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Home My WebLink About974893STATE OF WYOMING COUNTY OF TETON CONTRACTOR'S LIEN STATEMENT s s. 974893 1/9/2014 11:00 AM LINCOLN COUNTY FEES: $57.00 PAGE 1 OF 16 BOOK: 826 PAGE: 580 LIEN STATEMENT JEANNE WAGNER LINCOLN COUNTY CLERK 111 111111 III Hill IIII II 111 IIIII III I IIII 111 I Hi 1111 111 1111111 111 1 Glenn W. Myers, Attorney for Ferguson Enterprises, Inc., an Idaho Corporation, 1524 Martin Lane, Jackson, Wyoming 83001, the lien claimant herein, does hereby swear and affirm that the following statements are true and accurate to the best of his knowledge: 1. I have personal knowledge of the matters set forth herein and am duly authorized to execute this Lien Statement. 2. Ferguson Enterprises, Inc. contracted with Cowboy Custom Plumbing, Inc., of 3200 E. Wildhorse Rd., Jackson, Wyoming 83001, as subcontractor for FIDC XXX LLC d/b /a Shopko, an Ohio LLC, of 100 Debartolo Place, Suite 400, Boardman, Ohio, 44512 -6099, for delivery of plumbing materials and supplies and related materials on the following described real property, known as: Shopko 679 S. Washington Ave. Afton, WY 83110 More particularly described as: Old Fair Grounds Addition, Lot 13, Town of Afton, Wyoming. 3. The said work was furnished pursuant to a written contract, a copy of which is attached hereto. 4. The work performed for said improvements on the land described above is described in Exhibit A attached hereto. 5. With all just credit being given, there is now due and owning a total sum of Six Thousand Seven Hundred Ninety Seven and 34/100 Dollars ($6,797.34), which amount is accruing interest at 1.5% per month since October 31, 2013. 6. The last day that materials were provided to the Project under the above referenced contract was October 13, 2013. 7. The name and address of the owner of the above described land upon which the services were furnished is FIDC XXX LLC, 100 Debartolo Place, Suite 400, Boardman, Ohio, 44512 -6099 as determined from the Lincoln County Assessor's Office. NOW THEREFORE, Ferguson Enterprises, Inc. claims the benefits of the Statutes of the State of Wyoming relating to contractor's and materialman's liens on the real estate and improvements thereon, said real estate being hereinabove described to the extent of the amount of property allowed by the laws of the State of Wyoming, for the payment of Six Thousand Seven Hundred Ninety Seven and 34/100 Dollars ($6,797.34), together with interest thereon at 1.5% per month since October 31, 2013. IN WITNESS WHEREOF, the Claimant has hereunto set his hand this day of January, 2014. SEAL PAT MICHAEL Notary Public Teton County, Wy i g My Commission Expire- ii Ferguson Enterpjs�es, Inc. By: Atto ey at law Subscribed and sworn before me Glenn W. Myers, on this day of January, 2014. Witness my hand and official seal. Invoice Number Customer Page SC35430 64868 1 FERGUSON ENTERPRISES, FEE #3003 586 N LOCUST GROVE MERIDIAN, ID 83642 -4083 Please Contact With Questions: 208 376 -6660 Please refer to Invoice Number when making payment and remit to: FERGUSON ENTERPRISES #3003 PO BOX 802817 CHICAGO, IL 60680 -2817 Sold To: COWBOY CUSTOM PLUMBING INC SHOPKO PO BOX 7451 JACKSON, WY 83002 Invoice Sub -Total Tax Total Amt PRINT DUPLICATE INVOICE Deliver To: From: Rristina Ratliff Comments: Ship To: TOTAL DUE 99.58 Ship Whse 3119 Ordered Sell Whse 3119 Shipped Tax Code Customer Order Number SERV CHGE Item Number Sales Person Job Name Description Service charge Unit Price Invoice Date 11/30/2013 UM Balch Amount 99.58 ALL ACCOUNTS ARE DUE AND PAYABLE PER THE CONDITIONS AND TERMS OF THE ORIGINAL INVOICE. ALL PAST DUE AMOUNTS ATTORNEY FEES IF INCURRED. FREIG TERMS ARE FOR OUR DALLOWED LLESS OTHERWISE PLUS COSTS ABOVE. COLLECTION INCLUDING T N CONDITIONS ARE AVAILABLE UPON REQUEST OR CAN BE VIEWED ON THE WEB AT http: /wolseleyna .cam /terms_condittonsSale.html GOVT BUYERS: ALL ITEMS QUOTED ARE OPEN MARKETUNLESS NOTED OTHERWISE. 