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Home My WebLink AboutFlorida Department of Highway Safety & Motor Vehicles-1985 04 08 ~ r .~ . Ii ~ ~-~\~TE~ I-l_. ~~(j ~'l "~u'''''''''>'';:,'i '."" '< f I ~ U . I ) ; .~'>w . "'," / .../ \, ~~, ~. .,;, ~:"-t~::1'i~~~'. " CITY OF WINTER SPRINGS, FLORIDA 400 NORTH EDGEMON AVENUE WINTER SPRINGS, FLORIDA 32708 Telephone (305) 327-1800 April 8, 1985 Mr. Billy B. King Motor Vehicle Tag Administrator Dept. of Highway Safety & Motor Vehicles Kirkman Building 2900 Apalachee Parkway Tallahassee, Florida 32301=8209 Dear Mr. King: Enclosed please find application for certificate of title and registration and City Tag for a new truck for the Building Department for the City of Winter Springs. Enclosed is the Certificate of Origin, Certificate of Motor Vehicle Sales Exemption and City check in the amount of $12.85 to cover costs. If there is any further information you may need, please let me know. Thank you. Yours very truly, CITY OF WINTER SPRINGS ~7~ Mary T. Norton, City Clerk enc. DR-41.A Rev. 4-1-76 NOTE: Purchasers holding. Certificate of Exemption, such as state agencies, counties, etc., or when vehicle is used for rental exclusively should use this form. The purchase of motor vehicles to be offered for rent as living accommodations does not qualify for exemption. CERTIFICATE OF MOTOR VEHICLE SALES TAX EXEMPTION Date 4-8-85 I certify the motor vehicle described below has been purchased by: Check One -X-A person holding sales tax certificate of exemption. -A business for use exclusively for rental purposes. and is exempted from the sales tax imposed by chapter 212, Florida Statutes. CHEV lIIake 1985 Year FLEETSlDE T}'pe lGCBS14E9F2l6l4l2 CSl0603 Engine or I.D. l\umtll'r ~Iodel Starling Chevrolet. Inc.. p.a.Box l150,Kissimmee, Fl. 32742 l\ame of Seller Address City Agenc}' or Organizntion By RICHARD 04-00195-00-69 1. 400 N. Edgemon Ave. Address Certificate of Exemption No. 2. This space to be completed by purchaser of vehicle to be used for rental purposes: NOTE: The purchase of motor vehicles to be offered for rent as living accommodations does not qualify for exemption. Sales Tax Reglstrntion No. "E" Tag No. Firm Name By Address HSMV 8,~,091 (Rev. 9/84) TEMPORARY TAG NO. 1:- d (3 8 Y 3 STATE OF FLORIDA DIVISION OF MOTOR VEHICLES DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES NEIL KIRKMAN BLDG. - TALLAHASSEE 32301 STREET AND NUMBER y1tlt THIS IS TO CERTIFY THAT '-t6~ ~. (j HAS MAIJE APPLICATION FQR.MHTBEEN ISSUED A TEMPORARY TfG. 9J:L.... ~ S- J) NOT VALID ..-/ J-r k ) AFTER I } MONTH DA Y YEAR MONTH DA Y YEAR HE FOLLOWING DESCRIBED MOTOR VEHICLE: MAK' 0",'"'''.' 5-( u 11~ 0,"00' L~ ( 1/ V IDENTIFICATION <{ tJl~AiUji DEALER LICENSE By ADD~)S'~F DEALER SIGNATURE OF APPLICANT...--- /7lf'~' -i-P ....;; INSTRUCTIONS This form must be carried by APPLICANT and shall he in his possession at all times while vehicle is being operated with the temporary tag. This is a temporary permit issued to applicant u, operate with temporary tag for a period of not more than twenty days from the time of issuance. TEMPORARY TAG MUST BE DESTROYED: 1. Upon reeeipt of regular license plate. 2. At the expiration of twenty days r!'gardless of whether or not r'egular license plate has been received. PEN A LTY: Any person unlawfullv using any such temporary tag or violating any rule or regulation issued by the Division of Moulr V ehides pursuant to this Act shall be guilty of a misdemeanor, and upon eonviction shall be fined not more than One Hundred ($100.00) Dollars or imprisoned for n(\t more than thir.ty days, or both, in the discretion of the Court. DUPliCATE .. .. '. j U) w ..... U :c "" > a: Cl ~ Cl_ :ECl CO) u., N Cl CO) Zc ClCl 0- _a: >Cl -..... Clu., uS.... ww .....