Item 05 Approval of Motorcycle Lease Agreement with Teddy Morse’s Daytona Harley-DavidsonAr-ALT/ O-Me- t'.
Financial Impact:
The City of Ocoee will be required to pay $1,420.00 monthly to lease two FLHP Road King police motorcycles
for six years. This price includes the replacement of the motorcycles every two years (equipped with lights and
all related equipment). These funds have already been budgeted for in the current fiscal year budget.
Type of Item: (please mark with an 'Y)
Public Hearing
Ordinance First Reading
Ordinance Second Reading
Resolution
X Commission Approval
Discussion & Direction
For Clerk's Dept Use:
Consent Agenda
Public Hearing
Regular Agenda
Original Document/Contract Attached for Execution by City Clerk
Original Document/Contract Held by Department for Execution
Reviewed by City Attorney Scott Cookson (11-28-22)
Reviewed by Finance Dept. Rebecca Roberts (11-28-22)
Reviewed by
N/A
N/A
N/A
N
This Motorcycle Lease Agreement (The "Lease"), is made this 23rd day of
November, 2022 by and between EMAG DAYTONA HD, LLC., DBA Teddy Morse's
Daytona Harley-Davidson, 1637 North US Highway 1, Ormond Beach, FL 32174
("Dealer" or "Lessor"), and the City of Ocoee (The "Department" or "Lessee"), whose
address is I North Bluford Avenue, Ocoee, FL 34761, for the lease of police motorcycles
(Hereinafter referred to as "the vehicles"), as described in Exhibit "A" attached hereto,
for use by the Department's authorized employees in the performance of police -related
or law-enforcernent duties. The terms and conditions of the Lease are as follows:
1, Tet-m: The term of this Lease shall be seventy-two (72) months commencing
on October 1, 2022 and ending on September 30, 2028. Lessee shall have the right to
extend the term of this Lease, provided that Lessor agrees, upon the same terms and
conditions as provided in the Lease. In the event Lessee elects to exercise its option to
renew the terms of this Lease, then Lessee shall provide Lessor with written notice of its
election.
2. Payment: Lessee shall make monthly lease payments, on or before the I st day
of each month to Lessor in the amount of $685.00 for each vehicle, ($4 7 5 .00 per
month for the lease and $2 10.00 per month for the police emergency equipment). At the
end of two years around September 1, 2024, Teddy Morse's Daytona Harley -Davison
will come to the City of Ocoee, pick up your 2022 model year motorcycles, return to
Daytona and swap the police emergency equipment to the next bikes, 2024 model year
motorcycles and return them to the City. At the end of four years around September 1,
2026, Teddy Morse's Daytona Harley-Davidson would come to the City of Ocoee,
pick up your 2024 model year motorcycles, return to Daytona and swap the police
emergency equipment to the next bikes, 2026 model year motorcycles and return them to
the City. Transfer of equipment and tag fees would all be included in the monthly tease
payment of $685.00.
3. Miscellaneous Fees: Lessor agrees to pay for all official fees in
connection with the certificate of title, registration and license fees and ' any applicable
taxes foreach of the lease vehicles. Lessor agrees to waive all charges with respect to
freight and dealer prep of the vehicles.
M
4. Maintenance, ]Repairs and Operating Expenses: Lessee is responsible
for and agrees to pay for all maintenance and repairs to keep the vehicles in good
working order and condition and other expenses associated with operating the vehicles.
Lessee agrees to service the vehicles according to the manufacturer's recommendations
as outlined in the owner's manual for the vehicles at any factory authorized Harley-
Davidson dealership. Lessee's use or repair of the vehicles must not invalidate any
warranty.
6• Use and Subleasing: Lessee agrees that the vehicles (a) will be operated
only by authorized licensed Travers employed by Lessee as law -enforcement officers; (b)
will be kept free of all fines, liens and encumbrances; (c) will not be used illegally,
improperly, for hire, or contrary to the manufacturer's recomixlendations, and (d) will not
be altered, marked or have equipment installed on thern without Lessor's consent.
6. Insurance: During the term of the Lease, Lessee must maintain public
liability and physical damage insurance on the vehicles that covers both Lessee and
Lessor. Lessee agrees that the Department's own liability and personal injury protection
insurance will provide primary insurance coverage up to its full policy limits. The Lessor
or Dealer will accept written certification that the Lessee is self -insured for general
liability and auto liability under Section 768.28 of the Florida Statues. Lessee will
provide Lessor with evidence of this insurance. Lessee's insurance policy must provide
that Lessor will be notified in writing at least 10 days before the insurance is cancelled or
coverage altered and that Lessor, or its representatives, may have full access to any claim
file in the event of an insurable loss. In the event of a total loss or destruction of vehicles,
Lessee's maximum exposure shall be the Dealer's cost of the vehicle as shown on its
books/records.
Lessor or Dealer shall provide the Lessee or Department with evidence of
insurance as follows: 'Workers Compensation. General Liability, Automobile Liability,
and Errors and Omissions (Professional) Liability.
Lessors or Dealers insurance shall apply only when the vehicles are in
Dealer's care, custody or control.
7. Notice of accidents and Cooperation: Lessee agrees to cooperate fully
with Lessor and any insurance company in the investigation and defense of any and all
claims arising from their possession and use of the vehicles. Lessee will snake a
complete report to Lessor within 48 hours after any accident, theft or loss involving the
vehicles.
8. Indemnification: Lessee agrees to indemnify and hold Lessor, its
affiliates, assignees, officers, agents and employees harmless from all losses, liability,
damages, injuries, claims, demands and expenses, including attorneys' fees, arising out of
the use of the vehicles while in the care, custody or control of the Lessee.
2
Lessor agrees to indemnify and hold Lessee, its affiliates, assignees,
officers, agents and employees harmless from all losses, liability, damages, injuries,
claims, demands, and expenses, including attorneys, fees, arising out of the use of the
vehicles while in the care, custody or control of the Lessor.
Lessee does not waive its right to sovereign immunity tinder 768.28 of the
Florida State Statues,
9. Limitation of Liability: Lessor shall not be liable for any indirect or
consequential damages or inconvenience (except for those relating to personal injury)
which may result to Lessor fi-orn any damages to, or de--fect in, the vehicles for the time
needed to repair or service the vehicles. Monthly lease payments shall continue and not
be reduced or delayed during this time. Lessor makes no express warranties covering the
vehicles. In particular, Lessor makes no express warranties of vehicle condition,
merchantability, durability or fitness for a particular purpose Of use covering the vehicle,
and Lessor expressly disclaims any such express warranties.
10. Return of the Vehicles: At the end of the Lease, the Department must
return the vehicles to Lessor in good condition, without damage, excessive wear or use
and with all the original equipment installed by the manufacturer.