99.58 0.00 99.58 TOTAL DUE 99.58 AMOUNT DUE DATE CUSTOMER 11 PAGE 64868 1 6.797 11/29/2013 1 ',FERGUSON ENTERPRISES,INC: 586 N LOCUST GROVE MERIDIAN, ID 83642 -4083 Please Contact Wlfh Questions: 208- 376 -6660 COWBOY CUSTOM PLUMBING INC SHOPKO PO BOX 7451 JACKSON, WY 83002 99.58 6,697.76 PAST DUE AMOUNTS ARE SUBJECT TO A FINANCE CHARGE AT THE MAXIMUM RATE ALLOWED BY STATE LAW. PRINT DUPLICATE STATEMENT AMOUNT PAID IMPORTANT T O INSURE PROPER CREDIT PLEASE INDICATE INVOICES TO WHICH PAYMENT APPLIES AND RETURN A COPY OF THIS STATEMENT WITH YOUR CHECK TO: FERGUSON ENTERPRISES #3003 PO BOX 802817 CHICAGO, IL 60680 -2817 This document does not represent a total account statement for this period. INVOICE DATE Job: 64868 09/30/13 10/02/13 10/08/13 10/08/13 10/11/13 10/11/13 10/31/13 11/30/13 INVOICE NUMBER Warehouse 3003 SHOPKO 1200955 1202623 1198882 1202626 1202477 1205210 SC35175 SC35430 CUST. ORDER NO. 1200955 1202623 1198882 1202626 1202477 1205210 SERV CHGE SERV CHGE SubTotais: CURRENT 99.58 PAST DUE 3,930.49 318.02 721.85 267.41 930.24 470.79 58.96 INVOICE DATE Job: 09/30/13 10/02/13 10/08/13 10/08/13 10/11/13 10/11/13 10/31/13 11/30/13 INVOICE NUMBER Warehouse 3003 64868 SHOPKO 1200955 1202623 1198882 1202626 1202477 1205210 SC35175 SC35430 AMOUNT 3,930.49 318.02 721.85 267.41 930.24 470.79 58.96 99.58 TOTAL AMOUNT DUE I 6,797.34 "'FERGUSON EN7'ERPRISES,INC: 586 N LOCUST GROVE MERIDIAN, ID 83642 -4083 Please Contact With Questions: 208 376 -6660 COWBOY CUSTOM PLUMBING INC SHOPKO PO BOX 7451 JACKSON, WY 83002 99.58 6,697.76 PAST DUE AMOUN1S ARE SUBJECT 10 A FINANCE CHARGE AT THE MAXIMUM RATE ALLOWED BY STATE LAW. PRINT DUPLICATE STATEMENT AMOUNT DUE 6,797.34 AMOUNT PAID i DATE 11/29/2013 FERGUSON ENTERPRISES 83003 PO BOX 802817 CHICAGO, IL 60680 -2817 CUSTOMER 64868 This document does not represent a total account statement for this period. PAGE 1 1 IMPORTANT TO INSURE PROPER CREDIT PLEASE INDICATE INVOICES TO WHICH PAYMENT APPLIES AND RETURN A COPY OF THIS STATEMENT WITH YOUR CHECK TO: INVOICE DATE Job: 64868 09/30/13 10/02/13 10/08/13 10/08/13 10/11/13 10/11/13 10/31/13 11/30/13 INVOICE NUMBER Warehouse 3003 SHOPKO 1200955 1202623 1198882 1202626 1202477 1205210 SC35175 SC35430 CUST. ORDER NO. 1200955 1202623 1198882 1202626 1202477 1205210 SERV CHGE SERV CHGE SubTotals: CURRENT 99.58 PAST DUE 3,930.49 318.02 721.85 267.41 930.24 470.79 58.96 INVOICE DATE Job: 09/30/13 10/02/13 10/08/13 10/08/13 10/11/13 10 /11/13 10/31/13 11/30/13 INVOICE NUMBER Warehouse 3003 64868 SHOPKO 1200955 1202623 1198882 1202626 1202477 1205210 SC35175 SC35430 sJ AMOUNT 3,930.49 318.02 721.85 267.41 930.24 470.79 58.96 99.58 TOTAL AMOUNT DUE t 6,797.34 Ship Whse Sell Whse Tax Code Customer Order Number Safes Person Job Name Invoice Date Batch SERV CHGE 10/31/2013 Ordered Shipped Item Number Description Unit Price UM Amount Service chorge 88.96 Invoice Number Customer Page SC35175 64868 1 FERGUSON ENTERPRISES, FEI #3003 586 N LOCUST GROVE MERIDIAN, ID 83642 -4083 Please Contact With Questions: 208 376 -6660 Please refer to Invoice Number when making payment and remit to: FERGUSON ENTERPRISES #3003 PO BOX 802817 