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HomeMy WebLinkAbout2011-129 Agrmt - SOU RVTV Services CITY OF ASHLAND AGREEMENT FOR RVTV SERVICES BETWEEN CITY OF ASHLAND AND SOUTHERN OREGON UNIVERSITY This Agreemenlis entered into this 15day of July, 2008, by and between THE CITY OF ASHLAND, a municipal corporation (hereinafter 'City"), and the Stale of Oregon acling by and Ihrough the State Board of Higher Education on behalf of SOUTHERN, OREGON UNIVERSITY ("SOU") RECITALS A. ORS 190,110 and ORS 190.010 aulhorizes a unit of local government to enter inlo an agreement with ana/her unit of local government or state agency for the performance of any or all functions and activities Ihat a party to Ihe agreement has authority to perform; and B. The City and SOU have provided cable access television to Ihe community lor several years as reflected in the prior agreements belween the City and SOU and ils predecessors, including agreements dated June 11, 1996 and September 9, 2005; and 8, The 2005 agreement expires on June 30, 2008 and Ihis Agreement is intended to replace all prior wrilten or verbat agreements belween the ' pariies; and C,' City and SOU enter inlo this Agreement to identily their roles and responsibilities in the provision of cable access services by SOU through the operalion of Rogue Valley Community Television (RVTV); and NOW, THEREFORE, in consideration for Ihe mutual covenants contained herein, the receipt and sufficiency of which are hereby acknowledged, the pariies agree as follows: 1. RECITALS. The recitals sel forih aboye are true and correcl and are incorporated herein by this reference. 2. DURATION. [ORS 190.020(1)(e)) Except for termination as provided herein, the term of this agreement shall commence upon approval and execution by both Cily and SOU and shatllerminate on June 30, 2010, unless administratively extended in writing as provided for herein. The City Administrator may extend Ihis Agreement twice, by one year each extension, by indicating in writing to SOU that an extension of the Agreement is sought under the same terms and conditions of this Agreemenl. The extension shall be effective upon receipLoi- a documenl from an authorized SOU representative consenling to Ihe RVTV Agreemenlbelween sou & CITY 7-15-08 extension under the same terms and conditions, allowing for increase in funding as noted herein. 3. SOU SERVICES, FUNCTIONS AND RESPONSIBIlITIES. IORS 190.020(1)J SOU shall use ils best efforis to achieve the following objectives during the period of Ihis Agreement: 3.1 Opera Ie Rogue Valley Community Television (RVTV). 3.2 Engage in the cablecast of Public, Education and Government (PEG) access programming and subject to this agreement, assume control of, all cable channels and interconnect facililies made available to the City for ils use, 3.3 Provide to Ihe citizens of Ashland educational courses in video production. Upon complelion, citizens become Certified Producers and are trained in the safe, proper and effeclive use of RVTV's equipment , and facilities. Certified Producers are granted access to RVTV facilities and equipment to produce local community programming that will be cablecast free of charge on the designated Public Access channel. 3.4 Provide regular equipment maintenance services up to four hou~' '/ per month t6'311 video equipment at City'S council chambers. All such \ equipment is the properiy of CITY .------> 3.5 Ensure proper repair, maintenance and security of equipment v purchased for use at the RVTV facility with City funds, All such equipment shall become properiy of SOU, 3.6 Produce government access programming for the City, the regularly scheduled bi,monthly City Council meetings, monthly Planning Commission meetings, annual Budget Hearings per fiscal year, one , hour,long monthly live studio show, such as Town Hall and up to twelve /' additionalteleyised meetings in council chambers and up to seyen City Band conceris in Lithia Park (weather permitling), Additional services may be purchased by or under the direction of the City Administrator with unrestricted city funds or PEG fees notwithstanding the not-to- exceed limit of this agreement; such additional services shall be charged at the rates reflected on the attached Exhibit A, "price sheet addendum". ' 3.7 RVTV will reserve playback capabilities for a channel provided by Ashland Fiber Network (AFN), or its designated cable television provider. If AFN, or its designated provider chooses to utilize the playback capaJ!iljties reserved for ilsuse, SDU agrees)omake , available all programming listed in 1.7, all programming paid for in the price list for RVTV services and other RVTV programming. If AFN, or RVTV Agreemenl belween sou & CITY 7-15-08 2 ils designated provider, wishes RVTV to "package" content for the , channel, a conlract for services shall be agreed to by the parties, 3.8 Proyide Video on Demand ("VOD") services 10 include archiving up to 1 00 proQram files of City government access programming for a ' period of one yea.rJLQQ! date of captLMe. RVTV provides the City wilh links to tne-Cltywebsite and the City determines program selection for the VOD services. 