HomeMy WebLinkAbout2013-406 Invoice - SOS Alarm
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INVOICE
SOS ALARM 55037 1
3273 Biddle Road
Medford OR 97504
Phone: (541) 773-3900
Fax: (541) 776-2819 ACCOUNT ( DATE 1
http://sosasap.com 1 04797 111/26/131
1-11
ASHLAND PARKS & RECREATION.
340 S PIONEER ST
ASHLAND OR 97520
1 Ordered I completed I PO/Contract no. Sales Tech Terms
111/07/13 111/18/13 1 HOUSE 1 JC I NET 10 DAYS 1
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1 Site Description AMOUNT
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1 06: ICE SKATING TRAILER, 95 WINBURN WAY, ASHLAND 1
1 SETUP FEE . . . . . . . . . . . . . . . . . . . . 90.001
I 11
NOVEMBER BILLING 11/18/13 - 11/30/13 . . . . . . 11.981
12 DAYS AT $29.95/MONTH 1
1 MONTHLY BILLING - DECEMBER . . . . . . . . . . . . 29.951
1
1 Total of this invoice: $131.931
1 Previous balance: $0.001
i Balance due on account: $131.931
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1We accept VISA, MASTERCARD, and DISCOVER. 1
1Any check may be processed electronically. 1
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479.1959
GRANTS PASS 6"_,` ;''s;r: 772-6668
MEDFORD
515 N.E. NTH, GRANTS PASS, OREGON 97526 3273 BIDDLE ROAD, MEDFORD, OREGON 975th
AGREEMENT FOR SALE OF SECURITY SYSTEM N`\ 3010
THIS AGREEMENT la smarad Imo mist Pr/`S/dryd OGTORER acU 1O
iry mca Eeleesn MEOPoRD ALARM & SIGNAL CD,
an Oregon ACaRV ai OBA. SOS. Alarm handsel nf.mad to as Tomanny; end~r/ G F S/-1 CA An • p g2~cJ C2E C
•.Z"CE SKAT/u /L/yL T2glC ER - -
I...,,o.IQf / T R ' n1 Ir_I.nf{J F/44nilJ i5ala ^O
harNMAW rebind toes •BUy . (TeIePllons Na.1 ~Sy/
1. PURCHASE AND INSTALLATION OF THE SYSTEM
1.1 BuyW a, as be as t e SW end CNmsbry egress b Me terms and dealt w woes m M Inf WNdl
e BuyeM1 pnmbee tlpsatudry eyMem ea deecnped NerekMMr
and nonetheless nlamca b Ste
ym; In ewoNerxe Wiry the terms rum denotation. heninagar eat 1wUt.
aM b wrhdele pn teysee MNmHry etl tl iM mebMl aM IvOer M mae ter iM mTipetlon o11M System b acwbMiw WM 1M apeoillwBOna asset brm Mnln
3. TYPE OF BYSTEY sypam b e Greml W aOrkmanllM amnsroc
TM"of -knoriwl PmbeNe aervm. m a furntaMd Is es firm.- ACG 6G✓CD S 1'6 TE M
2.1 ScryrMUb aI.PnlMmn; TNa Wbekq Potegion eMg IM bstasbd:
ODANTITY TYPE OF OPENING PROTECTION TO BE INSTALLED
C,0 - LOCATION
k- ;t 9,0 C CO /
. O l Gp l t 400
OO T 000 a
-r 10
Ec G t //V /Ly U
SUM DESIRES NO FURTHER PROTECTION AT THIS TIME OTHER THAN THAT LISTED ABOVE.
3. PRICE AND PAYMENT -
C 1`1 n reur b2pr/ m Pay m Cooked" W IM stole; Insulators 0 me System Mwin 1V11/ {U
0 A-1•`tl o r WT'/cpgsAluwO A"/LM
2 'LI/T 61 'CvL1 Perm ToT-. .
$Doren upon eaawtbn tl this apraarnNdyW
i Doilare upon wmPeddn of Installation 0 the Syawnl
4. AUTk10RGATION INSTAUl DELAY IN &ISTALLATION
4.1 Buyer eupwdmsuld smpgwrs COmpbry. or lb deelgwe,memeruponlM pnmUes of BUysrb amerbinaalllrye System a Peese Me System to bas IrrMMled.