CHICAGO, IL 60680 -2817. Sold To: COWBOY CUSTOM PLUMBING INC SHOPKO PO BOX 7451 JACKSON, WY 83002 Invoice Sub -Total Tax Total Art PRINT DUPLICATE INVOICE Deliver To: From: Kristina Ratliff Comments: Ship To: TOTAL DUE 58.96 58.96 0.00 58.96 TOTAL DUE 58.96 ALL ACCOUNTS ARE DUE AND PAYABLE PER THE CONDITIONS AND TERMS OF THE ORIGINAL INVOICE. ALL PAST DUE AMOUNTS ARE SUBJECT TO A SERVICE CHARGE AT THE MAXIMUM RATE ALLOWED BY STATE LAW PLUS COSTS OF COLLECTION INCLUDING ATTORNEY FEES IF INCURRED. FREIGHT TERMS ARE FOR OUR DOCK UNLESS OTHERWISE SPECIFIED ABOVE. COMPLETE TERMS AND CONDITIONS ARE AVAILABLE UPON REQUEST OR CAN BE VIEWED ON THE WEB AT hftp:// wolseleyna .com /terms GOVT BUYERS: ALL ITEMS QUOTED ARE OPEN MARKETUNLESS NOTED OTHERWISE. LEAD LAW NOTICE: BRASS /BRONZE PRODUCTS WITHOUT "LF" IN THE DESCRIPTION FIELD MAY CONTAIN LEAD AND THUS NOT COMPLY WITH LOW LEAD LAWS. THESE PRODUCTS MUST NOT BE USED IN POTABLE WATER APPLICATIONS. O FERGUSON FEI #3003 586 N LOCUST GROVE MERIDIAN, ID 83642 -4083 Please Contact With Questions: 208- 376 -6660 Please refer to Invoice Number when making payment and remit to: FERGUSON ENTERPRISES #3003 PO BOX 802817 CHICAGO, IL 60680 -2817 Sold To: COWBOY CUSTOM PLUMBING INC SHOPKO PO BOX 7451 JACKSON, WY 83002 Invoke Sub -Total Freight Tax Total Amt PRINT DUPUCATE INVOICE Deliver To: From: Kristina Ratliff Comments. Invoice Number 1202477 i Customer 64868 Page 1 1 Ship To: COUNTER PICK UP 1524 MARTIN LANE JACKSON, WY 83001 TOTAL DUE 930.24 Ship Whse 3119 Ordered 60 1 Sell Taos Customer Sales Whse Code Order Number Person TDS Shipped item Number 3119 Job Name SHOPKO Description 60 SP -S-5-1J S-5-U CLAMP 1 B 15OUK NLA 'NP 2 BLKM! 150# BRS GJ UNION Invoice Date Batch 10/11/2013 41998 Unit Price UM Amount 14.00 1 EA 21.323 EA i 840.00 21.32 TOTAL DUE 930.24 ALL ACCOUNTS ARE DUE AND PAYABLE PER THE CONDITIONS AND TERMS OF THE ORIGINAL INVOICE. ALL PAST DUE AMOUNTS ARE SUBJECT 70 A SERVICE CHARGE AT THE MAXIMUM RATE ALLOWED BY STATE LAW PLUS COSTS OF COLLECTION INCLUDING ATTORNEY FEES IF INCURRED. FREIGHT TERMS ARE FOR OUR DOCK UNLESS OTHERWISE SPECIFIED ABOVE. COMPLETE TERMS AND CONDITIONS ARE AVAILABLE UPON REQUEST OR CAN BE VIEWED ON THE WEB AT http /woiseteyno.com /terms conditionsSale.html GOVT BUYERS: ALL ITEMS QUOTED ARE OPEN MARKETUNLESS NOTED OTHERWISE. 861.32 16.26 52.66 930.24 Invoice Number Customer Page 1205210 64868 1 1 fiS FERGUSON i? P RI FEI #3003 586 N LOCUST GROVE MERIDIAN, ID 83642 -4083 Please Contact With Questions: 208 -376 -6660 Please refer to Invoice Number when making payment and remit lo: FERGUSON ENTERPRISES #3003 PO BOX 802817 CHICAGO. IL 60680 -2817 Sold To: COWBOY CUSTOM PLUMBING INC SHOPKO PO BOX 7451 JACKSON, WY 83002 Invoice Sub -Total Tax Total Amt Deliver To: From: Kristina Ratliff Comments: Ship To: COUNTER PICK UP 1524 MARTIN LANE JACKSON. VW 83001 PRINT DUPLICATE INVOICE TOTAL DUE TOTAL DUE 470.79 Ship Whse 3119 Ordered 21 105 Sell Whse 3119 Tax Customer Code Order Number WY2TET Description 21 DBPTCA53K 2 8LK T &C A53A 540 PIPE Sales Person Job Name TDS SHOPKO Invoice Date Batch 10/11/2013 41998 Shipped Item Number Unit Price UM Amount 624,568 C 131.76 298.073 C 312.98 1 05 OBPTCA53G 1 BLK T &C A53A 540 PIPE ALL ACCOUNTS ARE DUE AND PAYABLE PER THE CONDITIONS AND TERMS OF THE ORIGINAL INVOICE. ALL PAST DUE AMOUNTS ARE SUBJECT TO A SERVICE CHARGE AT THE MAXIMUM RATE ALLOWED BY STATE LAW PLUS COSTS OF COLLECTION INCLUDING ATTORNEY FEES IF INCURRED. FREIGHT TERMS ARE FOR OUR DOCK UNLESS OTHERWISE SPECIFIED ABOVE. COMPLETE TERMS AND CONDITIONS ARE AVAILABLE UPON REQUEST OR CAN BE VIEWED ON THE WEB AT hitp:// wolseleyna .com /terms_conditionsSale.html GOVT BUYERS: ALL ITEMS QUOTED ARE OPEN MARKERJNLESS NOTED OTHERWISE. 