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DocuSign Envelope ID: C327FODO-D8DF-4343-B5DB-90853D1ED8AA <br />PORT CONSOLIDATED <br />MIAM(. FORT LAUDERDALE, <br />WEST PALM. FOIT:' PIERCE. <br />TAMPA. JACKSONVILLE <br />1.800.683.5823 <br />MIAMI: (305)887-1268 <br />FT LAUDERDALE: (954)522-1182 <br />Account Number: 101910/001 <br />Invoice Number: 2929426 <br />Involce Debs: 10/28121 <br />Attachment F - Sample Invoice Diesel and Unleaded Gasoline <br />CITY OF POMPANO BEACH NEF <br />PO DRAWER 1300 <br />POMPANO BEACH, FL 33061-13 <br />PURCPME ORDER: 310160 <br />POA REQUIRED <br />TERMS : NET 16 DAYS <br />Product Product Description <br />Exhibit A - RFP E-03-22 <br />REMIT TO <br />P.O. BOX 350430 <br />FT LAUDERDALE, FL 33335-0430 <br />FEIN: 69-1173292 <br />Amount Due: $ 21,031.40 <br />Due Date: 11110121 <br />Shipping Address: <br />CENTRAL GARAGE - TP <br />1190 NE 3 AVE - BLDG A <br />DEL 7 AM -2 PM <br />POMPANO BEACH, FL 33060 <br />COUNTY: BROWARD <br />kathryn.achlndel(gcopbfl.com <br />CWlvered Quanlity Unit Price E)tonded Prise <br />Driver: LUIS VILLEGAS Vehicle Code: 5933 Loc 1011101/64 <br />Salesperson: PORT HOUSE <br />Shipping / Freight Total: <br />Order Number: 2929426 <br />BOLNumber: 194460 <br />$2,491.14 <br />913MI ULTRA LOW SULFUR DSL FUEUSULK GALLONS <br />8,914.0000 $2.68300 <br />$18,550.26 <br />DFE FEDERAL EXCISE DIE5EL <br />$0.24300 <br />$0.00 <br />DMF STATE MOTOR FUEL DIESEL <br />$0.18500 <br />$1,279.09 <br />LOCAL OPTION DSL BROWARD <br />$0.16000 <br />$1,037.10 <br />POLLUTION DIESEL <br />$0.02071 <br />$143,22 <br />L.U.S.T. DIESEL 8 FED OIL SPILL <br />$0.00314 <br />$21.73 <br />$21,031.40 <br />Item We: TANK 1 <br />DELIVERY BETWEEN 7AM - 2PM <br />Comment: THIS DIESEL FUEL DOES NOTCONTAIN VISIBLE EVIDENCE OF DYE <br />There Is a 1 If^ service charge per month for unpaid amounts over 10 days past <br />credit termalt Is agreed that In the event tide bill must be turned over for collection, <br />the oost of collection, attorneys fee and Court coals will be paid for by the above <br />ramed company or vassal and Its owners. <br />320198 <br />Products Total• <br />519,560.16 <br />Shipping / Freight Total: <br />$0.00 <br />Tax Total: <br />$2,491.14 <br />Total Due: <br />$21,031 AO <br />