39 Determine, after consultation and approval by city, use of channels assigned 10 City. 310 SOU shalt provide information to the City, upon request, that Ihe City deemsreasonably appropriate regarding SOU's RVTV actiYities, including ;::;e of funds and accomplisl1ments under this Agreement. 3.11 SOU shall immedialely report to the City upon becoming aware of any unexpected development or prob1ems regarding programming or fiscal considerations which may jeopardize theprovisions of service under this Agreement. 3.12 SOU shall provide an unaudited.i!onual report to the City prior 10 September 30 of each year regarding RVTV workshops and training conducted; government and public access programming; revenue and capital and operaling expenses and a budget-Io-aclual financial slatement based on the fiscal year. SOU !ViII certify that the unaudited annual report provided to the City are the final numbers reported 10 SOU by RVTV, 4, PAYMENT. [ORS 190.020(1)(a)J This agreement inyotves the payment of money from the City of Ashland to SOU for RVTV services. 4,1 Subject to the conditions set out in this Agreement, the Cily shall pay to SOU for RVTV services includted in the body of this agreement from legally available funds, in amoul'Jts nOl,lo exceed: FY 08 - 09 $49,500 FY 09 - 10 $50,985 FY 10,11 $52,515 4.2 When paying for RVTV services under this Agreement, City shall first ulilize PEG fees, if any, colleclefj under franchise agreements, In the event City receives PEG iees in ;amounts greater than the amounts specified above, Ihe overage shall be used to purchase addition at RVTV services set forth in Exhibit 1 or PEG equipment upgrades at Ashland Cily' Councilcham15els-bTotnercitY-l6tatioiis:- RVTV Agreemenl between SOU & CITY 7.15-08 ...--' ~ /' 3 4,3 City shall provide all necessary inforrnation to SOU to establish the City as a vendor of SOU, such information shall include, but 'not be limited to City's contact information and tax identification number. 4.4 Equipment upgrades desired by the City, as contrasted with , ~ replacement, will be funded separately by the City, SOU will be responsible for repairingand'repiaCmg-this equiprnent. ,/ 4.5 SOU will credit the City $4501or each in studio show, such as Town Hall when City cancels the show up to twenly four (24) hours in advance of the scheduled show and will credit fhe City for cancelled meetings f'Yr when the City cancels Ihe show up to Iwenty four hours in advance. The credit will show as $145 for the first hour and $100 for each subsequent hour, 4.6 All payments made to SOU under fhis Agreement should be sent to the following address: .' SOU Business Services Attn: Valerie Dean, Accounts Receivabte 1250 Siskiyou Blvd. Ashland, OR 97520 4.7 SOU is required t9 comply with the Ashland Municipal Code by paying a liYing wage, as defined in City Code, 10 all employees performing work under this Agreement and to any subcontracfor who performs 50% or more, of Ihe service work under this Agreement. SOU is also required to posl the living wage notice predominantly in areas where all employees will see it. 5. BUDGET NONAPPROPR!ATION The City's obligation to pay and SOU's obligation to provide services under this Agreement are subject to non- ~ppropriation of funds in the budget process. 5.1 The amount of money payable to SOU under section 4.1 is subject 10 final appropriation by the City in the budget process on an annual basis. Notwithstanding the termination provisions herein, termination may also occur for such non-appropriation. Specifically, all City obligations to expend money under this Agreement are contingent upon future appropriation as part of the City budget process and local budget law, and the failure of the Council and Budgel Commiliee to make the appropriation shall necessarily result in termination of the Agreement. As such, in the event insufficient funds are appropriated for the payments under this Agreement and the City elects ncit to utilize any other lawfully , 'available-funds~then the City may terminate this Agreemenl at the end of its current fiscal year, with no fur1her liability or penalty to the City. The City shall deliver written notice to SOU of such termination no later I I i I I I I RVTV Agre~menl between sou & CITY 7-15-08 4 " than thirty (30) days from the determination by Ihe City of the event of non,apPJopriation. 