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DISPLAY T / INVOICE <br /> Hollywood Pyrotechnics, Inc. <br /> HOLLPYROTECHNICSOD INC 1567 Antler Point, Eagan, MN 55122 HOLLYWOOD <br /> CHNICS INC <br /> Telephone 651-454-7976 • Fax 651-454-7975 <br /> Display Date: ,Dull 19k",2019 Rain Date: Juull 26'°,2019 <br /> Name/Organization: City of Ceunterviilllle Minnesota <br /> Contact Name: IMark Statz Tel: 651-792-7931 Fax: 651-429.6629 <br /> E-Mail Address: irnstaU@CIEIN'TIEIRVIIILILIEIMIN„corn <br /> Address: 1666 IMaiiun St City: Centerviilllle State: IMIN Zip: 5 036 <br /> Billing Name: same Tel: Fax: <br /> Do you need an extension of our Insurance? R YES ❑ NO <br /> F0 Hollywood Pyrotechnics Choreographed and Fired <br /> ❑ Wholesale Order <br /> Delivery Name: ILauairiie ILaunotte Park Tel: 651-454-7976 Fax: <br /> Address: 6979 ILarnotte IDrive City: Ceirnterviilllle State: IMIN Zip: 56936 <br /> County: Anolka <br /> Notes/Comments <br /> Show slhot electrically and clholreoglralplhed folr(bestIpelrfolrinnalnce,. <br /> ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- <br /> IRetulrin -to the Iball diialrnolnds in ILaMotte Park. <br /> ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ <br /> Safety distances of 300 feet caln Ibe obtained folr 412 maxlimunn shell diameter size. <br /> IMaliln (body of the show will utlilllize 25” 3"y and 4" material, with Innulltli-shot calker to 2" <br /> Wide flrolnts will Ibe used to create a stunning vlisuall display. <br /> THIS AGREEMENT is made and entered into the date signed on following page, <br /> by and between Hollywood Pyrotechnics, Inc., a Minnesota corporation, having Fireworks Subtotal: $5380 <br /> its principle place of business at, 1567 Antler Point, Eagan, Minnesota, 55122, Discount: $g <br /> hereinafter mutually referred to as Seller,as named on the this Display <br /> Agreement. Insurance Extension: $720 <br /> Seller shall furnish to Buyer fireworks display(s),as per this Display Agreement Permit Fee: $0 <br /> accepted by the Buyer, including the services of the Sellers as Pyrotechnician to Shoot Fee: $600 <br /> take charge of and fire the display. Haz-Mat Delivery: $200 <br /> Continued on next page Total Due: $6,,000 <br /> Multi-Year client free bonus of extra product - 15% <br /> PAYMENT: ❑ 33%down,Balance on Display Date; ❑ 60 Days Prepay; ❑ 30 Days Prepay; ❑ Purchase Order# <br /> OFFICE USE ONLY Sales Rep: (Bennie Net;dey O# C# <br /> ❑ Tax Exempt Certificate Received ❑ Order Form Signed ❑ Insurance Questionnaire Received <br /> ❑ Permit Received ❑ Full Payment Received ❑ S/P <br /> 49 <br />