444.14 26.65 470.79 470.79 Invoice Number Customer Page 1198882 64868 1 J 1ERPRISES V FEI #3003 586 N LOCUST GROVE MERIDIAN, ID 83642 -4083 Please Contact With Questions: 208 -376 -6660 Please refer to Invoice Number when making payment and remit to: FERGUSON ENTERPRISES #3003 PO BOX 802817 CHICAGO, IL 60680 -2817 Sold To: COWBOY CUSTOM PLUMBING INC SHOPKO PO BOX 7451 JACKSON, WY 83002 Ship Whse 3119 Ordered 1 Sell Whse 3119 Shipped 1 Tax Code WY2TET Customer Order Number Item Number WSRHMS Sales Person TDS Job Name SHOPKO Description 'CVR' SAN MOD ROOOF HYDS MTG SYS Unit Price 612.840 Invoice Date 10/08/2013 UM EA Batch 41963 Amount 612.84 Invoice Sub -Total Freight Tax Total Amt Ship To: COUNTER PICK UP 1524 MARTIN LANE JACKSON, WY 83001 PRINT DUPLICATE INVOICE TOTAL DUE Deliver To: From: Kristin Ratliff Comments: 721.85 612.84 68.15 40.86 721.85 TOTAL DUE 721.85 ALL ACCOUNTS ARE DUE AND PAYABLE PER THE CONDITIONS AND TERMS OF THE ORIGINAL INVOICE. ALL PAST DUE AMOUNTS ARE SUBJECT TO A SERVICE CHARGE AT THE MAXIMUM RATE ALLOWED BY STATE LAW PLUS COSTS OF COLLECTION INCLUDING ATTORNEY FEES IF INCURRED. FREIGHT TERMS ARE FOR OUR DOCK UNLESS OTHERWISE SPECIFIED ABOVE. COMPLETE TERMS AND CONDITIONS ARE AVAILABLE UPON REQUEST OR CAN BE VIEWED ON THE WEB AT http:// wolseleyna .com /terms_conditionsSale.html GOVT BUYERS: ALL ITEMS QUOTED ARE OPEN MARKETUNLESS NOTED OTHERWISE. FERGUSON ENTERPRISES, FEI #3003 586 N LOCUST GROVE MERIDIAN, ID 83642 -4083 Please Contact With Questions: 208- 376 -6660 Please refer to Invoice Number when making payment and remit to: FERGUSON ENTERPRISES #3003 PO BOX 802817 CHICAGO, IL 60680 -2817 Sold To: COWBOY CUSTOM PLUMBING INC SHOPKO PO BOX 7451 JACKSON, WY 83002 Invoice Sub -Total Tax Total Amt Deliver To: From: Kristina Ratliff Comments: 1 Invoice Number 1202626 1 Customer 64868 Page 1 1 Ship To: COUNTER PICK UP 1524 MARTIN LANE JACKSON, WY 83001 PRINT DUPLICATE INVOICE TOTAL DUE TOTAL DUE 267.41 Ship Whse 3119 Ordered 1 1 1 Sell Whse 3119 Shipped 1 1 1 Tax Customer Code Order Number WY2TET Item Number R37825 R37830 R37835 R37845 R37850 Sales Job Name Invoice Person Date Batch TDS SHOPKO 10/08/2013 41963 Descdpfon 1/2 -14 NPT PIPE DIE F/ 12R 3/4 12R NPT PIPE DIE 12RPD 1 NPT PIPE DIE 12R Unit Price 43.296 43.296 51.436 57.112 57.112 UM EA EA EA EA Amount 43.30 43.30 51.44 7-1/2 NPT PIPE DIE F/ 12R 2 NPT PIPE DIE 12R 57.11 57.11 ALL ACCOUNTS ARE DUE AND PAYABLE PER THE CONDITIONS AND TERMS OF THE ORIGINAL INVOICE. ALL PAST DUE AMOUNTS A1TORNEY FEES F INCURRED. CHARGE TERMS ARE MAXIMUM DOCK UNLESS OT SPECIFIED ABOVE.. L COMPLEETE TERMS AND CONDITIONS ARE AVAILABLE UPON REQUEST OR CAN BE VIEWED ON THE WEB AT http:// wolseleyna .com /terms_conditionsSale.htmi GOVT BUYERS: ALL ITEMS QUOTED ARE OPEN MARKETUNLESS NOTED OTHERWISE. 252.26 15.15 267.41 267.41 Ship Whse Sell Whse Tax Code Customer Order Number Sales Person Job Name Invoice Date Batch 3119 3119 WY21'ET TDS SHOPKO 10/02/2013 41922 Ordered Shipped Item Number Description Unlf Price UM Amount 7 7 IBNGP 1X4 BLK STL NIP 7.964 E4 7.96 1 1 IBNGU 1X6 BLK STLNIP 2.753 EA 2.75 2 2 IBNGCL 1- 1 /4XCLOSE BLKSTL NIP 7.728 EA 3.46 1 1 IBNHP 7-1/4X4 BLK SA NIP 2.465 EA 2.47 1 1 IBNHU 1 -1/4X6 BLKSTL NIP 3.501 EA 3.50 2 2 IBNJCL 1- 1 /2XCLOSE BLKSTL NIP 2.151 EA 4.30 1 1 I8NJP 1 -1/2X4 BLKSTL NIP 2.913 EA 2.91 1 1 IBNJU 1 -1/2X6 BLKSTL