• Lessor will not be responsible for accident or training damage
® Tank, fenders, and saddlebags will be free of dents
• Chrome edges of floor boards shall not be completely worn down
m Clutch and brake levers shall not be bent
• Windshields shall be flee of scratches and distortion
• Tires must have a minimum of 4/32 tread depth
• Service must be up to date as per factory recorfilliendation
* Police decals must bo removed by department if required
DAYTONA HARLEV-DAVIDSON CITY OF OCOE E
By: By: _
Randy Hoff -man Signature
Chief Operating Officer
Title:
Print Name:
3
EXHIBIT A
Page l
April 7, 2022
Lessee's Naive: City of Ocoee
Model Year: 2022/2024/2026
Model :Description: FLHP Road King solid birch white
Number of Units: 3
Vin numbers:
I .
2.
3.
The following is a, list of police emergency equipment that we would install as per your
specifications on the FLHP Road King police motorcycle and transfer from the first bike
to the second and the second to the third.
53000712DH Harley-Davidson black box
68000277 Triple stack red/blue LED lights (3)
68000.284 Mega thin red/blue LED lights
53196-09 Adapter. plate
65989-97E Auxiliary battery
68000137 Wiring kit
140553 Three outlet power supply mounted inside the box
OSBO()MCR Small blue ovals
76001039 Siren amplifier, siren speaker, microphone
90201903 Saddlebag Rails
RBKTHD9 Rear saddlebag bracket that holds two LED lights each (2)
RBKTHDI Brackets that mount on the side forks with a red/blue LED light (2)
TLIJ Red/Blue LED lights (2)
TIONFC Chrome flanges
LiNZ6J Red/Blue split LED lights (4)
PAR32F2RB Red/Blue split with white driving light (2)
M07T Windshield light array that mounts in front of the windshield (R/BIB/R)
53194-07 Barrel lock key that installs in the box to match the bike
45732.86 Helmet lock
67800645 Red turn signal lens (2)
Brushed moto lights, LED bulbs, wig -wag harness, switch kit
M
Barry T. Kuhnly
Manager
]Deputy Chief "Vince Ogburn
Ocoee Police Department
ISO North Lakeshore Drive
Ocoee, FL 34761
Dear Deputy Chief Ogburn:
Thank you for taking the time .:from your busy schedule to speak with me and discuss
topics of mutual interest regarding the current fleet and related topics. Please consider
this letter as a follow-up to our conversation and an open proposal offered for your
review and consideration.
EMAG DAYTONA HD, LLC., DBA Teddy Morse's Daytona Harley-Davidson, 1637
North ITS Highway 1, Ormond Beach, FL 32174 is prepared to make the following offer
for the lease of Harley-Davidson police motorcycles.
Teddy Morse's Daytona Harley-Davidson, is prepared to lease 3.2023 FLI-fP Road King
Police motorcycles, solid birch white, for six years (72 months) for $490.00 per month
per motorcycle plus an additional $220.00 per month for new police emergency
equipment as per your specifications for a total of $710.00 per month effective March 1,
2023 to Februaty 28, 2029.
At the end of two years around February 1, 2025, Teddy Morse's Daytona Harley-
Davidson will come to the City of Ocoee, pick up your 2023 model year motorcycles,
return to Daytona and swap the police emergency equipment to the next bikes, 2025
model year motorcycles and return them to the City, At the end of four years around
February 1, 2027, Teddy Morse's Daytona Harley-Davidson would come to the City of
Ocoee, pick up your 2025 model year motorcycles, return to Daytona and swap the police
emergency equipment to the next bikes, 2027 model year motorcycles and return them to
the City. Transfer of equipment and tag fees would all be included in the monthly lease
payment of $710.00.
Daytona Harley-Davidson = 1637 North US Hwy 1 •Ormond Beach, FL, 32174
Cell: 954-257-2073 • Fax: 386-671-7077 • E-snail: BarryKuhnly@)tnadhd.cona
a
It would fOne Payment $710.00 per bi • • • •• «costs -
4 • t 0 •
• •
The only additional cost to the City of Ogee would be the cost for routine maintenance
according to the manufacturer's recommendations as outlined in the owner's manual for
the vehicles, tires, and brakes, which must be done at any factory authorized Harley-
Davidson dealership.
At the end of six years the police emergency equipment would become the property of
the City of Ocoee.
The following is a list of police emergency equipment that we would install as per your
specifications on the FLHP Road King police motorcycle.
53000712DH Harley-Davidson black box
68000277 Triple stack red/blue LED lights (3)
68000284 Mega thin red/blue LED Iights (4)
53196-09 Adapter plate
65989-97E Auxiliary battery
68000137 Wiring kit
140553 Three outlet power supply mounted inside the box
OBOOMCR Small blue ovals
76001039 Siren arzapifier, siren speaker, microphone
90201903 Saddlebag Rails
RBITHD9 Rear saddlebag bracket that holds two LED lights each (2)
RBKTHD 1 Brackets that mount on the side forks with a red/blue LED light (2)
TLIJ Red/Blue LED lights (2)
TIONFC Chrome flanges
LINZ6J Red/Blue split LED lights (4)
PAR32F2RB Red/Blue split with white driving light (2)
M07T Windshield light array that mounts in front of the windshield (R/B/B/R)
53194-07 Barrel lock key that installs in the box to match the bike
45732-86 Helmet lock
67800645 Red turn signal lens (2)
Brushed moto lights, LED bulbs, wig -wag harness, switch kit
Daytona Harley-Davidson ► 1637 North US Hwy 1 •Ormond Leach, FL 32174
Cell: 954.257.2073 . Fax: 386.671.7077 . E-mail: BarryKuhnly cc tiildhd.coni
The motorcycles can be programmed to have the rear turn signals run as brake and
turn signals and the motorcycle can be Programmed to run in stealth mode. The new
FLHP Road King comes standard with the new MilwapI
i th
control, tire pressure motifforing system, and cornering enhanced anti -lock brakes.
I have enclosed a lease agreement so you can see -the verbiage of the agreement. I'm sure
you would have to run it buy legal but we use the same lease
agreement for all our
agencies. The lease agreement would be between EMAG DAYTONA HD, LLC,, DBA
Teddorse's Daytona Harley-Davidson and the City of Ocoee. There would be no
third Party involved,
aC you have any finther questions. inleass fee IIIIIIIIIIIIA ((•. I 6� Wk
Thanking you in advance,
/01---
Barry T Kuhnly
Manager, Police and Fleet Sales
TM4 Mors�ls_?R?
