Official Form 410 Proof of Claim

Transcription

1 Claim #116 Date Filed: 1/9/2018 Fill in this information to identify the case: LaPorte Power, LLC Debtor United States Bankruptcy Court for the: District of Delaware (State) Case number Official Form 410 Proof of Claim 04/16 Read the instructions before filling out this form This form is for making a claim for payment in a bankruptcy case Do not use this form to make a request for payment of an administrative expense Make such a request according to 11 USC 503 Filers must leave out or redact information that is entitled to privacy on this form or on any attached documents Attach redacted copies or any documents that support the claim, such as promissory notes, purchase orders, invoices, itemized statements of running accounts, contracts, judgments, mortgages, and security agreements Do not send original documents; they may be destroyed after scanning If the documents are not available, explain in an attachment A person who files a fraudulent claim could be fined up to 500,000, imprisoned for up to 5 years, or both 18 USC 152, 157, and 3571 Fill in all the information about the claim as of the date the case was filed That date is on the notice of bankruptcy (Form 309) that you received Part 1: Identify the Claim 1 Who is the current creditor? AIR PRODUCTS AND CHEMICALS, INC Name of the current creditor (the person or entity to be paid for this claim) Other names the creditor used with the debtor 2 Has this claim been acquired from someone else? 3 Where should notices and payments to the creditor be sent? Where should notices to the creditor be sent? Federal Rule of Bankruptcy Procedure (FRBP) 2002(g) Yes From whom? AIR PRODUCTS AND CHEMICALS, INC Steve Parks Name 7201 HAMILTON BLVD ALLENTOWN, PA Number State Contact phone Contact Name Street City Where should payments to the creditor be sent? (if different) Number ZIP Code parkssg@airproductscom Street City State ZIP Code Contact phone Contact Uniform claim identifier for electronic payments in chapter 13 (if you use one): 4 Does this claim amend one already filed? Yes Claim number on court claims registry (if known) Filed on MM 5 Do you know if anyone else has filed a proof of claim for this claim? Official Form 410 / DD / YYYY Yes Who made the earlier filing? Proof of Claim 1 g7m1,*dr Vk« page 1

2 Part 2: Give Information About the Claim as of the Date the Case Was Filed 6 Do you have any number you use to identify the debtor? Yes Last 4 digits of the debtor s account or any number you use to identify the debtor: How much is the claim? 184,95803 Does this amount include interest or other charges? Yes Attach statement itemizing interest, fees, expenses, or other charges required by Bankruptcy Rule 3001(c)(2)(A) 8 What is the basis of the claim? Examples: Goods sold, money loaned, lease, services performed, personal injury or wrongful death, or credit card Attach redacted copies of any documents supporting the claim required by Bankruptcy Rule 3001(c) Limit disclosing information that is entitled to privacy, such as health care information Monthly invoicing for O and M contract associated with managing Laporte Facility 9 Is all or part of the claim secured? Yes The claim is secured by a lien on property Nature or property: Real estate: If the claim is secured by the debtor s principle residence, file a Mortgage Proof of Claim Attachment (Official Form 410-A) with this Proof of Claim Motor vehicle Other Describe: Basis for perfection: Attach redacted copies of documents, if any, that show evidence of perfection of a security interest (for example, a mortgage, lien, certificate of title, financing statement, or other document that shows the lien has been filed or recorded) Value of property: Amount of the claim that is secured: Amount of the claim that is unsecured: (The sum of the secured and unsecured amount should match the amount in line 7) Amount necessary to cure any default as of the date of the petition: Annual Interest Rate (when case was filed) % Fixed Variable 10 Is this claim based on a lease? Yes Amount necessary to cure any default as of the date of the petition 11 Is this claim subject to a right of setoff? Yes Identify the property: Official Form 410 Proof of Claim page 2