NIP 4.077 EA 4.08 2 2 IBNGCL 2XCLOSE BLKSTL NIP 2.928 EA 5.86 1 1 IBNKP 2X4 BLK STL NIP 4.069 EA 4,07 1 7 IBNKU 2X6 BLKSTL NIP 5.487 EA 5,49 2 2 IBNGCL 1XCLOSE BLK STL NIP 7.365 EA 2.73 1 1 RAG60 5L8 TERRY RAGS BDL WHIT 25.630 BD 25.63 2 2 841590 1 QT DARK THRD OIL 11.907 EA 23.87 12 72 M70885 1/2X1429 BLUE MONSTER TEF TAPE 3.525 EA 42.30 80 80 BB22SHGALV20 7-5/8X7-5/8X20 12 GALV H /SL STRUT 205.875 C 164.70 Invoice Number Customer Page 1202623 64868 1 0 FERGUSON ENTERPRISES, INC: FEI #3003 586 N LOCUST GROVE MERIDIAN, ID 83642 -4083 Please Contact With Questions: 208 -376 -6660 Please refer to Invoice Number when making payment and remit to: FERGUSON ENTERPRISES #3003 PO BOX 802817 CHICAGO, IL 60680 -2817 Sold To: COWBOY CUSTOM PLUMBING INC SHOPKO PO BOX 7451 JACKSON, WY 83002 PRINT DUPUCATE INVOICE Deliver To: From: I ristina Ratliff Comments: Ship To: COUNTER PICK UP 1524 MARTIN LANE JACKSON, WY 83001 TOTAL DUE 318.02 ALL ACCOUNTS ARE DUE AND PAYABLE PER THE CONDITIONS AND TERMS OF THE ORIGINAL INVOICE. ALL PAST DUE AMOUNTS ARE SUBJECT TO A SERVICE CHARGE AT THE MAXIMUM RATE ALLOWED BY STATE LAW PLUS COSTS OF COLLECTION INCLUDING ATTORNEY FEES IF INCURRED, FREIGHT TERMS ARE FOR OUR DOCK UNLESS OTHERWISE SPECIFIED ABOVE. COMPLETE TERMS AND CONDITIONS ARE AVAILABLE UPON REQUEST OR CAN BE VIEWED ON THE WEB AT hftp://wolseleyna.com/terms_conditionsSale.html GOVT BUYERS: ALL ITEMS QUOTED ARE OPEN MARKETUNLESS NOTED OTHERWISE. 1 C TER PRISESV Invoice Number 1202623 Customer I Page 64868 2 Invoice Sub -Total Tax Total Amt ALL ACCOUNTS ARE DUE AND PAYABLE PER THE CONDITIONS AND TERMS OF THE ORIGINAL INVOICE. ALL PAST DUE AMOUNTS ARE SUBJECT TO A SERVICE CHARGE AT THE MAXIMUM RATE ALLOWED BY STATE LAW PLUS COSTS OF COLLECTION INCLUDING ATTORNEY FEES IF INCURRED. FREIGHT TERMS ARE FOR OUR DOCK UNLESS OTHERWISE SPECIFIED ABOVE. COMPLETE TERMS AND CONDITIONS ARE AVAILABLE UPON REQUEST OR CAN BE VIEWED ON THE WEB AT hffp://wolseleyna.comiterms_conditionsSale.html GOVT BUYERS: ALL ITEMS QUOTED ARE OPEN MARKETUNLESS NOTED OTHERWISE. 300.02 18.00 318.02 TOTAL DUE 318.02 Invoice Number Customer Page 1200955 64868 1 Ship Whse Sell Whse Tax Code Customer Order Number Sales Person Job Name Invoice Date got 3119 3119 WY2TET I TDS SHOPKO 09/30/2013 41899 Ordered Shipped Item Number Description Unit Price UM Amount 105 84 DBPTCA53K 2 8LK T &C A53A S40 PIPE 482.292 C 405.13 5 5 PF88CG 1 BRZLEV HDL 2PC GAS BV 14.745 EA 73.73 60 60 SP -S-5 -U S-5-U CLAMP 14.000 EA 840.00 I 1 BRCJH 1-7 /2X1-1/4 BLK MI 150# RED COUP 6.429 EA 643 2 2 BRCKF 2X3/4 BLK MI 750# RED COUP 10.670 EA 21.34 3 3 BRCKJ 2X1-1/2 BLK MI 150# RED COUP 9.315 EA 27.95 5 5 BCAPF 3/4 BLK MI 150# CAP 1.914 EA 9.57 5 5 BCAPG 1 BLK MI 150# CAP 2.314 EA 11.57 2 2 BTHGG 1-1/4X7 X7 BLK MI 150# TEE 9.776 EA 19.55 4 4 BTHHF 1 -1/4X 1- 1/4X3/4 BLK MI 150# TEE 8,369 EA 33.48 2 2 BTHHG 1-1/4X1-1/4X1 BLK MI 150# TEE 9.071 EA 78. 74 3 3 BTJJG 1 -1 /2X1 -1 /2X7 BLK MI 150#TEE 10.563 E4 3 1.69 20 16 B9F 3/4 BLK MI 150# 90 ELL 1.687 EA 26.99 4 1 BTKKF 2X2X3/4 BLK MI 150# TEE 16.552 64 16.55 3 3 BTKKG 2X2X I BLK MI 150# TEE 16.552 EA 49.66 3 3 BTKKH 2X2X 1 -1/4 BLK MI 150# TEE 17.820 EA 53.46 O FERGUSON ENTERPRISES, FEI #3003 586 N LOCUST GROVE MERIDIAN, ID 83642 -4083 Please Contact With Questions 208 376 -6660 Please refer to Invoice Number when making payment and remit to: FERGUSON ENTERPRISES #3003 PO BOX 802817 CHICAGO, IL 60680 -2817 Sold To: COWBOY CUSTOM PLUMBING INC SHOPKO PO BOX 7451 JACKSON, WY 83002 Ship To: COUNTER PICK UP 1524 MARTIN LANE JACKSON, WY 83001 