P
1637 North US Highway I
Ormond Beach, FL 332174
Phone: 954-257-2073
Email: BarryKuhnly@tmdhd.com
Daytona Harley-Davidson - 1637 North US Hwy I , Ormond Beach, FL 32174
Coll: 954.257.2073 - Fax: 386.671.7077 - E-rail: 13arryKuhnly@tmdhd.CoIII
lipli 11, ri;lrsil��i IFF11111111:111i igv��m'
111 ild
Harley-Davidson Motor Company
3700 W. Juneau Ave. Milwaukee, W1 53208
Robert.Lyrimsley0harlev-davidson.coLn
414-397-9244
HARLEY-DAVIDSON MOTOR COMPANY, POLICE AND FLEET SALES
Address: P.0, Box 653, Milwaukee, W1 53201 Ui,&A. Phone: 1-800-luv-2ride Online: www.harley-devidsonpolicemotors.com orwww.harley-davidson.com
This Asset Purchase Agreement (the "Agreement") is made as of July 7, 2022 (the
"Effective Date"), by the following parties:
"Seller": ROSSMEYER DAYTONA MOTORCYCLES, INC, a Florida
corporation d/b/a BRUCE ROSSMEYERIS DAYTONA HARLEY-
DAVIDSON ("Rossmeyer");
DESTINATION DAYTONA, LLC, a Florida limited liability company
("DD");
DESTINATION DAYTONA MANAGEMENT, LLC, a Florida limited
liability company ("DDM");
DESTINATION DAYTONA III, LLC, a Florida limited liability
company ("DDIH,11 and together with Rossmeyer, DD, and DDM,
"Seller');
Im
"Buyer": MORSE OPERATIONS, INC., a Florida corporation, or its assignee
("Buyer").
A. Rossmeyer owns a franchised Harley-Davidson dealership primarily located at 1637
North U.S. Highway 1, Ormond Beach, Volusia County, Florida 32174, and a Harley-
Davidson ARO located at 510 Main Street, Daytona Beach, Volusia County, Florida
32116, as further described in this Agreement (collectively, the "Dealership
Business").
B. DD: (1) owns and operates a restaurant and bar known by the fictitious name Saints &
Sinners Pub and owns associated fixed assets, a 4COP-Class 8 Liquor License, and
inventory; (2) owns a Clarion Inn Hotel franchise, along with hotel equipment,
furniture, and other assets; (3) owns the fictitious name Destination Daytona; and (4)
owns furniture and event equipment used by DD to host biking and other events
(collectively, the "DD Business");
C. DDM operates the Clarion Inn Hotel franchise and owns various hotel equipment and
inventories (such as toiletries and food) (the "DDM Business,,);
D. DDIII owns the hotel furniture in one of the Clarion Inn Hotel's 2 bedroom/2 bathroom
units (the "DDRI Business");
E. Seller desires to sell, transfer, assign and deliver to Buyer, and Buyer desires to
purchase from Seller, the Assets of the Business (as defined in Section 2.1 below) and
IN WITNESS WHEREOF, the parties have executed and delivered this Agreement as of
the date first written above.
ROssIneYer Daytona Motorcycles, Inc.
a Florida rporation
By:
Nae•
Title:
Destination Daytona, LLC,
a Florida Ifinjted liability company
Title:
Destination Daytona Management, LLC,
a Florida limited liability company
B
Name:
Title: —
Destination Daytona 111, LLC,
a Florida li4ted liability compa
Title:
042622a 44
Morse Operations, Inc.
A Florida Corporation
B
y Edward J. MorsJ`,---III, —
v
0
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D
LICENSE CERTIFICATE
STATE OF FLORIDA
DEPARTMENT OF HIGHWAY SAFETY AND
MOTOR VEHICLES
DIVISION OF MOTORIST SERVICES
EMAG DAYTONA HD LLC
2850 S FEDERAL HWY
DELRAY BEACH, FL 33483-3216
License
FOR A DEALER IN FRANCHISED
EFFECnVE DATE MOTOR VEHICLES
11/17/2022
THIS CERTIFIES, THAT
BRAG DAYTONA HD LLC
DAYTONA HARLEY DAVIDSON
TEDDY MORSE'S DAYTONA HARLEY DAVIDSON
LICENSE NUMBER
VF/1144501/1
PRIMARYLOT
E"IRAWN DATE
12/31/2023
AT 1637 N US HIGHWAY 1
ORMOND BEACH, FL 32174-2539
IS HEREBY LICENSED UNDER THE PROVISIONS OF SECTION
320-27, FLORIDA STATUTES TO CONDUCT AND CARRY ON BUSINESS AS
A DEALER IN FRANCHISED MOTOR VEHICLES AT THE ABOVE DESCRIBED
LOCATION
GIVEN UNDER MY HAND AND SEAL THE ABOVE DATE WRITTEN.
BUREAU CHIEF
DIRECTOR
't Gov
WE
HSHV 84103 (RM 2/11)S
STATE OF FLORIDA
Request for Taxpayer
Give
FomlW-9
(Rev. October 2018) Identification Number and Certification
Form to the
requester. Do not
Department
of the Treasury
send to the IRS.
Internal
Revenue Service 10, Go to wwwJrs.gov1FbrmW9 for instructions and the latest information.
I Name (as shown on your income tax return). Name is required on this line; do not leave this line blank,
EMAG Daytona HD LLC
2 Business name/disregarded entity name, if different from above
Teddy Morse's Daytona Harley-Davidson
3 Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the
4 Exemptions (codes apply only to
01
al
following seven boxes,
certain entities, not individuals; see
a
0C
El Individuallsole proprietor or El C Corporation n S Corporation El Partnership El Trust/estate
instructions on page 3):
2
0
single -member LLC
Exempt payee code (if any)
Limited liability company, Enter the tax classification (C=C corporation, S=S corporation, P=Partnership) 10, P
o
Note: Check the appropriate box in the line above for the tax classification of the single -member owner. 60 not check
Exemption from FATCA reporting
LLC if the LLC is classified as a single -member LLC that is disregarded from the owner unless the owner of the LLC is
another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single -member LLC that
code (if ally)
o
is disregarded from the owner should check the appropriate box for the tax classification of its owner.
Other (see instructions) ►
(Apphos to l/w US)
6 Address (number, street, and apt. or suite no.) See instructions.
Requester's name and address (optional)
1637 North U.S. Highway 1
6 City, state, and ZIP code
Ormond Beach, FL 32174
7 List account number(s) here (optional)
1�=
Taxpayer Identification Number (TIN)
Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid
Social security number
backup withholding. For individuals, this is generally your social security number (SSN). However, for a
resident alien, sole proprietor, or disregarded entity, see the instructions for Part 1, later. For other
n
-Ell
entities, it is your employer identification number (EIN), If you do not have a number, see Now to get a
TIN, later,
or
Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and I Employer identification number
Number To Give the Requester for guidelines on whose number to enter. F—F-1 I I 1 1-7-
Under penalties of perjury, I certify that:
1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and
2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am
no longer subject to backup withholding; and
3. 1 am a U.S. citizen or other U.S. person (defined below): and
iL The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct,
Certification instructions, You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because
you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid,
acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments
other than interest and dividends, yW-#re not required to sign the certification, but you must provide your correct TIN, See the instructions for Part 11, later.