5.2 If sufficient funds are not provided in future legislatively approved budgets of SOU to permit SOU in the exercise of its reasonable administrative discretion to continue this Agreement, or if the program for which this Agreement was executed is abolished, notwithstanding any other provision of Ihis agreement, SOU may terminate this Agreement without further liabilily by giving Ihe City nolless than 30 days prior notice, In detennining the ayailability of funds for Ihis Agreement, SOU may use the budgel adopled for it by the Joint Ways and Means Committee of the Oregon Legislative Assembly, SOU will include in its budgel request for each fiscal year sufficient for this Agreement. '6. REVENUE. IORS 190.020(1)(b).) This agreement does not involve Ihe receipt of revenue which must be apportioned between the parties. Each party shall be solely responsible for revenue, if any, received. 7, PERSONNEL. IORS 190.020(1)(c).] No employees will be transferred pursuant to this Agreement. SOU shall be solely responsible for wages and benefits paid to employees working for RVTV, 8. REAL OR PERSONAL PROPERTY. IORS 190,020(1)(d),] There shall be no transfer of title or possession to any real or personal property pursuant to this agreement. 9. TERMINATION, [ORS 190.020(1)(0,) 9.1 All or part of this agreement may be terminated by mutual consent by both parties; or by either party at any time, upon ninety days (90) days notice in writing and delivered by certified mail. In the event of ' termination of Ihe agreement, each party shall be responsible for its own costs and expenses in complying with the agreement. 9.2 This Agreement may be terminated by eilher party if the other party commits any material breach of any of the terms or conditions of this Agreement and fails or neglects to correct the same within 30 days after written notice of such breach. If the breach is of such nature that it cannot be completely remedied within the 30-day period, this proYision shall be complied with if correction of the breach begins within the 30- day period and thereafter proceeds with reasonable diligence and in good faith to effect the remedy as soon as is practicable. 9.3 This Agreement may be terminated for non-appropriation as specified in Section 5. RVTV Agreement between SOU & ~rTY 7-15-08 5 10. REMEDIES. In the event of termination, SOU shall pay 10,Ihe City any unexpended funds received by SOU at any time from the City, City shall pay SOU for services rendered and costs incurred by RVTV prior to the termination date. 11. ASSIGNMENT. SOU shall not assign or transfer any interest in this Agreement without prior written consent of the City, provided, however, thaI SOU may subcontract the performance of any provision or obligation required by this Agreement, so long as SOU remains primarily responsible 10 the City for the performance of such provision or obtigation, 12. INSPECTION RECORDS. 12,1 City shall maintain books, records, documents, and other evidence and accounting procedures and practices sufficient to refiect properly all costs of whateyer nature claimed 10 have been incurred and anticipated in the performance of the Agreement. The Oregon Depar1ment of Higher Education, Oregon Secretary of State, Federat Government, and their duly authorized representatives shall haye access to the books, documents, papers, and records of City which are directly per1inent to the Agreement for the purpose of making audit, examination, excerpts, and transcripts. Such books and records shall be maintained by Cily for three years from the date of the completion of work unless a shorter period is aulhorized in wriling. City is responsible for any CITY audit discrepancies involYing deviation from the terms of the Agreement. 12.2 City shall have access at all reasonable times, including during normal working hours, to all books and records of RVTV. SOU shall maintain books, records, documents, and other eyidence and accounting procedures and practices sufficient to refiect properly all costs of whatever nature claimed 10 have been incurred and anticipated in the performance of the Agreement. CITY, and their duly authorized representatives shall have access to the books, documents, papers, and records of SOU which are directly per1inent to the Agreement for the purpose of making audit, examination, excerpts, and transcripts. Such books and records shall be maintained by SOU for three years from the date of the comptetion of work unless a shor1er period is authorized in writing. SOU is responsible for any SOU audit discrepancies inyolving deyiation from the terms of the Agreement. 