PRINT DUPUCATE INVOICE TOTAL DUE Deliver To: From: Kristina Ratliff Comments: 3930.49 ALL ACCOUNTS ARE DUE AND PAYABLE PER THE CONDITIONS AND TERMS OF THE ORIGINAL INVOICE. ALL PAST DUE AMOUNTS ARE SUBJECT TO A SERVICE CHARGE AT THE MAXIMUM RATE ALLOWED BY STATE LAW PLUS COSTS OF COLLECTION INCLUDING ATTORNEY FEES IF INCURRED. FREIGHT TERMS ARE FOR OUR DOCK UNLESS OTHERWISE SPECIFIED ABOVE. COMPLETE TERMS AND CONDITIONS ARE AVAILABLE UPON REQUEST OR CAN BE VIEWED ON THE WEB AT http:// worseleyna .com /terms_conditionsSale.html GOVT BUYERS: ALL ITEMS QUOTED ARE OPEN MARKETUNLESS NOTED OTHERWISE. Invoice Number Customer Item Number Page 1200955 64868 2 I Ordered Shipped Item Number Description Unit Price UM Amount 25 25 89G 7 BLK MI 150# 90 ELL 2.932 EA 73.30 5 5 891-1 1 -1/4 BLK MI 150# 90 ELL 4.833 EA 24,17 6 6 B9K 2 BLK MI 150# 90 ELL 10.962 EA 65.77 4 4 B 750UF "NL4 'NP 3/4 BLK MI 150/1 BRS GJ UNI 7.105 EA 28,42 5 5 BCF 3/4 BLK MI 150/1 COUP 2.265 EA 11.33 5 5 BCG 1 BLK M1150# COUP 3.390 EA 16.95 5 5 BCH 1 -1/4 BLK MI 150# COUP 4.394 EA 21.97 5 5 BCJ 1 -1/2 BLK MI 150# COUP 5.937 EA 29.66 4 4 BTF 3/4 BLX MI 150# TEE 2.681 EA 10.72 5 5 BTG 1 BLX MI 150# TEE 4.592 EA 22.96 5 5 8750UG 'NLA "NP 1 BLK MI 150# BRS GJ UNION 9.256 EA 46.28 5 5 BCK 2 BLK MI 150# COUP 8.791 EA 43.96 4 4 BRCHG 1-7/4X7 BLK MI 150# RED COUP 5.086 EA 20.34 4 4 PF88CF 3/4 BRZ LEV HDL 2PC GAS BV Z765 EA 28.66 25 25 FNW7873Z0075 3/4 IPS PLTD RIGID STRUT CLMP 1.218 EA 30.45 35 35 FNW7873Z0100 1 IPS PLTD RIGID STRUT CLMP 1.400 EA 49.00 78 18 FNW7873Z0125 1 -1/4 IPS PLTD RIGID STRUT CLMP 1.442 EA 25.96 18 18 FNW787320750 1-1/2 IPS PLTD RIGID STRUT CLMP 1.596 EA 28.73 18 18 FNW7873Z0200 2 IPS PLTD RIGID STRUT CLMP 1,918 EA 34.52 147 147 DBPTCA53F 3/4 BLK T &C A53A S40 PIPE 158.372 C 232.81 210 210 DBPTCA53G 1 BLK T &C A53A 540 PIPE 230.172 C 483.36 105 105 DBPTCA53H 1 -1/4 BLK T &C A53A 540 PIPE 299.652 C 314.63 105 105 DBPTCA53J 1 -1/2 BLK T &C A53A S40 PIPE 358.720 C 376.66 O FEIRGUSON Freight Tax Total Amt ALL ACCOUNTS ARE DUE AND PAYABLE PER THE CONDITIONS AND TERMS OF THE ORIGINAL INVOICE. ALL PAST DUE AMOUNTS ARE SUBJECT TO A SERVICE CHARGE AT THE MAXIMUM RATE ALLOWED BY STATE LAW PLUS COSTS OF COLLECTION INCLUDING ATTORNEY FEES IF INCURRED. FREIGHT TERMS ARE FOR OUR DOCK UNLESS OTHERWISE SPECIFIED ABOVE. COMPLETE TERMS AND CONDITIONS ARE AVAILABLE UPON REQUEST OR CAN BE VIEWED ON THE WEB AT http: /wolseleyna.com /terms condltionsSale.html GOVT BUYERS: ALL ITEMS QUOTED ARE OPEN MARKETUNLESS NOTED OTHERWISE. 3665.86 42.13 222.50 3930.49 TOTAL DUE 3930.49 y of License Held State Name of older Helder t Number Expiration Date .d 1 1 u/Y ,e� C.4$44, 44 4G )D 3 �,a, U 4 G 1 fi''1 dl t .7 j �•1 84/26/200 ''6 22086580306 Name r ".1 t�" o Y N.I i FER 'IWQUOTE I7 Q New Applicant I X Update Branch Mail or Pad Credit A Bastion To; 125 S. GREGORY LN 1 PO BOX 13048 JACKSON WY 33002 307-734-2674 'AGE 03 Phone 7 6 t 1 o Fax .20 7 2 t"7 1 Street Address CIry frGs, C &ems State Zip glee/. Mobilel?ager„y7 670 Email Yesl please send me special Wets and updates vie email. List the year of anybankruptcy or insolvency by principal/off or any affiliated corporation MC, partnership or business. Silting Address (if different from above) Are Purchase Orders Xssued? City Stare Zip Are job names required? 6N Sales Tax Exemption State, Please attach an exemption certificate for each state. Special Billie Instructions !I f�" 4 ka co w .