01911
Here
Signature of
I U.S. ► I
person
Data
General Instructions
• Form 1099-DIV (dividends, includ4g'thosVfrom stocks or mutual
funds)
Section references are to the Internal Revenue Code unless otherwise
* Form 1099-MISC (various types of income, prizes, awards, or gross
noted,
proceeds)
Future developments, For the latest Information about developments
* Form 1099-B (stock or mutual fund sales and certain other
related to Form W-9 and its instructions, such as legislation enacted
transactions by brokers)
after they were published, go to wwwJrs.gov1FormW9.
# Form 1099-S (proceeds from real estate transactions)
Purpose of Form
* Form 1099-K (merchant card and third party network transactions)
An individual or entity (Form W-9 requester) who is required to file an
* Form 1098 (home mortgage interest), 1098-E (student loan interest),
information return with the IRS must obtain your correct taxpayer
1098-T (tuition)
identification number (TIN) which may be your social security number
o Form 1099-C (canceled debt)
(SSN), individual taxpayer identification number (ITIN), adoption
taxpayer identification number (ATIN), or employer identification number
.Form 1099-A (acquisition or abandonment of secured property)
(EIN), to report on an information return the amount paid to you, or other
Use Form W-9 only if you are a U.S, person (including a resident
amount reportable on an information return. Examples of Information
alien), to provide your correct TIN.
returns include, but are not limited to, the following.
If you do not return Form W-9 to the requester with a TIN, you might
• Form 1099-INT (interest earned or paid)
be subject to backup withholding, See What is backup withholding,
later.
Cat. No. 10231X Form W-9 (Rev. 10-2018)
Form W-9 (Rev.1 0-2018)
By signing the filled -out form, you;
1. Certify that the TIN you are giving is correct (or you are waiting for a
number to be issued),
2. Certify that you are not subject to backup withholding, or
3. Claim exemption from backup withholding 1f you area U.S. exempt
payee. If applicable, you are also certifying that as a U.S. person, your
allocable share of any partnership income from a U.S. trade or business
Is not subject to the withholding tax on foreign partners' share of
effectively connected income, and
4. Certify that FATCA code(s) entered on this form (if any) indicating
that you are exempt from the FATCA reporting, is correct. See What Is
FATCA reporting, later, for further information.
Note: If you are a U.S. person and a requester gives you a form other
than Form W-9 to request your TIN, you must use the requester's form if
It is substantially similar to this Form W-9.
Definition of a U.S. person. For federal tax purposes, you are
considered a U.S, person If you are:
• An individual who is a U.S. citizen or U.S. resident alien;
® A partnership, corporation, company, or association created or
organized in the United States or under the laws of the United States;
• An estate (other than a foreign estate); or
® A domestic trust (as defined In Regulations section 301.7701-7).
Special rules for partnerships. Partnerships that conduct a trade or
business in the United States are generally required to pay a withholding
tax under section 1446 on any foreign partners' share of effectively
connected taxable income from such business. Further, In certain cases
where a Form W-9 has not been received, the rules under section 1446
require a partnership to presume that a partner is a foreign person, and
pay the section 1446 withholding tax. Therefore, if you are a U.S. person
that is a partner in a partnership conducting a trade or business In the
United States, provide Form W-9 to the partnership to establish your
U.S. status and avoid section 1446 withholding on your share of
partnership income.
In the cases below, the following person must give Form W-9 to the
partnership for purposes of establishing its U.S. status and avoiding
withholding on its allocable share of net income from the partnership
conducting a trade or business in the United States.
• in the case of a disregarded entity with a U.S, owner, the U.S. owner
of the disregarded entity and not the entity,
• In the case of a grantor trust with a U.S. grantor or other U.S. owner,
generally, the U.S, grantor or other U.S. owner of the grantor trust and
not the trust; and
• in the case of a U.S. trust (other than a grantor trust), the US. trust
(other than a grantor trust) and not the beneficiaries of the trust,
Foreign person, if you are a foreign person or the U.S. branch of a
foreign bank that has elected to be treated as a U.S. person, do not use
Form W-9. Instead, use the appropriate Form W-8 or Form 8233 (see
Pub.516, Withholding of Tax on Nonresident Aliens and Foreign
Entities).
Nonresident alien who becomes a resident alien. Generally, only a
nonresident alien individual may use the terms of a tax treaty to reduce
or eliminate U.S. tax on certain types of income. However, most tax
treaties contain a provision known as a "saving clause." Exceptions
specified in the saving clause may permit an exemption -from tax to
continue for certain types of income even after the payee has otherwise
become a U.S. resident alien for tax purposes.
If you are a U.S. resident alien who is relying on an exception
contained in the saving clause of a tax treaty to claim an exemption
from U.S. tax on certain types of Income, you must attach a statement
to Form W-9 that specifies the following five items.
1. The treaty country. Generally, this must be the same treaty under
which you claimed exemption from tax as a nonresident alien.
2. The treaty article addressing the Income.
3, The article number (or location) In the tax treaty that contains the
saving clause and Its exceptions.
4. The type and amount of income that qualifies for the exemption
from tax.
5. Sufficient facts to justify the exemption from tax under the terms of
the treaty article.
,Example. Article 20 of the U.S.-China income tax treaty allows an
exemption from tax for scholarship Income received by a Chinese
student temporarily present in the United States. Under U.S. law, this
student will become a resident alien for tax purposes If his or her stay In
the United States exceeds 5 calendar years. However, paragraph 2 of
the first Protocol to the U.S.-China treaty (dated April 30, 1984) allows
the provisions of Article 20 to continue to apply even after the Chinese
student becomes a resident alien of the United States. A Chinese
student who qualifies for this exception (under paragraph 2 of the first
protocol) and is relying on this exception to claim an exemption from tax
on his or her scholarship or fellowship income would attach to Form
W-9 a statement that includes the Information described above to
support that exemption.
If you are a nonresident alien or a foreign entity, give the requester the
appropriate completed Form W-8 or Form 8233,
What Is backup withholding? Persons making certain payments to you
must under certain conditions withhold and pay to the IRS 24% of such
payments. This is called "backup withholding." Payments that may be
subject to backup withholding include Interest, tax-exempt interest,
dividends, broker and barter exchange transactions, rents, royalties,
nonemployee pay, payments made in settlement of payment card and
third party network transactions, and certain payments from fishing boat
operators. Real estate transactions are not subject to backup
withholding.
You will not be subject to backup withholding on payments you
receive if you give the requester your correct TIN, make the proper
certifications, and report all your taxable Interest and dividends on your
tax return.