4.2 Compem, Is herby autMrUW to make" preparation sum as dolling MIaN carving milt making eMchmsnb or doing other thbRR nods or Partners
Is the Installation or service of me ayatem.
4.3 CompeM assumes no 11"Ifty W delay In Installation at be SWIss, due la etrbea rdte, Iboda, NarmR eanlpuaiu; fires power hllunR Neunambn. ado of
Om, or a" other route bested the wNml of Comwny.
AA 11 BUyeriarW thaownsrtlthe pmmiaes Man be SystambloMinarelbd. the BUyerwemnu lMthe MSevdbrlry Trom caw ownerwlb authddzM nprosms
Iles b
e.. gECEIPr OF CMC lea OFCdthe bystem.
0%
5.1 BUYER ACKNQVLEDOES RECEIPT OF A COPY OF THIS CONTRACT.
S. LINKED WARRANTY
6.1 THE COMPANY HEREBY WARRANTS THAT ALL OF THE MATERIAL INSIALLED IS AGREED TO BE AS SPECIFIED AND IS IN ACCORDANCE WITH THE
MANUFACTURERS SPECIFICATIONS IN THE EVENT THAT ANY PART IN THE SYSTEM SHALL BECOME DEFECTIVE OR IN THE EVENT THAT ANY REPAIRS SHALL BE
REQUIRED, THE COMMNY HERESY AGREES TO MAKE ALL REPAIRS AND REPLACEMENTS OF HARRIS WITHOUT COST TO THE BUYER FOR A PERIOD OF TWELVE
MONTHS FROM THE DATE OF WST.kLLATION. COMPANY RESERVES THE OPTION TO EITHER REPLACE OR REPAIR THE PRODUCT, AND RESERVES THE WIGHT TT
SUBSTITUTE MATERIALS OF E UVU. QUALITY AT TIME OF REPLACEMENT THIS WARRANTY DOES NOT CO/ER ANY DAMAGE TO MATERIAL OR EQUIPMENT CAUSED
BY ACCIDENT, MISUSE, ATTEMPTED UNAUTHOgQED REPAIR SERVICE, MODIFICATION, OR IMPROPER INSTALLATION BY ANYONE OTHER THAN COMPANY THIS
WARRANTY DOES NOT INCLUDE IUTMIES AND WDICONS. '
6.2 EXCEPT es SET FORTH IN PARAORAPM E1 ABOVE, THIS SALE IS MADE ON AN x 18-B IS, AND WITH ALL FAULTS' AND COMPANY MARES NO
EXPRESS OR IMPLIED WARRANTIES AS TO AMY MATTER WHATSOEVER, INCLUDING WITHOUT UMRATION, THE CONDITION OF THE EOUIPMENT TM MERCMANA.
BIITTY OR IS FITNESS FOR ANY PMTK;UTAR PURPOSE. COMPANY WES NOT REPRESENT HER WARRANT. T1IATTHE SECIIROY SYSTEM MW I BE COMPROMISED
OR ARDE THE VEPROTECTION FOR WHKOI CIS INSTALLED OR INTENDED BUYER ALL NOT : COMPANY SHALL NOT LIABLE LE MR CONSPOUENN
DAMAGET
ES; THAT ANY YS FIR SIOLTO OF FACTOR PROMISE MADE COMPANY SMALL T B SE DEEMED EMED TO CREATE AN "PRESS W WARRANTY; THAT BUYER 19 NOT
BELYING IECOMPANYS SKILL R JUDGMENT THO E IN SELECTING OR FURNISHING A SYSTEM. BUYER SUITABLE FOR ANY PARTI THAI PURPOSE AND THAT THERE MENO
WANMMIES YMK;NEBEYOND PARONTME FACE OV THEAGREEMENT FORTH OF.BUYER T BUYER SITYERNA HAS READ ANO O QUA10IDS
ALL OF TITS AREEMEW. RTICUURLY RLY PATIAWYMIS le AND 1) "CH CHCX SET SET FORTH COMPANNS MAXIMU MA%IMUM LKINLITHA LIABILITY IN THE EVENT OF .WY LOSS0R AAMME
TO SWEAT ON ANYONE EPA PA ELSE.