+a:•Y ✓i,� 1 r• 1 r ta i I s Angle Family t 11 rcial cal PVF Waterworks D' ulti Paraily C R C g Q Other DV Residential-Remodel Industrial PV Govtmmant Estimated Monttil$ Volulae t Date Business Started 119 No. of Employees T` Surety/Bonding Company Don of taco oration /793 .3 State of Xnoo Clrc1 Nei E 3(a 2 Rev) AT ii?finfillii 4'11Q'011$M 'acfarn tiavlurM Timid t MAIM rNn• 41s0Stoni a tit ItlATtAit ,,,,ist t 4 R t Name Ctt /State Y Plume Fax A� d 1 Bank r f k �y q £c l• )D 3 �,a, ^7 3 331144, �;331144, fa mu', 8 ,applisr �Sd t .7 j �•1 Supplier OMB i �cr. .400, C7 ,3`-7 1 Supplier 1� f./ •-gY2; 84/26/200 ''6 22086580306 Name r ".1 t�" o Y N.I i FER 'IWQUOTE I7 Q New Applicant I X Update Branch Mail or Pad Credit A Bastion To; 125 S. GREGORY LN 1 PO BOX 13048 JACKSON WY 33002 307-734-2674 'AGE 03 Phone 7 6 t 1 o Fax .20 7 2 t"7 1 Street Address CIry frGs, C &ems State Zip glee/. Mobilel?ager„y7 670 Email Yesl please send me special Wets and updates vie email. List the year of anybankruptcy or insolvency by principal/off or any affiliated corporation MC, partnership or business. Silting Address (if different from above) Are Purchase Orders Xssued? City Stare Zip Are job names required? 6N Sales Tax Exemption State, Please attach an exemption certificate for each state. Special Billie Instructions !I f�" 4 ka co w .+a:•Y ✓i,� 1 r• 1 r ta i I s Angle Family t 11 rcial cal PVF Waterworks D' ulti Paraily C R C g Q Other DV Residential-Remodel Industrial PV Govtmmant Estimated Monttil$ Volulae t Date Business Started 119 No. of Employees T` Surety/Bonding Company Don of taco oration /793 .3 State of Xnoo Clrc1 Nei E 3(a 2 Rev) AT ii?finfillii 4'11Q'011$M 'acfarn tiavlurM Timid t MAIM rNn• 41s0Stoni a tit ItlATtAit ,,,,ist t 4 R f ES,INc. I lam! 'K ENTIRE AGREEMENT: These terms and conditions along with the terms and conditions on Seller's invoice and delivery t eket which are incorporated by reference (together referred to as "TERMS") represent the entire agreement between the parties, Na other terms, including those on Applicant's Purchase Order, whieb are different may add to, modify, supersede or otherwise alter to TERMS without express written approval signed by an authorized representative of the Seller. All other terms are hereby rejected. PAYMENT: Applicant agrees to pay for the products according to the TERMS, If Applicant fails to make any payment to Seller when due, the Applicant's entire aecount(s) with Seller shall become immediately due and payable; and Seller may repossess and remove any such product without notice or demand or may require Applicant to easemble the collateral and make it available to allow Seller to take possession. All past due amounts are subject to a service charge of 1.S% per month or, at Seller's option, up to the maximum rate permitted by law, If Applicant is in default for non -payment, then in addition to other remedies, Applicant agrees to reimburse Seller all casts of collections, including reasonable attorneys' fees. Ili jurisdictions where a stated raze is required, reasonable attorneys' fees will be 15%. SECURITY: To secure payment and performance of all obligations, Applicant herby Banta Seller a Purchase Money Security Interest in all inventory, equipment, and goods distributed by Seller, whenever sold, consigned, leaned, rented or delivered, directly or indirectly, to or for the benefit ofApplicant by Seller, wherever located, now owned and hereafter Acquired ina]udiag but not Minted to all Pttzmbin fixtures, Tools, Safety products, Waterworks Products, HVAC Products, PVP Mechanical St Industrial Products accessories and The security =west extends to all repossessions and