Payments you receive Will be subject to backup withholding If:
1. You do not furnish your TIN to the requester,
2. You do not certify your 11N when required (see the instructions for
Part li for details),
3. The IRS tells the requester that you furnished an Incorrect TIN,
4. The IRS tells you that you are subject to backup withholding
because you did not report all your interest and dividends on your tax
return (for reportable interest and dividends only), or
5. You do not certify to the requester that you are not subject to
backup withholding under 4 above (for reportable Interest and dividend
accounts opened after 1983 only).
Certain payees and payments are exempt from backup withholding,
See Exempt payee code, later, and the separate Instructions for the
Requester of Form W-9 for more information,
Also see Special rules forpartnershlos, earlier.
What is FATCA Reporting?
The Foreign Account Tax Compliance Act (FATCA) requires a
participating foreign financial institution to report all United States
account holders that are specified United States persons. Certain
payees are exempt from FATCA reporting. See Exemption from FATCA
reporting code, later, and the instructions for the Requester of Form
W-9 for more Information,
f °:
You must provide updated information to any person to whom you
claimed to be an exempt payee if you are no longer an exempt payee
and anticipate receiving reportable payments in the future from this
person. For example, you may need to provide updated Information If
you are a C corporation that elects to be an S corporation, or if you no
longer are tax exempt. In addition, you must furnish a new Form W-9 If
the name or TIN changes for the account; for example, if the grantor of a
grantor trust dies.
Failure to furnish TiN. If you fail to furnish your correct TIN to a
requester, you are subject to a penalty of $50 for each such failure
unless your failure Is due to reasonable cause and not to willful neglect.
Civil penalty for false Information with respect to withholding. If you
make a false statement with no reasonable basis that results In no
backup withholding, you are subject to a $500 penalty.
Form W-9 (Rev.10-2018) Page 3
Criminal penalty for falsifying information. Willfully falsifying
certifications or affirmations may subject you to criminal penalties
including fines and/or imprisonment.
Misuse of TINs. if the requester discloses or uses TINS in violation of
federal law, the requester may be subject to civil and criminal penalties.
•- a
11=7
You must enter one of the following on this line; do not leave this line
blank. The name should match the name on your tax return.
if this Form W-9 is for a joint account (other than an account
maintained by foreign financial institution (FFI)), list first, and then
circle, the name of the person or entity whose number you entered In
Part I of Form W-9. If you are providing Form W-9 to an FFI to document
a joint account, each holder of the account that is a U.S, person must
provide a Form W-9.
a. Individual. Generally, enter the name shown on your tax return. If
you have changed your last name without Informing the Social Security
Administration (SSA) of the name change, enter your first name, the last
name as shown on your social security card, and your new last name.
Note; ITIN applicant. Enter your individual name as it was entered on
your Form W-7 application, line 1 a. This should also be the same as the
name you entered on the Form 1040/1040A/1040EZ you filed with your
application,
b. Sole proprietor or single -member LLC. Enter your individual
name as shown on your 1040/1040A/1040EZ on line 1. You may enter
your business, trade, or "doing business as" (DBA) name on line 2.
c. Partnership, LLC that is not a single -member LLC, C
corporation, or S corporation. Enter the entity's name as shown on the
entity's tax return on line 1 and any business, trade, or DBA name on
linen.
d. Other entities. Enter your name as shown on required U.S, federal
tax documents on line 1, This name should match the name shown on the
charter or other legal document creating the entity. You may enter any
business, trade, or DBA name on line 2.
e. Disregarded entity. For U.S. federal tax purposes, an entity that is
disregarded as an entity separate from its owner is treated as a
"disregarded entity." See Regulations section 301.7701-2(c)(2)(iiQ. Enter
the owner's name on line 1. The name of the entity entered on line 1
should never be a disregarded entity. The name on line 1 should be the
name shown on the income tax return on which the income should be
reported. For example, if a foreign LLC that is treated as a disregarded
entity for U.S. federal tax purposes has a single owner that is a U.S.
person, the U.S. owner's name is required to be provided on line 1. If
the direct owner of the entity is also a disregarded entity, enter the first
owner that is not disregarded for federal tax purposes. Enter the
disregarded entity's name on line 2, "Business name/disregarded entity
name." If the owner of the disregarded entity Is a foreign person, the
owner must complete an appropriate Farm W-8 instead of a Form W-9.
This Is the case even if the foreign person has a U.S. TIN.
Line 2
if you have a business name, trade name, DBA name, or disregarded
entity name, you may enter it on line 2.
Line 3
Check the appropriate box on line 3 for the U.S. federal tax
classification of the person whose name is entered on line 1. Check only
one box on line 3.
IF the entity/person on line 1 Is
THEN check the box for...
a(n) ...
• Corporation
Corporation
• individual
Individual/sole proprietor orsingle-
• Sole proprietorship, or
member LLC
• Single -member limited liability
company (LLC) owned by an
individual and disregarded for U.S.
federal tax purposes.
• LLC treated as a partnership for
Limited liability company and enter
U.S. federal tax purposes,
the appropriate tax classification.
• LLC that has filed Form 8832 or
(P= Partnership; C= C corporation;
2653 to be taxed as a corporation,
or S= S corporation)
or
• LLC that Is disregarded as an
entity separate from its owner but
the owner Is another LLC that Is
not disregarded for U.S. federal tax
purposes.
• Partnership
Partnership
• Trust/estate
Trustlestate
If you are exempt from backup withholding and/or FATCA reporting,
enter In the appropriate space on line 4 any code(s) that may apply to
you.
Exempt payee code.
• Generally, individuals (including sole proprietors) are not exempt from
backup withholding,
• Except as provided below, corporations are exempt from backup
withholding for certain payments, including interest and dividends.
• Corporations are not exempt from backup withholding for payments
made In settlement of payment card or third party network transactions.
• Corporations are not exempt from backup withholding with respect to
attorneys' fees or gross proceeds paid to attorneys, and corporations
that provide medical or health care services are not exempt with respect
to payments reportable on Form 1099-MISC.
The following codes identify payees that are exempt from backup
withholding. Enter the appropriate code in the space in line 4.
1—An organization exempt from tax under section 601(a), any IRA, or
a custodial account under section 403(b)(7) if the account satisfies the
requirements of section 401(%2)
2—The United States or any of Its agencies or instrumentalities
3--A state, the District of Columbia, a U.S. commonwealth or
possession, or any of their political subdivisions or instrumentalities
4—A foreign government or any of its political subdivisions, agencies,
or instrumentalities
5—A corporation
6—A dealer in securities or commodities required to register in the
United States, the District of Columbia, or a U.S. commonwealth or
possession
7—A futures commission merchant registered with the Commodity
Futures Trading Commission
8—A real estate Investment trust
9—An entity registered at all times during the tax year under the
Investment Company Act of 1940
1®--A common trust fund operated by a bank under section 584(a)
11—A financial institution
12—A middleman known in the Investment community as a nominee or
custodian
13—A trust exempt from tax under section 664 or described in section
4947
Form W-9 (Rev.10-2018)
The following chart shows types of payments that may be exempt
from backup withholding. The chart applies to the exempt payees listed
above,/ through 13.