E3 WTHISTRANSACTIONISWRHARFg OF~WM C FM,YWIMYCMICEL AN IMEPRMTOMIDNIGMOFTHETH BUSWESS YMOM
THE DATE OF THIS AGREEMENT.
MEDFORD ALARM & SIGNAL CO. D.B.A. SOS ALARM Buv Uio L GOB
BY BY c
,mLF .Q Gy'Q0. n )11 rlNr In
APPq K OMwr
Autt prlasd - T
❑ CORPORADON ❑ SOLE PgOPRIEIOR
D PARTNERSHIP ❑ OTHER
THIS AGREEMENT SHALL NOT BE BINDING UPON COMPANY UNLESS THE TERMS ANT CONDITIONS CONTAINED ON THE REVERSE SIDE OF THIS
APPROVED IN N'RIMM BY AN OFFICER OF COMPANY. IN THE EVENT OF NOW AGREEMENT ME INCORPORATED HEREIN AND BY REFERENCE MADE A PART
APPRUML,THESOLE LIABILITY OF COMPANY SHALL BE TO REFUND M BUYER HEREOF.
THE AMDU TTHAT HAS BEEN PAID TO COMPANY UPON THE SIGNING OF THIS
AGREEMENT.
479-1959 772-6668
GRANTS PASS
MEDFORD
**40
515 N.E. 8TH, GRANTS PASS. OREGON 97526 3273 BIDDLE ROAD, MEDFORD, OREGON 97500
MONITORING-MAINTENANCE AGREEMENT NO 7753
This Agreement is entered into tee Z!Eday of O GTO/3 EK • ?1_L, by and bVtwaon MEDFORD ALARM 8 SIONAL Cn
in Oregon Corporation her Inafter referred to as "COmpanr and C/T OC Ad (-AA,D fGF. SSA-TJN(i 1C/N(TTRAILfjL pgA/(f [rl(EO
located et (Address) 4T G)/tie 13MA) (City) A (State)_QK (Telephone No)S' I
hereinafter re/erred to as "Subscriber."
1. SERVICES TO BE PROVIDED: / 1
A. MONITORING SERVICE (See Paragraphs 3 and 4) )/YES ❑ }}JJO
B. MAINTENANCE SERVICE (See Paragraph 5) ❑ YES GYNO -
CHECK ONLY ONE OF THE FOLLOWING: y
1. Time and M 41dervlFq~~.;..
2 24 r MeiMenence...........❑ 3. Limited Maintenance ❑
''77 yV IY'' 'Y.r( ;LAdG
EXPie /
i
C TYPE OF SYSTEM: ^G~
/'7 I
I
2. PAYMENT A TERMS: 3ybscrlber ..the. to pay to Comoa its ~-IQWW or assigns:
(a) The su J[-Dollars I. ( rv tial connect n Install [lore and%or Inspection, p yebe u n mplot
io .
(b) For monitoring and/or mainteiran,.ce, the sum o(fbJf /++>N/^t /ilf Dollam (E )per month, payable / ~ N
In Neva C0 on the tat day of Ncf:~ti7 • Commentln9 with the month following completion Of IN Insbllallon far a pYlaa
led o.f three
(3) Y...s. In addition, SUPSCIIpor Mail Day the we /era her. DI Ina monthly charge sal 11. month In which flu connection, Inticm f lr I'
e p6 This Agreement fiall automatically No renewed tram Year to yNr thereafter at the same monitoring. he elnIn' rob, ks OI Inspection X
thr shoo puty
asn01111N the other in willing al it. Inbnllen to terminate this Agreement, not INS than thirty (30) days prior to the earar main of the original term it any sup
ggmt renewal IN.. In the dint any pay meet due nereundo 1{ more than tan anz it., ln,scent. the Coma." they Import and Collect a dYlnauent Charles
of 1Nx aer
month (18% par annum) or $3.00 whICMVY is great.,. Suburlper Iz is receive OF Credit against ins service Charlie If tee zYZbm Is temporarily Cut of I Or Oul
of NniN to, any reeWn. -
S. MONITORING SERVICES: Company agnN to menlter without I1ab111tV and not seen insurer punt, th.term of this Agreement, the Sgnels Of i
ad term tyt em Owner by upzGr ter at the promises hYYnabave art forth.
