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Bryan & Bryan Asphalt, LLC P.O. Box 1639 Jackson, MS 39215-1639
at #[.ILED F9R RECORD 'Ab o clock f? _M
AUG 10 2017
Re: Consent to Assignment of Contracts with Hunt County, TX (the "County")
Gentlemen:
You have informed us that effective July 1, 2017 (the "Effective Date"), Bryan & Bryan Asphalt, LLC, a wholly-owned subsidiary ofErgon Asphalt & Emulsions, Inc. ("Bryan & Bryan"), acquired substantially all the assets of Bryan and Bryan Asphalt Road Oil, Ltd. and Bryan Asphalt Products, LLC (the "Bryan Companies"). In connection with the transaction, the Bryan Companies wish to assign to Bryan & Bryan, and Bryan & Bryan wishes to assume, the contract(s) currently in place with the County listed below (the "Assumed Contracts") from and after the Effective Date. This will confirm that the County consents to assignment of the Assumed Contracts to Bryan & Bryan and that Bryan & Bryan assumes all obligations under the Assigned Contracts from and fter the Effective Date .
......_ ~~~': -::r; h N L. f-1 0 {( 1\1 Name: ~IU-T-_&uv~ Title: Eot{tv*J:li(d<yi Reference Contract(s): Bid# 157-17
AGREED:
BRYAN & BRYAN ASPHALT, LLC
By: ·--:?::::::-~#? N ?.--.'
ame: . ;,·~ll-t TrA//V
Title:-------~--
Bryan & Bryan Asphalt, LLC
RETURN) BY FAX tO 903-655-0061 OR BY EMAIL TO [email protected]
GOVERNMENTAL ENTITY CREDIT ACCOUNT INFORMATION QUESTIONNAIRE
The information in this form must be supplied by any government entity wishing to purchase materials on an open account. The information required allows us to establish an account with the proper billing information.
Entity Requesting an Account: +I U~ C"JJ u..l..)f'j
Entity's Employee requesting Account: {!,hl?!e.<{f Low R!j -.J-/u.H-Chua"'J ".p4-f.C).m;,hj f1:?r Phone Number: 903~£/og,.J.//41 Email Address: {!../()we~@ hu.a{<'AunfJ .. oe-f=
Complete Billing Address:
Gr<.ee-AIV,·tfe.-1}( 75cf03 •
Accounts Payable Contact: /!] lch e/ It? S pi I ( Ef<S~-----Phone Number:· Cf03- </O<g • L/1~1 Fax Number: ___ L{_· "'(J ...... 8._~_t.f.,_· ~=-r..o.8i...=V .........
Email Address: @tJ_5fJ~.lJe_r.s_@ Jh u..n+(!..{)u..n +') .. oed:
Do you requirel a Purchase Order? Q Yes ~ No
Invoices may ~e sent by mail/email/or fax. If you prefer email or fax please provide the correct email address or fax number below. If this space is left empty invoices will be mailed.
~ rnaJ.I - fY" cs (? i I I e.r s @ h u.t'\+eeu."'3. f\ ek
Will customer's truck pick up product at the Bryan & Bryan Facility? QYES @No (circle one)
Will Bryan & Bryan arrange delivery of product? ~S Q NO (circle one)
If customer arranges shipping please provide name of carrier: -------------
If applicable please provide a sales tax exemption certificate.
Signature:~~"(:; Type or Print Name: {2/lt;t<y/ /&w?j
Date: Z"" lt!J--17
8621 FM 2276 North, Henderson, TX 75652
.;.A' ~r~a~- 01·339 (Sitek) Yt!' "W)V1
' {Ruv.4•13/8)
Texas Sales and u;se Tax Exemption Certification Tjhls oert(f(oate does not reqolre
1 a number to be val/d.
I, the purchaser named aboo/e, claim an exemption from payment of sales and use taxes (for the purchase of taxable items described below or onHhe attached order or lnvo:lce) from:
'
seller:J3~PtN f [6~-~-~}~php,/-f:)~----··· . ~--·~---·--·--··· Street address: 'P_t2_ __ /3p.,"Z,. ..... :d_3~.8:---~-·-· _____ City, State, ZIP code:r~~-.1 ms ;3_9.~- :J...F
I Description of llems to be pur~tH:lS.(;!d or on the attached order or lnvoicel
__ ,__....., ·-------""---"'"----- __,..,___,_.,.....,.. _______ ,....;:-----~-----·--·-·-----,--~-.. ....,._ ___ ,.....__;,:,_~ __ ....._ ______ ~ _________ ...,......_ ----------
-"""'-'--.;...', ";-.--.,--.,-----------------------------,.,.-· ·: ... .:-.. +tt_ ... __ ...... ...___...._.._,_, .. .,,_,_"----------
l
; Purchaser claims this exemptlqn for the following reason:
County Government _____ ....,_ ________ , .. ¥-·~----· _________ .,. ______ ....;_-------··-------· .. -·.-·------~------___ , ....................... __ ,_..,... __ .. __ ,.....,_ __ ........_ ___ _ ·--------''-----,-.. -----------_,..~~-,------....-...-~"·---------
1 1 understand that I will be llable;for payment of all state and local sales or use taxes which may become due for failure to comply with the provisions of the Tax Codejand/or all applicable law.
1 tundat~~tanclthafttiMIOrlmlnalol(en~>Bto.glv~!:Dn(!X"fltnPffqnr-:,Q.(:IfflCate to the sellerfortaxable items that/know, at the time of purchase, j wllllm us.erlltJ:trroamun:·?t~ertll~tJ.~h~t~pres.~o,d:Jrlllrls:Qe_r;tlf{&tJf~, anddependlng on the amountoftax c~.vaded, thsoffense may range ,.frgtn tl Ohl$8 e t'nlscltlm"GfltWrlp a {(1/ony Ottl!13'"~13(iO/ld ,,~~(~,e .. i .
~~7.#~-- c~~~~~-~~-~~ Au:~:;-· .. ·--=rAI& .'z.._·'.(.~D~·.-· ~----' NOTE: This o~rtl1icat!3 cannot be Issued for ihe purchase, lease, or rental of a motor vehicle, THIS CERT/Fl~ATE DOES NOT REQUIRE, A NUMBER TO BE VALID,
Sales and Use ~ax "Exemption Numbers" or ,;Tax Exempt" Numbers do not exist.
l This certificate shout~ be furnl~hed to the supplier. Do !12! s
1nd the c~mpleted certlflc~te to the Comptroller of Public Accounts •
.... . . ...., ________ , ... _.~ ... ·----- ·--·-·-----1.~.-·-·····
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