IF the payment Is for ...
THEN the payment is exempt
for:,.
Interest and dividend payments
All exempt payees except
for 7
Broker transactions
Exempt payees 1 through 4 and 6
through 11 and all C corporations.
S corporations must not enter an
exempt payee code because they
are exempt only for sales of
noncovered securities acquired
prior to 2012.
Barter exchange transactions and
Exempt payees 1 through 4
patronage dividends
Payments over $600 required to be
Generally, exempt payees
reported and direct sales over
1 through 52
$5,000,
Payments made In settlement of
Exempt payees 1 through 4
payment card or third party network
transactions
1 See Form 1099-MISC, Miscellaneous Income, and its instructions,
2 However, the following payments made to a corporation and
reportable on Form 1099-MISC are not exempt from backup
withholding: medical and health care payments, attorneys' fees, gross
proceeds paid to an attorney reportable under section 6045(f), and
payments for services paid by a federal executive agency.
i'cxemption from FATCA reporting code. The following codes identify
payees that are exempt from reporting under FATCA. These codes
apply to persons submitting this form for accounts maintained outside
of the United States by certain foreign financial institutions, Therefore, if
you are only submitting this form for an account you hold In the United
States, you may leave this field blank. Consult with the person
requesting this form if you are uncertain if the financial institution is
subject to these requirements. A requester may Indicate that a code Is
not required by providing you with a Form W-9 with "Not Applicable" (or
any similar indication) written or printed on the line fora FATCA
exemption code.
A —An organization exempt from tax under section 501(a) or any
Individual retirement plan as defined in section 7701(a)(37)
B—The United States or any of its agencies or Instrumentalities
C—A state, the District of Columbia, a U.S. commonwealth or
possession, or any of their political subdivisions or Instrumentalities
D—A corporation the stock of which Is regularly traded on one or
more established securities markets, as described In Regulations
section 1.1472-1(c)(1)(,
E—A corporation that is a member of the same expanded affiliated
group as a corporation described in Regulations section 1.1472-1(c)(1)@
F—A dealer in securities, commodities, or derivative financial
Instruments (including notional principal contracts, futures, forwards,
and options) that Is registered as such under the laws of the United
States or any state
G--A real estate investment trust
H—A regulated Investment company as defined in section 851 or an
entity registered at all times during the tax year under the Investment
Company Act of 1940
i—A common trust fund as defined in section 584(a)
J--A bank as defined in section 581
K—A broker
L—A trust exempt from tax under section 664 or described in section
4947(a)(1)
M—A tax exempt trust under a section 403(b) plan or section 457(g)
plan
Note: You may wish to consult with the financial Institution requesting
this form to determine whether the FATCA code and/or exempt payee
code should be completed.
Line 5
Enter your address (number, street, and apartment or suite number).
This Is where the requester of this Form W-9 will mail your information
returns. If this address differs from the one the requester already has on
file, write NEW at the top. If a new address is provided, there Is still a
chance the old address will be used until the payor changes your
address In their records,
Line 6
Enter your city, state, and ZIP code.
« . a • . .. • . • - 1
Enter your TIN In the appropriate box. If you are a resident alien and
you do not have and are not eligible to get an SSN, your TIN is your IRS
individual taxpayer Identification number (MN). Enter it in the social
security number box. If you do not have an [TIN, see Now to get a TiN
below.
If you are a sole proprietor and you have an EIN, you may enter either
your SSN or EIN.
If you are a single -member LLC that Is disregarded as an entity
separate from its owner, enter the owner's SSN (or EiN, If the owner has
one), Do not enter the disregarded entity's EIN. If the LLC Is classified as
a corporation or partnership, enter the entity's EIN.
Note: See What Name and Number To Give the Requester, later, for
further clarification of name and TIN combinations.
How to get a TIN. It you do not have a TIN, apply for one immediately,
To apply for an SSN, get Form SS-5, Application for a Social Security
Card, from your local SSA office or get this form online at
www,SSA,gov. You may also get this form by calling 1-800-772-1213.
Use Form W-7, Application for IRS Individual Taxpayer Identification
Number, to apply for an ITIN, or Form SS-4, Application for Employer
Identification Number, to applyfor an EIN, You can apply for an EIN
online by accessing the IRS website at www.1rs.govlBusfnesses and
clicking on Employer identification Number (EIN) under Starting a
Business. Go to www.frs.govlForms to view, download, or print Form
W-7 and/or Fort SS-4. Or, you can go to www.Irs.gov1Ons'erForms to
place an order and have Form W 7 and/or SS-4 mailed to you within 10
business days.
If you are asked to complete Form W-9 but do not have a TIN, apply
for a TIN and write"Applied For" In the space for the TIN, sign and date
the form, and give it to the requester. For Interest and dividend
payments, and certain payments made with respect to readily tradable
Instruments, generally you will have 60 days to get a TIN and give It to
the requester before you are subject to backup withholding on
payments. The 60-day rule does not apply to other types of payments.
You will be subject to backup withholding on all such payments until
you provide your TIN to the requester,
Note: Entering "Applied For" means that you have already applied for a
TiN or that you Intend to apply for one soon.
Caution: A disregarded U.S. entity that has a foreign owner must use
the appropriate Form W-8.
To establish to the withholding agent that you are a U.S. person, or
resident alien, sign Form W-9. You may be requested to sign by the
withholding agent even If item 1, 4, or 5 below indicates otherwise.
For a joint account, only the person whose TIN Is shown in Part I
should sign (when required). In the case of a disregarded entity, the
person Identified on line 1 must sign, Exempt payees, see Exempi payee
code, earlier.
Signature requirements. Complete the certification as indicated In
Items 1 through 5 below.
Form W-9 (Rev.10-2016) page 6
1. Interest, dividend, and barter exchange accounts opened
before 1984 and broker accounts considered active during 1983.
You must give your correct TIN, but you do not have to sign the
certification.
2. Interest, dividend, broker, and barter exchange accounts
opened after 1983 and broker accounts considered Inactive during
1983. You must sign the certification or backup withholding will apply. If
you are subject to backup withholding and you are merely providing
your correct TIN to the requester, you must cross out item 2 In the
certification before signing the form.
3. Real estate transactions. You must sign the certification. You may
cross out item 2 of the certification.
4. Other payments. You must give your correct TIN, but you do not
have to sign the certification unless you have been notified that you
have previously given an incorrect TIN. "Other payments" include
payments made in the course of the requester's trade or business for
rents, royalties, goods (other than bills for merchandise), medical and
health care services (including payments to corporations), payments to
a nonemployee for services, payments made in settlement of payment
card and third party network transactions, payments to certain fishing
boat crew members and fishermen, and gross proceeds paid to
attorneys pnciuding payments to corporations).