13. HOLD HARMLESS AND INDEMNIFICATION, 13,1 The City of Ashland is not providing services but purchasing services through SOU. Accordingly, to the extent permitted by the Oregon Constitution and the Oregon T or1 Claims Act, the par1ies both RVTV Agreemenl between sou & CITY 7-15-08 6 . !. shal.1 hold each olher harmless, defend and indemnify the other from any and all claims, demands, damages or injuries, Iiabilily of damage, including injury resulting in death or damage to property, Ihat anyone may have or assert by reason of any error, act or omission of the other, 'its Dfficers, employees, agents and contractors pursuant t6 Ihis Agreement or the Amendment contemplated herein. Such indemnification shall also cover claims brought against either party under state or federal employees' compensation laws. ProYided however, SOU shall not be held responsible for any claims, actions, costs, judgments or other damages, directly and proximately caused by the criminal or wanton acts of the City of Ashland, its officers, employees or agents or the negligence of the City of Ashland, its officers, employees or agents. Similarly, the Cily of Ashland shall not be held responsible for any claims, actions, costs, judgments or other damages, directly and proximately caused by the criminal or wanton acts of SOU, its officers, employees, or agents or the negligence of SOU, its officers, employees or agents. If any aspect of this indemnity shall be found to be illegal or invalid for any reason whatsoever, such illegalily or invalidity shall not affect the validity of the remainder of this indernnification, 13.2 Except as provided for in this Agreement, the City shatl not be liable for any obligations incurred by SOU. SOU shall nDt represent to any person Ihat Ihe City is liable for SOU'sobligations; except for such obligations the City may be liable as provided for in this Agreement. 14. INSURANCE. City and SOU, at their sole cost and expense shall maintain all risk property and public liability insurance policies on the prospective properties and resources included in this agreement. The initial limits of liability required will be, $2,000,000 for each occurrence and $2,000,000 in the aggregate for the . liability coverages and all property upon completion of construction shall be written on replacement costs basis. 15. DISPUTE RESOLUTION. City and SOU shall attempt to resolve all disputes through staff discussions at the lowest possible level. Both parties to this Agreement agree to provide other resources and personnel to negotiate and find resolution to disputes that cannot be resolved at the staff level. As a next step, claims, disputes or other matters in question between the parties to this Agreement arising out of or relating to this Agreement, or 9reach thereof shall be determined by mediation, arbitration, or litigation. Disputes shall be initially submitted to mediation by a mediator chosen by Ihe parties, The cost of mediation shall be bome equally by the parties. If the parties are unable to agree upon a mediator within 5 days or if medialion fails to resolve the dispute and if either party wants to further pursue the dispute, either party'may request that the dispute be submilled 10 arbitration before a single Rvrv Agreement between SOU & CITY 7.15-08 7 arbitrator agreed to by the parties. If both parties agree to arbitration but are unable to agree upon an arbitrator, each party shall select an arbitrator. The arbitrators so chosen shall select a third, and the decision of a majority of the arbitrators shall be final, bind,ing the parties; and judgment may be entered thereon. Unless the parties mutually agree otherwise, any arbitration proceeding shall be conducted in accordance with the currently in effect Arbitration Rules of the American Arbitration Association pursuant to ORS 190,720. Notwithstanding the above, either party may, at its own discretion, elect to resolve disputes in excess of $50,000 by litigation, if mediation is not successful. 16, NOTICE AND REPRESENTATtVES. All notices,. certificates, or communications shall be delivered or mailed postage prepaid 10 the parties at their respective ptaces of business as set forth below or at a place designated hereafter in writing by the parties. CITY of Ashland: Martha Bennelt City Administrator 20 East Main Ashland, OR 97520 Southem Oreqon University Beth Sunitsch Contracts Officer 1250 Siskiyou Bouleyard Ashland, OR 97520 And when so addressed, shall be deemed given upon deposit in the United States Mail, postage prepaid, In all other instances, notices, billS, and payments shall be deemed given at the time of actual deliyery. Changes may be made in the names and addresses of the person to whom notices, bills, and payments are to be giyen by giving notice , pursuant to this paragraph. 