SS9901-CS040624T H B C I T Y O
P.O. Box 478
255 Parkway Blvd
Coppell, TX 75019
Phone: (972)304-3679
Fax: (972)304-7041
ENGINEERING DEPARTMENT
FAX COVER SHEET
To: Ben Bishop / Mastec From: Suzan Taylor
Fax.. 214-571-2555 Date: June 24, 2004
Project No: SS 99-01 Line 'D" Pages: 2 (including cover sheet)
Re: Tax Exemption Certificate cc:
[] Urgent [] For Review [] Please Comment [] Please Reply X As Requested
.Comments:
IF YOU DO NOT RECEIVE ALL OF THE PA GES PLEASE CALL (972) 304-3679
ty of Coppell Engineenng- Excellence By Destgn
TEXAS SALES AND USE TAX EXEMPTION CERTIFICATE
CII~ OF COPPELL
255 PARKWAY BLV]),, P.O. BOX 9478
COPPF3.T.. 'I[']~.IEAR 75010
972-422-0022
I, the purchaser named above, claim an exemption from payment of sales and use taxes for the purchase of taxable items
described below or on the attached order or invoice form: -
Street address: &7&7 TRVTNC: R13/1~_ ~??] Cily, State, ZlPcode: I~A1.T.A.q. 11[.1[AR 752&7
Description of items to be purchased or on the attached order or invoice:
CONS'[?.UC'~T01~I OF DEFOREST ROAD LIFT STATION INPROV]~6gI~$ FORC~ NAIN LIl~
Purchaser claims this exemption for the following reason:
14UNICIPAL GO~
I understand that I will be liable for payment of sales or use taxes which may become due for failure
to comply with the provisions of the Tax Code: Limited Sales, Excise, and Use Tax Act, Municipal
Sales and Use Tax Act, Sales and Use Taxes for Special Purpose Taxing Authorities, County Sales
and Use Tax Act, County Health Services Sales and Use Tax and the Texas Health and Safety
Code: Special Provisions Relating to Hospital Districts, Emergency Services Districts, and
Emergency Services Districts in counties with a population of 125,000 or less.
I understand that it is a misdemeanor to give an exemption certificate to the seller for taxable items
which I know, at the time of purchase, will be used in a manner other than that expressed in this
certificate and that upon conviction may be fined not more than $500 per offense.
~lgn &
ere ·
_ _ FINANCE DIRECTOR 23, 2004
Note: This certificate cannot be issued for the purchase, lease or rental of a motor vehicle.
THIS CERTIFICATE DOES NOT REQUIRE A NUMBER TO BE VALID
Sales and Use Tax "Exemption Numbers" or "Tax Exempt" Numbers do not exist.
This certificate should be furnished to the supplier. Do ~ot send the completed certificate to the
Comptroller of Public Accounts.