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2025-499-E-Emergency Svc-Excellance-One new ambulance and two remounted ambulances
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2025-499-E-Emergency Svc-Excellance-One new ambulance and two remounted ambulances
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Last modified
8/14/2025 3:34:23 PM
Creation date
8/14/2025 3:34:03 PM
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Template:
Contract
Date
2/21/2025
Contract Starting Date
2/21/2025
Contract Ending Date
3/4/2025
Contract Document Type
Contract
Amount
$1,051,257.79
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REMOUNT PRICING <br />Version 23.0 <br />(1 )A. This is an initial quote. An initial quote means this order form is simply being used as a worksheet to generate a price quote. <br /> ADDITIONAL TERMS AND CONDITIONS AT END OF THIS DOCUMENT ARE INCORPORATED HERE IN BY REFERENCE. <br />APPROVED AND ACCEPTED BY: <br />PURCHASER:DATE: <br />TITLE:P. O. # : <br />DATE: <br />83 <br />84 <br />85 <br />86 TYPE OF UNIT: <br />87 <br />88 ORIGINAL BODY MANUFACTURER: <br />89 <br />90 MODEL/ MAKE/ YEAR: <br />91 <br />92 CHASSIS VEHICLE IDENTIFICATION NUMBER: <br />93 <br />94 CAB TO AXLE MEASUREMENT: <br />95 <br />96 WHEELBASE MEASUREMENT: <br />97 <br />98 CURRENT CHASSIS ODOMETER READING (Required if Excellance takes ownership of the take-off chassis): <br />99 <br />100 DESCRIPTION OF ANY CHASSIS DAMAGE (Required if Excellance takes ownership of the take-off chassis): <br />101 <br />103 <br />104 (1 )Excellance to take ownership of Take-Off Chassis -3,000.00 -3,000.00 <br />105 1 1 <br />106 0 MAKE THE CHASSIS ROADWORTHY <br />107 (1 )THERE WILL BE NO ADDED WORK PERFORMED TO THE TAKE-OFF CHASSIS. 0.00 0.00 <br />120 1 CHASSIS <br />123 (1 )Excellance Supplied Chassis <br />124 1 80,000.00 80,000.00 <br />125 <br />THE FOLLOWING FIELDS DESCRIBING THE NEW CHASSIS MUST BE FILLED OUT REGARDLESS OF WHO IS <br />SUPPLYING IT. <br />129 ENTER MODELYEAR FOR NEW CHASSIS: <br />130 ENTER MODEL OF NEW CHASSIS: <br />131 ENTER MAKE OF NEW CHASSIS: <br />132 ENTER CAB TO AXLE MEASUREMENT OF NEW CHASSIS: <br />133 ENTER WHEELBASE MEASUREMENT OF NEW CHASSIS:193" <br />2025 or Newer <br />F550 4x4 Gas Single Cab <br />Ford <br />108" <br />TBD <br />TBD <br />THE CHASSIS MUST BE IN RUNNING AND DRIVING CONDITION FOR THE FULL TRADE IN VALUE TO BE APPLIED <br />ENTER PRICE OF NEW CHASSIS: <br />TYPE IL <br />EXCELLANCE <br />FL M2 <br />TBD <br />102" <br />TBD <br />REMOUNT UNIT DESCRIPTION <br />Rev: 5/18/23 Page 2 of 16 9/17/2024 8:07 AM <br />Docusign Envelope ID: EF1EEE70-841D-4BBC-A429-CADADA6E1ED9
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