17. MERGER. This Agreement constitutes the Entire Agreement between the parties: .There are no understandings, agreements, or . representations, oral or written, not specified herein regarding this agreement. No amendment, consent, or waiver or lerms of this agreement shall bind either party unless in writing and signed by all parties. Any such amendment, consent or waiver shall be effective only in the specific instance and for the specific purpose given. The parties, by the signatures below or their authorized representalives, ackrlOwledge having read and understood the Agreement and the parties agree to be bound by its terms and conditions. RVTV Agreemenl between SOU & CITY 7-15-08 8 IN WITN ESS WHEREOF, the parties hereto have caused this instnument to be executed in two (2) duplicate'originals, either as individuals, or by their officers, thereunto duly authorized, DATED this k day of July, 2008. CITY OF ASHLAND By AC>~ ~'\<-. Tille ~ C>-V\' Date '. \ STATE OF OREGON, By and through the State Board of Higher Education.on.behalf of Southern o,regon un!2sity d.. '. ' By - ~(///'lNU~ ~~sun~, /)~ )' ( Date Assodate,Directorof Z-'f 0 Bosiness Services : APPROVED AS TO FORM By: RVTV Agreemenl between sou & CITY 7-15-08 APPROVED AS TO FORM fQl~~ 'CilyAttorney 9 Addendum City of Ashland Price List for RVTV Services The following applies to all services not included in the Agreement for Services Service Description Unit Fee Live Government meeling in Per Hour $145/first hour Council Chambers $100/each additional hour Studio based live call-in TV Per Hour $450 production City Band ' Per Show $350 Single camera shoot for a Per Show $250 meetinq / presentation RVTV Mobile Truck '-individually Per Per shoot neqotiated Shoot Video Productions -aye rage cost $2500 per 15 min. Each production shall be a negotiated price, depending on complexity Studio Producer 5 classes $50/$35' Field Producer 5 classes $50/$35' 'Reduced fee of $35 for residents have completed either the Studio Producer classes or Field Producer classes, 10. RVTV Agreement between sou & Cln' 7.15..08 RECEIVED JUN 1 7 2011 Southern OREGON UNIVERSITY June 15,2011 Ms. Martha Bennett City Administrator City of AsWand 20 E, Main Street AsWand, OR 97520 Dear Ms. Bennett: Thank you for the written request to continue the Agreement for RVTV Services between the City of AsWand and Southern Oregon University. This letter serves as SOU's consent to the extension of the Agreement under the same terms and conditions. Sincerely, Craigt:::! ~ Vice President for Finance and Administration cc: Sue Walsh, SOU Associate Provost Ann Seltzer, City of AsWand Management Analyst Vice President for Finance and Administration 1250 Siskiyou Boulevard Ashland, Oregon 97520-5033 Tel 541-552-6319 Fax 541-552-6337 C I TYO F ASHLAND May 16, 201] Elizabeth Sunitch, Associate Director of Business Services Southern Oregon University 1250 Siskiyou Boulevard Ashland, OR 97520 Dear Ms. Sunitch: The current Agreement for RVTV Services'between the City and SOU expires on June 30 20 10, unless, as stated in Section 2 "the Citv Administrator indicates in writing to SOU that an extension of the Agreement is sought under the same terms and conditions... the Agreement mav be extended twice. Section 2 further states "the extension is effective upon receipt of a document from an authorized SOU representative consenting to the extension under the same terms and conditions." ln April of 20 10 the City requested and received an extension of the Agreement. This letter serves as the City's written request to extend the current Agreement to June 30, 2012 and represents the second and final extension as allowed Section 2. i look forward to receiving a letter from SOU agreeing to the extension. Thanks to SOU and the RVTV staff for their excellent work for the City of Ashland. Sincerely ~~/~ M rtha Bennett, City Administrator cc: Susan Walsh, SOU Associate Provost Joe Brett, RVTV Ann Seltzer, City of Ashland Managemen1 Analyst \1 .. :i~~"~~1~~!" ..;' ,.