Company shall make such repairs and replacements as may tea necessary for proper operation and maintenance of the signal romlvlns equipment.
11, Ia it. eplnlen of Company, use lay the SupRlber adversely affects the use of tree monitoring equipment or se/vlcN, this Agreement may be Iermrwhad
thirty Got days following written mtks to Subscriber. Sups4lbar acknowledges that Company's maintenance obligation with respect to modltRlry nptee
ably to toe malnlenanc. and Persian Of in. signal receiving equipment ono transmitting equipment owned by Company. Camwir It In no Way ObllytN
to malntaln, request. service, repo,.., operate or a{Wre ins do.Nlion of the ROpY[y, system Or any dw.K.a 01 deVlc. Of the Sub%rbY, unfair eapeNly Pro.
video b Paragraph 1 (et holn.bove.
a. REca1FT OFSfON I.IRESPONSE: i
wel/anty. (ma)keCNYRal. STATION, -A d-lM1comp n or III a.Slgn.., ..Pl what. Ina system terminates at . Police o/ his NDartmenl. shall Without
not dtsrm sea deemed Sml tithe alarm tO hesOquarge of the Publit DoIICt deOYlment unlNS there h lust NVb t0
d) P wa101iar burglar
&$wme ine Ithat hum an py Usupplbd to Company In willing part deemed mC ssary by Company notify the Subscriber or MS designated nRssentMlM by telling she
telephon (2) Upon nCelpt at a hold-u0 alarm signal, transmit the alarm to the Public police department.
(3) UWn ocalOt Of a sprinkler water-flow signal. manual or automatic file alarm signal. transmit the alarm 10 the public fir. department un-
feu that* is Just Cause to ,Hume that an amer"nCy Condition does not exist; It deemed necessary by COrl notify 5...Crmer o1 his designated red-
rem nuuve by calunq the telephone number suoou.d to Company In writing by Subscriber. gnal. pllW in CompanyUpein writing by Subscriber, unless Inslmctled othe wrise5ubstdbe,
or his designated representative OY Calling the telephone number sup
(M POUCH/FIR[ D[PIaR TMENT CONNECTED gLgRMS Subscriber acknowledges that ilia appal{ transmitters from Subwibes's Or.mlua
will Oe monitored In munlclgal Doll. and/err fire departments or ether ocanant. and that tn. pwsMner of lam muph,10.1 poll. and/err Ilre pepartmenl er
Other location are not the agents of CompaaV, nor does Company ammo any responsibility for the manmr In which such denature monitored or the I.
'Pon.. If any. to such slOnaH.
(el TLLLFXOXL LINES s.taCnbar acknowledges met srgnan which are transmitted Over telephone company Signal Channel rifts are wholly bar
Yadd the ConOal a d mlidkt On of COmpanV.red are mdrdblo.d and serviced by the Applicable telephone company or utility.
5. MA1M1 NANCE 8CR V ICE, INS PL CT DNS' COST Oi REPq IRS: SYp{cr IM authorizes and empowYS Company 10 malntaln and service the
on. systa4 no 10 msb any nee zany nzpactlons. ,.,Or
and ra M n raNWed, subject to the following and me terms and conditions as a1 forth In
gangraqup 1 (B) al d.nln.bov. set ratio: ea
(8) TIMEaaNO MATLIgL..a VICC: All .A' us* INpec stairs and bats shall be.1 Subscriber',.... me. A11 n Yry repairs, '...action, and
Inks which may • l.qu r s aRbe Pr Dane. between the hours Of 'too A.M. and 5:00 P.M. on Monday through Friday, excluding national holidays. Rel
pairs that Company n 0.11e.ted la parlorm Dumont to this section Shad be performed on the neat business dry iNlewbN the request for urvlce be Sub
Ipw tinier! otherwise pravlNd. Sub. lost glass to pay for err material. parts aft tabor used for mid repairs, tests or InSou ors at Company'Nhe. Rs
telling Isla. Labor Insider Snau pee for a minimum of one nour for each Asit to Sub.11der's premise/ for the purposes of repairs. In{gction, or tests. Pay.
ment of angrier for maintenance service made Pursuant to this Paragraph mall be paid within ten (lb) pays Of recel%Of COMOAhY'a Invoice theater.