(1.) U(I.) -c ::C::c Wc >..... a:..... ClC ~1- Cl , :Eca OtJ!: >-C1 ~= W;:) u., CD Cz (l.)c >-E c:!ll:: ~a: ::c - ca:!ll:: =..... u.,Q ClZ ~ Z W :E ~ a: C CL. W CI APPLICATION FOR CERTIFICATE OF TITlE TITLE NUMBER AND/OR VEHICLE REGISTRATION STATE OF FLORIDA Owner's Name Sex & OOB Tax Stamp 1. C 6/30/85 DLH 2. 400 N EI.mM)N AVENUE City or Town DLH 3. WINTER SPRJR;S FL 32708 Hereby states that he, she, or it is the lawful owner of the following described motor vehicle and makes application for Iclllcll 011I . IIIlIIJ CERTIFICATE OF TITLE 0 VEHICLE REGISTRATION 0 MAKE YEAR TYPE 4. CHEV 1985 FLEEI'SIDE AUOIT State Prev. Registered ~ . ~ => > . '" Date Graded By Transaction Code 5. GVW MODEL IDHlTIFICATION NO. 19 FLORIDA TAG NO. 6. WEIGHT 2673 BHP CLASS CODE 7. Above described vehicle acquired by !'URCH']I..5'1<' (purchase, gift, trade. inheritance, ete) from STARLING rnwROLET mc P 0 EOX ~1t~Q) VISSJM.1FE FL 32742 (Name) (Zip) Application will not be accepted unless the following lien statements are completed. I/We certify that all liens on this vehicle are listed below LIEN HOLDER LIENS 8. If no lien write "None" above STREET ADDRESS DA TE OF LIEN 9. CITY AND STATE (Zip) 10 SIGNA TURF. O~ APPlICANT(S) THIS VEHICLE WILL 0 WILL NOT 0 BE U THIS VEHICLE WILL BE USED as a TAXICAB 0 U-DRIVE-IT 0 LO CI'IY OF WINTER SPRn:x:;s Subscribed anO S~orn to bef~re me at in the State of ~ (Signature of Persons Signing for Applicant) JC,I~<<""""Q1 Winter ~pri ng"'. This 2 day of llPQTT. , 1~l:i Notary Public ~:r ~~ATE Of FlOIllOo\Ai:':- D t C " . WllQN'IIL40 I a e ommlSSlon expires · DEALER'S CERTIFICATE AND TRANSFER I hereby certify that the motor vehicle described above is a new !I used 0 vehicle and was acquired by me from CEEVROLET MY.rOR DIVISION WARREN MI 48090 (Manufacturer, Distributor or Former Owner) (SEAL) (Address) and hereby tranSferpt m~~title and interest in the said vehicle to _ CITY OF WINTFR SPRIOOS 400 N EOOEMON AVE WINI'ER SffiINGS (Dealer or Purchaser) (Address) I hereby warrant title to the said vehICle and certify there are no existing liens except as shown in this application. I further certify that the sales tax imposed by Chapter 212, Florida Statutes, upon this vehicle has been paid by the purchaser thereof. Amo Sales Tax Collected $ -0- Sales Tax Reg. No. 59 05 00136 23 Deal IN - By Dealer License No 5VF 0 HSMV , .' HSMV 84091 (Rev. 9/84) TEMPORARY TAG NO. 1:- d r3 8 Y 3 STATE OF FLORIDA DIVISION OF MOTOR VEHICLES DEPARTMENT OF HIGHWAY SAFETY AND MOTOR VEHICLES NEIL KIRKMAN BLDG. - TALLAHASSEE 32301 THIS IS TO CERTIFY THAT q..\. ~J ()U >t()V STREET AND NUMBER HAS MAIfE APPLICATION FQR ..MHrBEEN ISSUED A TEMPORARY T ~G J-( .J J) NOT VALID ,./ J-r K ) AFTER I } MONTH DA Y YEAR MONTH DA Y YEAR .. ~ES~~;~ irE VEHICLE MAKE OF VEH>CLE ~ OF BOD> L~ ( <(I V By IDENTIFICATION <( tll~ALiUjEt DEALER LICENSE , ,gs OF DEALER SIGNATURE OF APPLICANT""""""': -# /7lf/" ~... INSTRUCTIONS This form must be carried by APPLICANT and shall be in his possession at all times while vehicle is being operated with the temporary tag. This is a temporary permit issued to applicant to operate with temporary tag for a period of not more than twenty days from the time of issuance. TEMPORARY TAG MUST HE DESTROYED: I. Upon receipt of regular license plate. 