returns; and all proceeds from the sale, lease or rental; and all existing or subsequently arising accounts and accounts receivable, chattel paper, general intangibles, and supporting obligations which may from tinge to time hereafter come into existence during the term of this Security Agreement. Seller's security interest is explicitly bruited to outstanding obligations between Seller and Applicant. CONDITION OF COLLATERAL: Applicant will Insure the Collateral against all expected risks. Applicant will not subject the Collateral to any adverse encumbrance or lien. Applicant authorizes Seller to file financing statements describing the collateral, and will assist Seller in taking the necessary action to perfect and protect Seller's security interest. WARRANTY: The Applicant's 3o le and exclusive warranty, if any is that provided by the Product's Manufacturer. SELLER MAKES NO EXPRESSED OR IMPLIED WARRANTIES. SELLER HEREBY DISCLAIMS ALL EXPRESSED OR IMPLIES) WARRANTIES, WHETHER IMPLIED BY OPERATION OF LAW OR OTHERWISE, INCLUDING WITHOUT LLMITATION ALL w.4RRANTIES OF MERCHANTABILITY AND FITNESS OR FITNESS FOR A PARTICULAR PURPOSE. DER NO CIRCUMSTANCES, WILL SELLER BE LIABLE FOR INCIDENTAL, PUNITIVE, SPECIAL OR CONSEQUENTIAL DAMAGES OP ANY KIND. SELLER'S LIABILITY, XP ANY, SHALL BE LIMITED TO THE NET SALHS PRICE RECEIVED BY SELLER. CERT ICA'TXON: The Applicant certifies the following: (I) the intbrmation I provided is true raid cotrect and has been submitted to obtain commercial ctedit (2) I am authorized to execute applications and other documents required to establish commercial credit accounts on behalf of Applicant; (3) Seller is hereby authorized to im'eadgate and verify any information provided and inquire of references or others as to credit worthiness; (4) Seller may answer questions from otters about its credit experience with the Applicant; and (5) I !rave read, understood, and agreed to all of the TERMS, and agree to notify Seller, in writing via certified mail, of any material change in name, ownership, location or corporate status within fiv (5) d PeF 04/26/2005 06:16 12086580306 Witness 'Witness Autbon1Y-ed Representative Guarantor FNWQUOTE _Alefgaset 'Thin Social Security if Dais Date PAGE 04 ?or and is consideration of the Seller extending credit to the Applicant, Ole Guarantor hereby personally guera tees the payment of any A:ligation of the Applicant to the Seller. Therefore, Guarantor hereby agrees to pay the Seiler on demand, without offset, any sum due to the seller by the Applicant if and when Applicant fails to pay such amount. guarantor further agrees to pay all cot of collection Including easoneble attorney's fees. This Guaranty tall be a continuing and irrevocable guaranty and indemnity for indebtedness ofTa Applicant: lie Guarantor hereby agrees to the extent permitted by law, to waive the Homestead exemption, nodce of acceptance, notice of presentment, lesnand, cons payment; dishonor and protest. Furthermore, Guarantor consents to and waives notice of any modification., amendment or xteasion of the terms of the credit agreement hereby guaranteed. Guarantor hereby autborhza Seiler to obtaia and use Constumc Reports rom time to time on the Guarantor for the sole purpose of evaluating current and ongoing credit worthiness in connection with the extension f i7usiness credit as contemplated by this credit iiiiiiiip Witness Guarantor 05 Social Secur d Date Revised 30030741 4(4 RCVD AT 412612405 9:00:00 AM fEact m rI wIk 1 Timplr x ran' 1)nQAAQnane a nl ladTinu lmmreMMY) •n r