3 12 Is all or part of the claim entitled to priority under 11 USC 507(a)? Yes Check all that apply: Amount entitled to priority A claim may be partly priority and partly nonpriority For example, in some categories, the law limits the amount entitled to priority Domestic support obligations (including alimony and child support) under 11 USC 507(a)(1)(A) or (a)(1)(b) Up to 2,850* of deposits toward purchase, lease, or rental of property or services for personal, family, or household use 11 USC 507(a)(7) Wages, salaries, or commissions (up to 12,850*) earned within 180 days before the bankruptcy petition is filed or the debtor s business ends, whichever is earlier 11 USC 507(a)(4) Taxes or penalties owed to governmental units 11 USC 507(a)(8) Contributions to an employee benefit plan 11 USC 507(a)(5) Other Specify subsection of 11 USC 507(a)( ) that applies 13 Is all or part of the claim pursuant to 11 USC 503(b)(9)? * Amounts are subject to adjustment on 4/01/19 and every 3 years after that for cases begun on or after the date of adjustment Yes Indicate the amount of your claim arising from the value of any goods received by the debtor within 20 days before the date of commencement of the above case, in which the goods have been sold to the Debtor in the ordinary course of such Debtor s business Attach documentation supporting such claim Part 3: Sign Below The person completing this proof of claim must sign and date it FRBP 9011(b) If you file this claim electronically, FRBP 5005(a)(2) authorizes courts to establish local rules specifying what a signature is A person who files a fraudulent claim could be fined up to 500,000, imprisoned for up to 5 years, or both 18 USC 152, 157, and 3571 Check the appropriate box: I am the creditor I am the creditor s attorney or authorized agent I am the trustee, or the debtor, or their authorized agent Bankruptcy Rule 3004 I am a guarantor, surety, endorser, or other codebtor Bankruptcy Rule 3005 I understand that an authorized signature on this Proof of Claim serves as an acknowledgement that when calculating the amount of the claim, the creditor gave the debtor credit for any payments received toward the debt I have examined the information in this Proof of Claim and have reasonable belief that the information is true and correct I declare under penalty of perjury that the foregoing is true and correct Executed on date 01/09/2018 MM / DD / YYYY /s/steven G Parks Signature Print the name of the person who is completing and signing this claim: Name Steven G Parks First name Middle name Last name Title Company Collection Supervisor NA Air Products and Chemicals Identify the corporate servicer as the company if the authorized agent is a servicer Address Number Street City State ZIP Code Contact phone Official Form 410 Proof of Claim page 3

4 Debtor: LaPorte Power, LLC District: District of Delaware Creditor: AIR PRODUCTS AND CHEMICALS, INC Steve Parks 7201 HAMILTON BLVD ALLENTOWN, PA, Phone: Phone 2: Fax: Has Supporting Documentation: Yes, supporting documentation successfully uploaded Related Document Statement: Has Related Claim: Related Claim Filed By: Filing Party: Authorized agent parkssg@airproductscom Other Names Used with Debtor: Basis of Claim: Monthly invoicing for O and M contract associated with managing Laporte Facility Total Amount of Claim: 184,95803 Has Priority Claim: Has Secured Claim: Amount of 503(b)(9): Based on Lease: Subject to Right of Setoff: Submitted By: Title: Company: Steven G Parks on 09-Jan :19:09 pm Pacific Time Collection Supervisor NA Air Products and Chemicals Amends Claim: Acquired Claim: Last 4 Digits: Yes Includes Interest or Charges: Priority Under: Nature of Secured Amount: Value of Property: Annual Interest Rate: Arrearage Amount: Basis for Perfection: Amount Unsecured: Uniform Claim Identifier:

5 <APCI> US15 US EN N Y 0 N </APCI> Air Products, LLC (610) Exporter EIN wwwairproductscom Page: 1 of 2 EXTEX LAPORTE LIMITED PARTNERSHIP EXELON BUSINESS SVC ACCTS PAYABLE PO Box BALTIMORE MD : Date: 10/19/2017 Bill-To : Account Number: CustVAT : Delivery Terms: DDP DELIVERY POINT Payment Terms: Net 45 days date of invoice Contact: STEWART, STACY Telephone: Fax: STEWARS3@airproductscom Copies of s and Delivery tes are available on wwwairproductscom/apdirect If you have any further questions relating to your, please contact STEWART, STACY immediately on Quantity - Price unit: TO = 1000 KG KM = 1000 M KG = Kilogram H = Hours L = Litre M3 = Cubic meter EA = Each LB = Pounds NM3 = rmal Cubic Meter FTS = 1scf (70F, 1atm) & FTU= 1000FTS FTR = 1scf (60F, 1atm) & FTT= 1000FTR Summary Product Price 50,06197 Net value 50,06197 Total to be paid USD 50,06197 Purchase Order Number: RELEASE 8 Payment Reference: (Please quote this reference when making your payment) Please pay the above invoiced amount to the bank account, or to the company, as indicated below on or before the Payment Due date Please remit ACH/WIRES payment in US Dollars to Air Products LLC Wells Fargo, Charlotte, NC, ACH ABA Wires ABA (Swift Code WFBIUS6S) ACCT Payment Due Date: 12/03/2017 To the maximum extent permitted by law, Seller shall not be liable under any liability theory for damage claims greater than the price of the product shipment or service giving rise to the claim

6 <APCI> US15 US EN N Y 0 N </APCI> Air Products, LLC (610) Exporter EIN wwwairproductscom Delivery Details Currency: USD Date: 10/19/2017 : Page: 2 of 2 Item Product Detail Quantity Price Price Unit Value Reimbursable Charges for LaPorte, TX for September 2017 Purchase Order /Date: RELEASE 8 / Release : Purchase Order/Reference : RELEASE 8 Ship From: Delte//Date / / / , EA REIMBURSABLE COST Product Price 100 USD 1 EA 48,88072 Purchase Order /Date: RELEASE 8 / Release : Purchase Order/Reference : RELEASE 8 Ship From: Delte//Date / / / GAL RAW H20 Product Price 100 USD 1 GAL Purchase Order /Date: RELEASE 8 / Release : Purchase Order/Reference : RELEASE 8 Ship From: Delte//Date / / / GAL DEMINERALIZED WATER Product Price 100 USD 1 GAL Net value 50,06197 Total to be Paid 50,06197 For Domestic Use Only Diversion contrary to US and Regional law is prohibited These items may be subject to licensing from both the US and the exporting country Various Itemized Charges: The total amount due from the customer may include various itemized charges, including: charges for the handling of hazardous materials and for compliance with laws and regulations concerning hazardous materials; charges for handling, delivery, and shipping; and/or charges for energy or fuel ne of the charges represent a tax or fee paid to or imposed by any governmental authority, and all of the charges are retained by the Company

7 <APCI> US15 US EN N Y 0 N </APCI> Air Products, LLC (610) Exporter EIN wwwairproductscom Page: 1 of 2 EXTEX LAPORTE LIMITED PARTNERSHIP EXELON BUSINESS SVC ACCTS PAYABLE PO Box BALTIMORE MD : Date: 11/16/2017 Bill-To : Account Number: CustVAT : Delivery Terms: DDP DELIVERY POINT Payment Terms: Net 45 days date of invoice Contact: STEWART, STACY Telephone: Fax: STEWARS3@airproductscom Copies of s and Delivery tes are available on wwwairproductscom/apdirect If you have any further questions relating to your, please contact STEWART, STACY immediately on Quantity - Price unit: TO = 1000 KG KM = 1000 M KG = Kilogram H = Hours L = Litre M3 = Cubic meter EA = Each LB = Pounds NM3 = rmal Cubic Meter FTS = 1scf (70F, 1atm) & FTU= 1000FTS FTR = 1scf (60F, 1atm) & FTT= 1000FTR Summary Product Price 25,99372 Net value 25,99372 Total to be paid USD 25,99372 Purchase Order Number: RELEASE 8 Payment Reference: (Please quote this reference when making your payment) Please pay the above invoiced amount to the bank account, or to the company, as indicated below on or before the Payment Due date Please remit ACH/WIRES payment in US Dollars to Air Products LLC Wells Fargo, Charlotte, NC, ACH ABA Wires ABA (Swift Code WFBIUS6S) ACCT Payment Due Date: 12/31/2017 To the maximum extent permitted by law, Seller shall not be liable under any liability theory for damage claims greater than the price of the product shipment or service giving rise to the claim