(bITWCNTY. FOVR HOUR MAINTENq NCE: pepelrt GaslbtN by ordinary wear and fast shall is At COmpady'S Wasense. All other repairs i
S..lr de at Su w Nr t esp.me punuan • arena and cendl[bna as tit IOnh in Paragraph 5 (a) n h... nab... elf lest.. All necessary InspclMns and
iwl. Which may der re Llred an In. part of in. Company, other than emergency maintenance. sham to Performed between ins hour, el 9:00 a.m. and 5100
p.m. on Monday through Friday, excluding national holiday, Unless otherwise provided, repairs that Company Is Obligated to Perform pursuant to left sec
Iron, Shall of performed within tw.ntY-lour (24) hours following the request for maintenance by Subscriber.
Id 41MITLDMAINTLXANCE: Repairs nensnbbd by ordinary wear and fast sham b. at CemWnY'lexpense. Allother repirs snarlbsatSup-
,RIbY'{ Ali pwsuanl [O 1 .and condition{ as Ns IRIh In Paragraph 5 (a) Y h.ninabove NI forth. All necessary service, repass. Inapectl00, add
,sets .1m may b I..a. OF the part Of m. C.Waany m... be performed between the hours 019:00 a.m. And 5:00 P.M. en MOnOaY through Friday. N-
OudlnO national hOrlNy, Us,.,, Otherwls. Provided, repairs that Company Is OOllgatb to Perform Pursuant to this s¢llan shall be pYlhow, on t.. next
business day lehewing the request for malmananC. by Subscriber.
a. RECEIP OF COFY: SUBSCRIBER ACKNOWLEDGES RECEIPT OF A COPY OF THIS AGREEMENT.
7. s LITYI Company does not (.present no, Warrad[I that the alarm System services heroin Tay n01 be COTROmIHd or clrCOm
Vested; Or t a a ys .m 0, wry "10vidN will pbv.m any IOU by 1,1191.1y. hard up. fire, err OtharWIN, Or ,hat In. system Or At YOvId.O W111 oil
Nses Provide the PI.I.ti.. far WhICh1they are Intended . SUBSCRIBER ACKNOWLEDGES AND AGREES: THAT COMPANY IS NOT AN INSURER;
THAT SUBSCRIBER ASSUMES ALL RISK OF LOSS OR DAMAGE TO SUBSCRIBER'S PREMISES OR TO THE CONTENT9 THEREOF ANO THgT
SUBSCRIBER HAS READ AND UNDERSTANDS ALL OF THIS AGREEMENT. PARTICULARLY PP 111,ORAFHS I2 AND 1. WHICH ATS FORTH
COMPANY'S MAXIMUM LIABILITY IN THE EVENT OF ANY LOSS OR DAMAGE TO SUBSCRIBES'lfTIVVZiTTE-ECSE~
a. DISCLAIMER OF WARRANTIES: COMPANY MAKES NO EXPRESS OR IMPLIED WARRANTIES AS TO ANY MATTER WHATSOEVER,
INCLUDI NO WITHOUT LIMITATION. CONDITION OF THE EQUIPMENT.ITS MERCHANTABILITY. OR ITS FITNESS FOR ANY PARTICULAR
PURPOSE. OR THAT THE EQUIPMENT OR SERVICES PROVIDED WILL AVERT OR PREVENT OCCURRENCES OR THE CONSEQUENCES THERE.
FROM WHICH THESE SERV ICE(S) OR SYSTEM IS DESIONEO TO'DETECT OR AVERT. SUBSCRIBER ACKNOWLEDGES. THATCOMPANY SHALL
NOT BE LIABLE FOR CONSEQUENTIAL DAMAGES; THAT ANY AFFIRMATION OF FACT OR VROMISE MADE BY COMPANY SHALL NOT BE
DEEMED TO CREATE AN EXPRESS WARRANTYI AND THAT THERE ARE NO WARRANTIES WHICH EXTEND BEYOND THOSE ON THE FACE
OF THE AGREEMENT HEREOF.
