1000-01 REV A flj'gw~~~ir.5°i

Total

NOTES

Current

Job No Cost

3486 $ 213

3486 So 3536 $ 252 3536 3486 $ 274 3486 3195 $ 505 3195 3486 $ 391 3486 3486 3486 3195 $ 78

3220 $ 4,750

3220 3595 $ 330

Current

Quanti~ Value

~~ $3,415 M. so • $16,128

$0

• $14,236 $0

5 $2,525 5 $0

~1a9\~ s1s,2s1 :~~~} $0

0

0

8

2

$0 $0

$624

$9,500

$0 $3,296

$64,974

APA Sale :< -~:-·f .. ,7!.·:_;:. ,.•·t''~ ~ , 'APk•~;~-~1n~ l ~!!!lg Exten,

$180 1::;~:r "/'t-;r'f{ia'b! $ 360 $ ...... , : • .At!::-:-··· •• I-. · • ..,; ., _:., · so· s

$180 :.)~( .· .. • $-i~,s-ioj $ 360 $

fJf ,,. --.. ! >so: s $223 ~ •'' · . $11,59.~ $ 446 $ :.r:. ' .·' .. t'.f·so: $ $337 ~;?:::.: , · ,, $-l~~s.' $ 625 $ . . ' ,,,. s

625 $

s $

$

$

r,

) ' '

353 $

$01::tgt; $ 4,00 '

$165 :);~;_ :=· · .. $1,~50, $ :;1-;_~~! ··. .r-- , --~-~ i ,.

1::. ~,- . .~\ ,7/ . . ·J ,;.~:;::'_ .: ': am· -~ir, -;_ ... :... .. . . ··- ·-- -~ :" ~-

~~~~~Ol~l~~ - Illinois.gov

Documents

Transcript of ~~~~~Ol~l~~ - Illinois.gov