8 <APCI> US15 US EN N Y 0 N </APCI> Air Products, LLC (610) Exporter EIN wwwairproductscom Delivery Details Currency: USD Date: 11/16/2017 : Page: 2 of 2 Item Product Detail Quantity Price Price Unit Value Reimbursable Charges for LaPorte, TX for October 2017 Purchase Order /Date: RELEASE 8 / Release : Purchase Order/Reference : RELEASE 8 Ship From: Delte//Date / / / , EA REIMBURSABLE COST Product Price 100 USD 1 EA 25,77784 Purchase Order /Date: RELEASE 8 / Release : Purchase Order/Reference : RELEASE 8 Ship From: Delte//Date / / / GAL RAW H20 Product Price 239 USD 1000 GAL 034 Purchase Order /Date: RELEASE 8 / Release : Purchase Order/Reference : RELEASE 8 Ship From: Delte//Date / / / , GAL DEMINERALIZED WATER Product Price 318 USD 1000 GAL Net value 25,99372 Total to be Paid 25,99372 For Domestic Use Only Diversion contrary to US and Regional law is prohibited These items may be subject to licensing from both the US and the exporting country Various Itemized Charges: The total amount due from the customer may include various itemized charges, including: charges for the handling of hazardous materials and for compliance with laws and regulations concerning hazardous materials; charges for handling, delivery, and shipping; and/or charges for energy or fuel ne of the charges represent a tax or fee paid to or imposed by any governmental authority, and all of the charges are retained by the Company

9 <APCI> US15 US EN N Y 0 N </APCI> Air Products, LLC (610) Exporter EIN wwwairproductscom Page: 1 of 2 EXTEX LAPORTE LIMITED PARTNERSHIP EXELON BUSINESS SVC ACCTS PAYABLE PO Box BALTIMORE MD : Date: 11/01/2017 Bill-To : Account Number: CustVAT : Delivery Terms: DDP DELIVERY POINT Payment Terms: Net 45 days date of invoice Contact: STEWART, STACY Telephone: Fax: STEWARS3@airproductscom Copies of s and Delivery tes are available on wwwairproductscom/apdirect If you have any further questions relating to your, please contact STEWART, STACY immediately on Quantity - Price unit: TO = 1000 KG KM = 1000 M KG = Kilogram H = Hours L = Litre M3 = Cubic meter EA = Each LB = Pounds NM3 = rmal Cubic Meter FTS = 1scf (70F, 1atm) & FTU= 1000FTS FTR = 1scf (60F, 1atm) & FTT= 1000FTR Summary Product Price Product Price 87,98895 Net value 87,98895 Total to be paid USD 87,98895 Purchase Order Number: Release 8 Payment Reference: (Please quote this reference when making your payment) Please pay the above invoiced amount to the bank account, or to the company, as indicated below on or before the Payment Due date Please remit ACH/WIRES payment in US Dollars to Air Products LLC Wells Fargo, Charlotte, NC, ACH ABA Wires ABA (Swift Code WFBIUS6S) ACCT Payment Due Date: 12/16/2017 To the maximum extent permitted by law, Seller shall not be liable under any liability theory for damage claims greater than the price of the product shipment or service giving rise to the claim