MEDFORD ALARM & SIGNAL CO. SUB& IBER 1nJ
BY. yy g/ .1/
t oo ,v~
TITLE. ILA
APPROVED ❑CORpORATION ❑SOLE PROPR IETOR
A.trmi.ad OffrcY ❑ PARTNERSHIP ❑ OTHER
THIS AGREEMENT SHALL NOT BE BINOING UPON COMPANY THE TERMS AND CONDITIONS CONTAINED ON THE RE-
UNLESS APPROVED IN WRITING BY AN OFF ICER OF COMPANY. VERSE SIDE OF THIS AGREEMENT ARE INCORPORATED
IN THE EVENT OF NON-APPROVAL. THE SOLE LIABILITY OF
COMPANY SHALL BE TO REFUND TO SUBSCRIBER THE HEREIN AND BY REFERENCE MADEA PART HEREOF.
AMOUNT THAT HAS BEEN PAID TO COMPANY BY SUBSCRIBER
UPON THE SIGNING OF THIS AGREEMENT.
SOS ALARM NOV 0 7 2013
3273 Biddle Road NUMBER: 55037
Medford OR 97504
Alarm wAs 6234-01 Accounting M 4797-06
Coun : JACKSON Date: 11/7113
JOB SITE: BILLING INFO:
CITY OF ASHLAND
PARKS & RECREATION DEPARTMENT USE EXISITING ACCT INFO
ICE SKATING RINK TRAILER
95 WINBURN WAY
ASHLAND OR 97520
Phone: 541.482-1236 W/CENTURY LINK Contact: RACHAEL DIALS 541-552-2260
Type ❑ CR ® CP . ❑ RR . ❑ RP ❑ DA ❑ TO ® RAE] MV THER
PLEASE SCHEDULE DATE TO RE-INSTALL CUSTOMER OWNED ALLEGRO BURGLAR ALARM
CS SYSTEM + GET NEW EMERGENCY CALL LIST FOR THE SKATING RINK TRAILER + RESTART
MONITORING ON 11/18-20/13 PER CUSTOMER'S REQUEST... PER RAY, NO ELECTRICAL PERMIT
IS NEEDED & PER CITY OF ASHLAND, EXISTING ALARM PERMIT #002215 FOR THIS SITES'S
SYSTEM IS GOOD THROUGH 6/30/2020... PER RACHEL DIALS, SHE & LONNIE FLORA WILL BE
AUTHORIZED ON THE ACCT THIS YEAR... PER RACHEL, PLEASE CALL LONNIE FLORA 541-552-
2250 TO SET INSTALL DATE & TIME... THANK YOU
PER RAY, CHARGE T&M, WHICH IS CURRENTLY $90 PER HOUR FOR 1 HOUR TO DO i
Accounting INSTALL... PER RAY C., USE M/M AGREEMENT # 7753 ON FILE FOR MONITORING & SERVICE
CHARGES... PER RAY C., NO NEW CONTRACT WILL BE NEEDED... PER RAY, NO ELECTRICAL
PERMIT IS NEEDED & PER CITY OF ASHLAND, EXISTING ALARM PERMIT #002215 FOR THIS
SITES'S SYSTEM IS GOOD THROUGH 6130/2020... FYI, SUBS HAVE SYSTEM RE-INSTALLED IN
FALL & PULLED AT END OF WINTER... THANK YOU
❑ REVIEW A/E ❑ MAKE MAP IR CHECKIREPLACE STICKERS
Service
INSTALL EQUIPMENT + RE-START MONITORING PLEASE'INSTALL ALARM EQUIPMENT ON T&M
BASIS + GET NEW EMERGENCY CALL LIST COMPLETED & SIGNED AT APPT - PER RACHEL
DIALS, OK TO BILL FOR CHARGES ($90 PER HOUR FOR LABOR)... PLEASE GET COF SIGNED BY
LONNIE FLORA OR RACHEL DIALS IF THERE ARE ANY OTHER CHANGES OR CHARGES...THANK
YOU
Tech Monthly +$29.95
Completed I I I Total due $90.00
Labor hours Amount paid
$00.00
CIS
I Balance due $90.00
CITY RECORIDER Page 1 1
Ashland Park Commission ....DATE PO NUMBER
20 E MAIN ST. 12/6/2013 00306
ASHLAND, OR 97520
(541) 488-5300
VENDOR: 000717 SHIP TO:
SOS ALARM, MEDFORD ALARM&SIGNAL DBA
3273 BIDDLE ROAD
MEDFORD, OR 97504-4122
FOB Point: Req. No.:
Terms: net Dept.:
Req. Del. Date: contact Rachel Dials
Special Inst: Confirming? NO
i
Quantity Unit - . ' - - -Description - Unit Price Ext-Price