S. Mortgage Interest paid by you, acquisition or abandonment of
secured property, cancellation of debt, qualified tuition program
payments (under section 629), ABLE accounts (under section 529A),
IRA, Coverdell ESA, Archer MSA or HSA contributions or
distributions, and pension distributions. You must give your correct
TIN, but you do not have to sign the certification,
What Name and Number To Give the Requester
For this type of account: I Give name and SSN of:
2. Two or more individuals fjoint
account) otherthan an account
maintained by an FFi
. Two or more U.S. persons
fioint account maintained by an FFI)
4. Custodial account of a minor
(Uniform Gift to Minors Act)
5. a. The usual revocable savings trust
(grantor is also trustee)
b. So-called trust account that is not
a legal or valid trust under state law
The actual owner of the account or, if
combined funds, the first individual on
the account
Each holder of the account
The minorx
The grantor -trustee'
The actual owner'
6. Sole proprietorship or disregarded The owner,
entity owned by an individual
7. Grantor trust filing under Optional The grantor'
Form 1099 Piling Method i (see
Regulations section 1.6714(b)(2)@
For this type of account I Give name and EiN of;
Individual
9. A valid trust, estate, or pension trust
10, Corporation or LLC stetting
corporate status on Form 8832 or
Form 2553
11. Association, club, religious,
charitable, educational, or other tax-
exempt organization
12. Partnership or muhi-member LLC
13. A broker or registered nominee
owner
Legal entity,
The corporation
The organization
The partnership
The broker or nominee
For this type of account; ( Give name and EIN of:
Agriculture to the name of a public
entity (such as a state or local
government, school district, or
prison) that receives agricultural
program payments
15. Grantor trust filing underthe Form
1041 Filing Method or the Optional
Form 10g9 Filing Method 2 (see
Regulations section 11.6714(b)(2)(i)(E
The trust
ME
r List first and circle the name of the person whose number you furnish.
It only one person on a joint account has an SSN, that person's number
must be furnished,
2 Circle the minor's name and furnish the minces SSN.
3 You must show your individual name and you may also enter your
business or DBA name on the "Business name/disregarded entity"
name line, You may use either your SSN or EW (if you have one), but the
IRS encourages you to use your SSN.
4 List first and circle the name of the trust, estate, or pension trust. (Do
not furnish the TIN of the personal representative or trustee unless the
legal entity itself Is not designated In the account title.) Also see Special
rufesforpartnershtps, earlier.
*Note: The grantor also must provide a Form W-9 to trustee of trust,
Note: If no name Is olrcled when more than one name Is listed, the
number will be considered to be that of the first name listed.
Secure Your Tax Records From Identity Theft
Identity theft occurs when someone uses your personal Information
such as your name, SSN, or other identifying information, without your
permission, to commit fraud or other crimes, An identity thief may use
your SSN to get a Job or may file a tax return using your SSN to receive
a refund.
To reduce your risk:
• protect your SSN,
• Ensure your employer Is protecting your SSN, and
• Be careful when choosing a tax preparer.
If your tax records are affected by identity theft and you receive a
notice from the IRS, respond right away to the name and phone number
printed on the IRS notice or letter.
If your tax records are not currently affected by identity theft but you
think you are at risk due to a lost or stolen purse or wallet, questionable
credit card activity or credit report, contact the IRS Identity Theft Hotline
at 1-800-908-4490 or submit Form 14039.
For more Information, see Pub.5027, identity Theft Information for
Taxpayers.
Victims of identity theft who are experiencing economic harm or a
systemic problem, or are seeking help In resolving tax problems that
have not been resolved through normal channels, may be eligible for
Taxpayer Advocate Service ITAS) assistance. You can reach TAS by
calling the TAS toil -free case intake line at 1-877-777-4778 or TTY/TDD
1-800.829-4059,
Protect yourself from auspicious emails or phishing schemes.
Phishing Is the creation and use of email and websites designed to
mimic legitimate business emails and websites. The most common act
Is sending an small to a user falsely claiming to be an established
legitimate enterprise In an attempt to soar the user Into surrendering
private information that will be used for identity theft.
Form W-9 (Rev.10-2018) Page 6
The IRS does not initiate contacts with taxpayers via emails. Also, the
IRS does not request personal detailed Information through email or ask
taxpayers for the PIN numbers, passwords, or similar secret access
information for their credit card, bank, or other financial accounts.
If you receive an unsolicited email claiming to be from the IRS,
forward this message to phlshing@lrs.gov. You may also report misuse
of the IRS name, logo, or other IRS property to the Treasury Inspector
General for Tax Administration (TIGTA) at 1-800-366-4484. You can
forward suspicious emails to the Federal Trade Commission at
seam@uce gov or report them at www.tic.govlcomplalnt You can
contact the FTC at www.fto.gov11dtheff or 877-IDTHEFT (877-438-4388)„
If you have been the victim of identity theft, see www.identity"Theft.gov
and Pub. 5027.
Visit www.!m,gov11dent1tyThaft to team more about identity theft and
how to reduce your risk.
Section 6109 of the Internal Revenue Code requires you to provide your
correct TIN to persons (including federal agencies} who are required to
file information returns with the IRS to report interest, dividends, or
certain other income paid to you; mortgage Interest you paid; the
acquisition or abandonment of secured property; the cancellation of
debt; or contributions you made to an IRA, Archer MSA, or HSA. The
person collecting this form uses the information on the form to file
information returns with the IRS, reporting the above Information.
Routine uses of this information Include giving It to the Department of
Justice for civil and criminal litigation and to cities, states, the District of
Columbia, and U.S. commonwealths and possessions for use in
administering their laws. The information also may be disclosed to other
countries under a treaty, to federal and state agencies to enforce civil
and criminal laws, or to federal law enforcement and Intelligence
agencies to combat terrorism. You must provide your TIN whether or
not you are required to file a tax return. Under section 3406, payers
must generally withhold a percentage of taxable Interest, dividend, and
certain other payments to a payee who does not give a TIN to the payer.
Certain penalties may also apply for providing false or fraudulent
information.
'�DA � � SOON
Barry T. Kuhnly
Manager
affl��
Rossmeyer Daytona Motorcycles, Inc., DBA Bruce Rossmeyer"s
Daytona Harley-Davidson, 1637 North US Highway 1, Ormond Beach,
FL 32174 has been the largest factory authorized Harley-Davidson
dealership for over thirty years and it is our clear intent to maintain,,
yet continue to grow,, that premier leadership position. On a personal
note., I would like to take this opportunity to thank you for the role you
have played In this ongoing endeavor by helping us to build our sales
and service business - throughout the years, which has enabled
Daytona Harley-Davidson to become the top law enforcement sales
dealership operation in the USA. Long and short, we could not have
done this without you and we humbly thank you for such dedication
and support.