10 <APCI> US15 US EN N Y 0 N </APCI> Air Products, LLC (610) Exporter EIN wwwairproductscom Delivery Details Currency: USD Date: 11/01/2017 : Page: 2 of 2 Item Product Detail Quantity Price Price Unit Value Purchase Order /Rel : Release 8 / Item : 0 Contract: Date: 12/01/ /31/ EA START UP FEE Item Net Value 44,99813 USD 1 EA 44,99813 Purchase Order /Rel : Release 8 / Item : 0 Contract: Date: 12/01/ /31/ EA MANAGEMENT FEE Item Net Value 42,99082 USD 1 EA 42,99082 Net value 87,98895 Total to be Paid 87,98895 Price escalation descriptions: ECI1: EMPLOYMENT COST INDEX\COMPENSATION, PRIVATE INDUSTRY WORKERS\TOTAL\NOT SEASONALLY ADJUSTED\SOURCE: BLS, EMPLOYMENT COST INDEX PRESS RELEASE average for 12 months ending June 2017 For Domestic Use Only Diversion contrary to US and Regional law is prohibited These items may be subject to licensing from both the US and the exporting country

11 <APCI> US10 US EN N Y 0 N </APCI> Air Products and Chemicals, Inc GST RT0001 QST TQ0001 Exporter EIN wwwairproductscom Page: 1 of 2 EX TEX LAPORTE LIMITED PARTNERSHIP EXELON BUSINESS SVC ACCTS PAYABLE PO Box CHICAGO IL : Date: 11/01/2017 Bill-To : Account Number: CustVAT : Delivery Terms: DDP DELIVERY POINT Payment Terms: Net 30 days date of invoice Contact: STEWART, STACY Telephone: Fax: STEWARS3@airproductscom Copies of s and Delivery tes are available on wwwairproductscom/apdirect If you have any further questions relating to your, please contact STEWART, STACY immediately on Quantity - Price unit: TO = 1000 KG KM = 1000 M KG = Kilogram H = Hours L = Litre M3 = Cubic meter EA = Each LB = Pounds NM3 = rmal Cubic Meter FTS = 1scf (70F, 1atm) & FTU= 1000FTS FTR = 1scf (60F, 1atm) & FTT= 1000FTR Summary Product Price Product Price 20,91339 Net value 20,91339 Total to be paid USD 20,91339 Purchase Order Number: RELEASE 5 Payment Reference: (Please quote this reference when making your payment) Please pay the above invoiced amount to the bank account, or to the company, as indicated below on or before the Payment Due date Please remit checks to Air Products and Chemicals P O Box Atlanta GA Payment Due Date: 12/01/2017 To the maximum extent permitted by law, Seller shall not be liable under any liability theory for damage claims greater than the price of the product shipment or service giving rise to the claim

12 <APCI> US10 US EN N Y 0 N </APCI> Air Products and Chemicals, Inc GST RT0001 QST TQ0001 Exporter EIN wwwairproductscom Delivery Details Currency: USD Date: 11/01/2017 : Page: 2 of 2 Item Product Detail Quantity Price Price Unit Value Purchase Order /Rel : RELEASE 5 / Item : 0 Contract: Date: 12/01/ /28/ EA ADJUSTED BASE RENT Ship-To: =BASE RENT + BASE RENT (CPIc - CPIb)/CPIb Item Net Value 20,91339 USD 1 EA 20,91339 Net value 20,91339 Total to be Paid 20,91339 Price escalation descriptions: CPIb: CPIc: US CONSUMER PRICE INDEX\ALL URBAN\HOUSTON-GALVESTON-BRAZO\ALL ITEMS\UNITS =100\SOURCE: BLS, CONSUMER PRICE INDEX average for 12 months ending August 2000 US CONSUMER PRICE INDEX\ALL URBAN\HOUSTON-GALVESTON-BRAZO\ALL ITEMS\UNITS =100\SOURCE: BLS, CONSUMER PRICE INDEX average for 12 months ending August 2016 For Domestic Use Only Diversion contrary to US and Regional law is prohibited These items may be subject to licensing from both the US and the exporting country

13