1.00 Each SOS Alarm - Ice Rink Trailer 90.00 90.00
Set up/install equipment owned by Parks
1.00 Each Dismantle equipment for Parks 90.00 90.00
4.50 Mo Monthly Fee (November to be prorated) 29.95 134.78 j
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SUBTOTAL 314.78
BILL TO: TAX 0.00
FREIGHT 0.00
TOTAL 314.78
Account Number. Project Number 'Amount Account Number ProjectNumber' '-Amount
E 211.12.03.02.60691 E 000007.999 314.78
i
- Authori d Signature VENDOR COPY
FORM#3 0 CITY OF
A request for a Purchase Order ASHLAND
REQUISITION Date of request: ila 2-7 lb
Required date for delivery: 1
Vendor Name ift
Address, City, State, Zip
Contact Name & Telephone Number
Fax Number
~ I -
SOURCING METHOD
❑ Exempt from Competitive Bidding ❑ Emergency
❑ Reason for exemption: ❑ Invitation to Bid (Copies on file) ❑ Form #13, Written findings and Authorization
❑ AMC 2.50 Date approved by Council: ❑ Written quote or proposal attached
❑ Written quote or proposal attached
Les Small Procurement Cooperative Procurement
s than $5,000 _ ❑ Request for Proposal (Copies on file) ❑ State of Oregon
❑ Direct Award Date approved by Council: Contract #
❑ Verbal/Written quote(s) or proposal(s) ❑ State of Washington
Intermediate Procurement ❑ Sole Source Contract #
GOODS a SERVICES ❑ Applicable Form (#5,6, 7 or 8) ❑ Other government agency contract
$5,000 to $100.000 ❑ Written quote or proposal attached Agency
❑ (3) Written quotes and solicitation attached ❑ Form #4, Personal Services $5K to $75K Contract #
PERSONAL SERVICES El Special Procurement Intergovernmental Agreement
$5,000 to $75,000 ❑ Form #9, Request for Approval ❑ Agency
❑ Less than $35,000, by direct appointment ❑ Written quote or proposal attached Date original contract approved by Council:
❑ (3) Written proposals/written solicitation Date approved by Council: (Dale)
❑ Form #4, Personal Services $5K to $75K Valid until: Date
Description of SERVICES Total Cost
56 Rates I-ru- R,vt,+e Treu c a~
Item # Quantity Unit Description of MATERIALS Unit Price Total Cost
) L
Zq.gS 14N" 131
ma I Ns G~lunn (--a- Nov. Pruvu>cd
TOTAL COST-
Per attached quote/proposal $
YrojectNumber0(~QO]-`14q AccountNumberhL-U-07i-V--U-Ud (311. 79
Account Number Account Number
'Expenditure must be charged to the appropriate account numbers for the financials to accurately reflect the actual expenditures.
IT Director in collaboration with department to approve all hardware and software purchases:
IT Director Date Support -Yes / No
By signing thic rtify thatt th-~e City's public contracting requirements have been satisfied.
Employee: ~~/A IT) Department Head:
(Equal to or greater than $5,000)
Department Manager/Supervisor: City Administrator:
(Equal to or greater than $25,000)
Funds appropriated for current fiscal year YES / NO
Finance Director- (Equal to orgreaterthan $5,000) Date
Comments: I
I
Form #3 - Requisition