There's some great news we'd like to share. We're changing and
wanted to let you know - and become part of that change. Ed Morse
Automotive Group, 2850 South Federal Highway, Delray Beach, FL
33483 has made an offer to purchase our dealership operation and it
has been accepted by sandy Rossmeyer, President of Rossmeyer
Daytona Motorcycles Inc.; essentially, this direction will effectively
enable the sale of the business.
Daytona Harley-Davidson * 1637 North US Hwy 1 9 Ormond Beach, FL 32174
Cell: 954-257-2073 * Fax: 386-671-7077 * E-mail: Bai-ryKulmly((_ftmdhd.conj
IR
What does all of this mean to me, or my agency, you might ask? Once
again, we're planning to maintain the business and our valued law
enforcement customer agencies will see no change in the way we do
business either today or into the foreseeable future. So as to simply
acknowledge this change, you'll find a brief statement,, or letter, which
we plan to attach to your current contract, or lease agreement. This
statement, along with the corresponding signatures of our dealership
ownership, or management staff, timply seeks an authorized person,
or department within your agency, to agree to our new ownership
change, otherwise, we plan to honor our original, current contracts, or
.2greements and all terms and conditions contained therein stand as
Itefore.
The Ed Morse Automotive Group is one of the largest dealer groups in
the nation having received numerous awards and recognition over
decades in business, Ed Morse Automotive Group is headquartered in
Delray Beach, FL and has been family -owned over 75 years.
Even better news - Ed Morse Automotive Group has advised that they
are Planning to continue with (and grow) our police, fleet and law
enforcement business. They understand the added value the police
business brings to the dealership with sales, service, parts and leasing.
They are looking forward to building upon our existing clientele while
building new relationships.
Over the next week there will be an ongoing transition to the new
owner. We will be able to provide the Ocoee Police Department with all
new vendor documents and bank account Information that will be
required to make this a seamless transition.
If any further information is needed, please feel free to contact me at
your convenience.
Mr. Barry T. Kuhhly
Manager, Police and Fleet Sales
EMAG DAYTONA HD, LLC.
DBA Teddy Morse's Daytona Harley-Davidson
Cell -954-257-2073
Daytona Harley-Davidson - 1637 North US Hwy I -Ormond Beach, FL 32174
Cell: 954.257,2073 * Fax: 386.671.7077 - E-mail: I3arryKuhjjly@tnidhd.eotn
State of Florida
Department of State
certify from the records of this office that TEDDY MORSES
DAYTONA HARLEY-DAVIDSON is a Fictitious Name registered
with the Department of State on September 20, 2022.
The Registration Number of this Fictitious Name is G22000118787.
I further certify that said Fictitious Name Registration is active.
I farther certify that this office began filing Fictitious Name
Registrations on January 1, 1991, pursuant to Section 865.09, Florida
Statutes.
Given under my hand and the Great Seal of
Florida, at Tallahassee, the Capital, this the
Twenty First day of eptember, 2022
Secretary ofstate
APPLICATION FOR REGISTRATION OF FICTITIOUS NAME
REGISTRATION# G22000118787
Fictitious Name to be Registered., TEDDY MORSE'S DAYTONA HARLEY-DAVIDSON
Mailing Address of Business: 2860 8 FEDERAL HIGHWAY
DELRAY BEACH, FL 33483
Florida County of Principal ,Place .of Business: MULTIPLE
j-
FEI Number:
Owner(s) Of Fictitious Name:'
EMAG DAYTONA HD LLC
2850 S FEDERAL HIGHWAY
DELRAY BEACH, FL 33483 US
MR11100
I the undersigned, being an owner in the above fictitious name, certify that the information indicated on this form is true and
accurate. I further certify that the fictitious name to be registered has been advertised at least once in a newspaper as defined
in Chapter 50, Florida Statutes, in the
bounty where the principal place of business is located. I understand that the electronic
signature below shall have the same legal effect as if made under oath and I am aware that false information submitted In a
document to the Department of State 6 : onstitutes a third degree felony as provided for in s. 817,155, Florida Statutes.
DENNIS MACINNES 09/20/2022
Electronic Signature(s) ----5a-te
Certificate of Status Requested (X) Certified Copy Requested (X)
C G5 D I IQ/
Issued Pursuant to Chapter 212, Florida Statutes
FLORIDA
1 74-8018894943-5 16;06/22
7
Certificate Nurnher Registration Effectivo Data
This certifies that
TEDDY MORSE'S DAY CHINA HARI,FY-I-,)AVI08
EMAG DAYTONA HD LI-C
1637 N US HIGHWAY 1
ORMOND BEACH FL 32174-2539
M
has plot the sales and use tax registration roqrfirornents for the business location stated above and is authorized to collect and reinit
tax as required by Florida law. This certificate is non-transferablo.
/ A \
Notify the Department immediately if You change
your:
business nanne;
mailing address;
location address within the same, county; of -
close or sell your business,
You can also notify the Department when YOU
temporarily Suspend or resume your bUsiness
operations, The quickest way to notify the
Department is by visiting
floridarevenue.cotTiltaxes/updateaGr,ouiit,
rif•IIh"R 10122
Submit a new registration (online of, paper)
when you:
* BrovO your businoss location from one Florida
COL111ty to another;
* add another location;
* p0rchase or acquire all existing bLISineSS; or.
* change the forro of ownership of your business,
W
This Certificate Expires on December 31, 2023
FLORIDA
fluakiass Marne and I ocation Address Ge Brie ate -ol) or
TEDDY MORSE'S DAYTONA HARLEY-DAVIDS 74-8018894943-5
EMAG DAYTONA HD LLC
1637 N US HIGHWAY I
ORMOND BEACH FIL 32174-2534
By extending Irk; certificate (,,)I the certificate nurnhor to a selling dealer to mako oligiblol 111"C'hases of taxable property or services exerript froin
a of
tax and discretionary sites surtax, the person or business named above oprtifres that the taxable property or services P"' Ohosed or tented will be
resold or re -rented for one or store of the iollowing putposos:
• Resale as fungible personal rlropmy I - Incorporation ns a omtefril, iogredv.jrt, or
• Re-iPritakv; tangible per-sional ptryrujny Inc cnpcaratinn into talqjibre p""Fsoural plopogly being courpollent part of falloible Porsonli property
na ale of a vices repaired that is being Plodkicod 1 for sale by marrulaounorr
no rented o's hall"irolir wmtal proparty CIMTTOUO(Jfflc), rri
Florida law provides for criminal and civil Penalties for fraudirlent rise of a Florida Annual Resale Gerflticato.
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