HomeMy WebLinkAbout2010-157 Agrmt - Qwest Wholesale Services
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CITY OF
ASHLAND
20 E MAIN ST.
ASHLAND, OR 97520
(541) 488-5300
CITY RECORDER
Page 1/1
"'-:" .; DATE'
9/29/2010
;',,' PO NUMBER
09821
VENDOR: 001982
\ OWEST, WHOLESALE SERVICES
POBOX 856184
LOUISVILLE, KY 40285-6184
SHIP TO: Ashland Fire Department
(541) 482-2770
455 SISKIYOU BLVD
ASHLAND, OR 97520
FOB Point:
Terms: Net
Req. Del. Date:
Speciallnst:
Req. No.:
Dept.:
Contact: David Martin
Confirming? No
: :Quantit\?:~ ".'=.Urii"f. :;"-.:;:"~'1 ....;-',.1, ~.~'. "Description.
THIS is A REVISED PURCHASE ORDER
EZ Route - Emergency hot line for
recorded emergency announcements
(adding feature to existing Owest
services)
Installation: $180.00
Monthly service charge: $80.00
Per minute charge: $0.02
Note: PO issued for installation and
monthly service charges.
";-''-UhkPrice_':~',' ',~ . .i,'Ex( p'rice-i:~,.:l::
980.00
BILL TO: Account Payable
20 EAST MAIN ST
541-552-2028
ASHLAND, OR 97520
SUBTOTAL
TAX
FREIGHT
TOTAL
980.00
0.00
0.00
980.00
r'~i::-~Accouni Numtier:-!~:~S~~ ,;:;.rp-roje-C:fli.Jumber', 1, , :ArTlfJ'unt.,f Account Number .. i'~":' Project Number' ..J: _ ,:',~/,,'AriiotlhC;il
. .
E 1 10.07.12.00.60311 980.00
.
~
.
~._.!i?/J
Aut rized Signature
VENDOR COPY
, fa,r {l { 4 fi;?- . -
, " V' -trli d VI. r I V
A,reqUestforapurChaSeOp~/~ ~~ /Y~
REQUISITION FO!\NrJ ~ ( P f & q ,~
THIS REQUEST IS A: ~
o Change Order(existing PO # Required Date of Delivery/Service: \01-28: -/61
tj) hJuz~-~ 12/N::# ~'f. oz.;"~Z'(}()
_p D. l30K 52-IEr fIJO€AJI?C r/r'-Z- ~c::n72~2./~7
CITY OF
.ASHLAND
Date of Request: \09-/0 -)01
Vendor Name
Addfess, City, State, Zip
Contact Name & Telephone Number
Fax Number
SOLICITATION PROCESS
o Exemot from Comoetitive BiddinQ 0 Emeraencv
Reason for exemption: 0 Invitation to Bid (Copies on file) 0 Written findings attached
Date approved by Council: o Quote or Proposal attached
o Small Procurement CooDerative Procurement
Less than $5.000 o ReQuestfor Prooosal (Copies on file) o State of Oregon
Note: Tolal contract amount, including any Date approved by Council: Contract #
amendments may not exceed $6,000 . o State of Washington
Intermediate Procurement 0 Sole Source Contract #
GOODS & SERVICES 0 Written findings attached o Other government agency contract
$5,000 to $100,000 0 Quote or Proposal attached Agency
o (3) Written quotes attached Contracf #
PERSONAL SERVICES 0 SDecial Procurement 0 Intergovernmental Agreement
$5,000 to $75.000 0 Written findings attached Agency
o Less than $35,000, by direct appoinlment o Quote or Proposal attached Contract #
o (3) Written prooosals attached Date annroved bv Council: Date approved by Council:
Description of SERVICES
E Z. >e..~ tE--",v~~-7 l5I-~ ~~
~ r~<L~ u2,.h-\<eY?<.24< "l0 C~AU<A~e~~
(t1..~.<.^~ ,.u.!t..#"~ <jC" <:-L!c7U?"t!.c {/)W<.pd- f:le.r....a~
Item # Quantity Unit Description of MATERIALS
Total Cost
-.f (e,O_.H>~f(-.tJ..tW "
~" ~ / ~u..f: . .:
O"~,~:_'<" ',. ,--,__ ~"~'-i:
$ 0(!'J,M c;Ly;'.
.'
ToiAtCOSY"
0 Per attached QUOTE' ~~ --",'.;,~-'
....
, .: .,
Unit Price
Total Cost
Project Number ______. ___
Account NUm(.'; LLO_ -Q,].~1:.t?Q.. .k;o3.1'9 Account Number ___' __' __' __' ___d_
Account Number ___' __' __' __' ______ Account Number ___' __' --' --' ------
'Expendffure must be charged to the appropnate account numbers for the financials to reflect the actual expenditures accurately. Attach extra pages If needed.
Ii
By signing this requisition fonn, I cerl' that the infonnation provided above meets the City's public contracting requirements, and the documentation can be provided
upon request.
~mPIOyee Signature:
Additional signatures (if applicable): ../
/~
Department Head Signature: , .
"i(...L...YLA..6S( ? /,.., } ,I?
t{~
Funds appropriated for current fiscal year: YES / NO
Finance Director
Date
Comments:
G: Finance\Procedure\AP\Forms\Fonn #3. Requisition.doc
Updated on: 8/512010