2. At the expiration of twenty days regardless of whether or not regular license plate has been received. PENALTY: Any person unlawfully using any such temporary tag or violating any rule or regulation issued by the Division of Motor Vehicles pursuant to this Act shall be guilty of a misdllmeanor. and upon conviction shall be fined not more than One Hundred ($100.00) Dollars or imprisoned for n('t more than thirty days. or both. in the discretion of the Court. DUPLlCATE . . STAALIII *** ------ CHEVROLET 4425W~ P.O. Box 1150, Kissimmee, FL 32741 SOLD TO: ADDRESS: CITY: PHONE NO: if> 'NEW OR j YEAR E : -.-USED. + S I C I R NEW i 1985 ~ I 'T I I I o N CITY OF WINTER SPRINGS 400 N EJ::X3EMCl\T AVENUE WINI'ER SmrNGS, FL 32708 P.O. 001585 MAKE MODEL CHEV CSI0603 FLEEISIDE 7448.40 TOTAL CASH PRICE P SALES TAX :U : LICENSE 8. TITLE R COLLISION INSURANCE ,C MECHANICAL BREAKDOWN INS. 'H CREDIT LIFE IA DISABILITY S DOC. ST AMP E FINANCE CHARGE S TOTAL TIME PRICE P TRADE ALLOWANCE A 7448.40 .TRADE PAYOFF 'Y ,CASH DOWN PAYMENT M I . E iTOTAL OF PAYMENTS i N TOT AL TIME PRICE :T CAR INVOICE NUMBER: DATE: SALESMAN: STOCK NO: 11157 4/2/85 menfield 111 161412 CDL 8989 SERIAL NO. 1GCBS14E9F2161412 ,EQUIPMENT 8. ACCESSORIES ADDED OR DELETED - PAYOFF TO: , iP"AYME~TS TO: ._' (SEE CONTRACT) DATE ~IlIVOICE NO. 03/20/85 lA014722101 VEHICLE IDENTIFICATION NO. YEAR MAKE' IGCBS14E9F2161412 1985 CHEVROLET BODY TYPE SHIPPING WEIGHT FLEE TSIDE PICKUP 2673 HP (SA E.) GVW.R NO. CYLS. SERIES OR MODEL 25.6 3785 04 CSI0603 N.T.R. S.D.C.W. CAPACITY H.P.(J245) 1/2 TON 1834 N/A 092 I, the undersigned authorized representative of the company, firm or corporation named below, hereby cer- tify that the new vehicle described above is the property of the said company, firm or corporation and is transferred on the above date and under the Invoice Number indicated to the following distributor or dealer. NAME OF DISTRIBUTOR, DEALER, ETC STARLING CHEVROLET INC POBX 1150 4425 W VINE ST KISSIMMEE FL 32742-1150 It is further certified that this was the first transfer of such new motor vehicle in ordinary trade and commerce. - CHEVROLET, MOTOR DIVISION ..GENERALMOTORS..CORPORATION. - - BY: - 04624 (SIGNATURE OF AUTHORIZED REPRESENTATIVE) 30007 VAN DYKE. WARREN.MI 48090 CITY - STATE , . cr'1'V 01-' \m~ ~p~S CUSTOM.R'. HAMI: ODOMETER MILEAGE STATEMENT i ... l , \ \ , I \ \ 1 1 .. I j' ,w,!'.. i' ' :.... , DECLARATIONS .. Agreement No FML 149 FLORIDA MUNICIPAL LIABILITY SELF-INSURERS PROGRAM I. NAMED INSURED City of Winter Springs Address 400 North Edgemon Avenue Winter Springs, FL 32708 II. COVERAGE PERIOD III. . ._ ... ....... ....... ..t '... '. t. From October 1, 1984 1200 Mldn.ght Standard Time September 30, 1985 to COVERAGES LIMITS OF LIABILITY FOR ANY OR ALL COVERAGES OR ENDORSEMENTS x ComprehenSIve General Liability A BOdily Injury B Property Damage C Personal InJury Law Enforcemenl Llablllly x ENDORSEMENTS $100.000 - Each person $200.000 - Each occurrence x X X X X X X X X X X X X X Automob.le lIab.llty Completed Operations and Product Hazard Contractual L.abillty (Designated Contracts Only) Public Oftlclals Errors and OmiSSions $ 35.000 Uninsured Motorost Protection Combined SIngle LimIt of LIability Watercraft L.abil.ty Host LIQuor Law L.ablllty Inc.dental MedIcal Malpractoce LiabIlity Owners' and Contractors' Protective Llab.llty PremIses MedIcal Payments Fire Legal LiabIlity MedIcal' Atlendants MalpractIce $ 1.000 $ 50,000 Each Person $ 10.000 Each Acclcent EaCh Occurrence Personal InJury Protection X Other Auto Medi ca 1 Payments Broad Form Property Damage $ 2,000 Each Person Est,mated Annual Prem.um 25.373 s ,. ... Pro Rata Premium (P, R s