~l"'<~:( SOUTHERN OREGON UNIVERSITY April 12, 2010 Ms, Martha Bennett City Administrator City of AsWand 20 E. Main Street AsWand, OR 97520 Dear Ms. Bennett: Thank you for the written request to continue the Agreement for RVTV Services between the City of AsWand and Southern Oregon University. This letter serves as SOU's consent to the extension ofthe Agreement under the same terms and conditions. Sincerely, ~ Craig Monis Vice President for Finance and Administration cc: Paul Steinle, SOU Associate Provost Nena Heitz, RVfV Admirlistrative Manager Ann Sel1zer, City of AsWand Management Analyst Vice President for Administration and Finance 1250 Siskiyou Boulevard Ashland, Oregon 97520-5033 Tel 541-552-6319 Fax 541-552-6337 bolstad@sou.edu CITY OF ASHLAND April 1,2010 Elizabeth Sunitch, Associate Director of Business Services Southern Oregon University 1250 Siskiyou Boulevard Ashland, OR 97520 Dear Ms. Sunitch: The current Agreement for RVTV Services between the City and SOU expires on June 302010, unless, as stated in Section 2 "the City Administrator indicates in writing to SOU that an extension of the Agreement is sought under the same terms and conditions." Section 2 further states "the extension is effective upon receipt of a document from an authorized SOU representative consenting to the extension under the same terms and conditions" This Jetter serves as the City's written request to extend the current Agreement to June 30,2011. 1 look forward to receiving a letter from SOU agreeing to the extension. Thanks to SOU and the RVTV stafffor their excellent work for the City of Ashland. Si":;t I~ M rtha BelUlett, City Administrator cc: Paul Steinle, SOU Associate Provost Nena Heinz, RVTV Administrative Manager Ann Seltzer, City of Ashland Management Analyst CITY RECORDER Page 1/1 ~~, CITY OF ASHLAND 20 E MAIN ST, ASHLAND, OR 97520 (541) 488-5300 I' 7/::ZTOE1'1" I ,PO NUMBER.. , 10274 VENDOR: 001245 SOUTHERN OREGON UNIVERSITY 1250 SISKIYOU BLVD ASHLAND, OR 97520 SHIP TO: City of Ashland (541) 488-6002 20 E MAIN STREET ASHLAND, OR 97520 FOB Point: Terms: Net Req. Del. Date: Speciallnst: Req. No.: Depl.: Contact: Ann Seltzer Confirming? No Quantiiv ' Unit, ' " ".,'. "Description ' UnitPrh:e' , . .:'Exl. Price' : ',,': RVTV Services - Public Television 54,090.45 FY 2011-2012 . , . SUBTOTAL 54 090.45 BILL TO: Account Payable TAX 0.00 20 EAST MAIN ST FREIGHT 0.00 541-552-2028 TOTAL 54,090.45 ASHLAND, OR 97520 ;, _ .:- Accou'ntlNumber . . , proje'ct Number , 'Amount Account Number. - Project Number' 'Amount'j~. ~~...; E 110.01.02.19.60416 54 090.45 ,th(. .A'~~ ?7h Au orized'Signature VENDOR COPY I FO~1 #3 1-\ !'€." , .. I: ,-.'" . 't. CITY OF ASHLAND REQUISITION Date of request: Required date for delivery: Vendor Name Address, City, State, Zip Contact Name & Telephone Number Fax Number ~ ~!;;('}tJ:;i~~Q()AetULJ}!J -/J::J.tIliJIA..v , D ( ~ J.APTJ ,~ ;; 1./II,Jpiif ) < C"" f1rlA . SOLICITATION PROCESS D Exemot from Comoetitive BiddinQ D EmerQencv D Wrillen Findings (Form attached) D Invitation to Bid (Copies on file) D Wrillen findings attached D Quote or Pro nasal allached Date annroved bv Council: D Quote or Prooosal attached D Small Procurement CooDerative Procurement Less than $5.000 D Reauest for ProDosal (Copies on file) D State of Oregon Note: Total contract amount, including any Date approved by Council: Contract # amendments may not exceed $6.000 D State of Washington Intermediate Procurement ~Sole Source Contract # GOODS & SERVICES D Written Findings (Form allached) D Other government agency contract $5,000 to $100,000 D Quale or Proposal allached Agency D (3) Wrillen quotes attached Contracl # PERSONAL SERVICES D SDecial Procurement D Intergovemmental Agreement $5.000 to $75,000 D Written Findings (Form attached) Agency D ~s,s than $35,000. by direct appointment D Quote or Proposal allached Contract # D 3 Written nronosals attached Date annroved bv Council: Date approved by Council: Description of SERVICES I t~TIl ~ / f""le- ~"~1 Total Cost II S'I, oqo, Vj' Item # Quantity Unit Description of MATERIALS Unit Price Total Cost TOTAL COST D Per attached QUOTE r Y ;LtJ t' e::z.. $ J~) 090, 'is Project Number ____h - n~ Account NumberLW, IJl-u:Ll1- -1Jf)IfJ),f) Account Number _n. n. __. __. _n_n Account Number ___. __ - __ - __. ______ Account Number ___. __. __' __. ______ 'Expenditure must be charged to the appropriate account numbers for the financials to reflect the actuat expenditures accurately, ANach extra pages if needed, By signing this requisition form. I certify that the information provided above meets the City's public contracting requirements, end the documentation can be provided upon request. (J ~/ Employee Signature:~ A,.J ~ J~ 'Department Head Signature: I(j'~:/ Additional signatures (If applicable): Funds appropriated for current fiscal year: @ / NO ~$- ~~ Finance Director 717 ;;/ Date Comments: G: Finance\Procedure\AP\Forms\Form #3 - Requisition (2).doc Updated on: 512312011