HomeMy WebLinkAbout2003-124 PO - Williams ZografosCITY OF ASHLAND
20 E MAIN ST.
ASHLAND, OR 97520
(541) 488-5300
CITY RECORD,._R S COPY
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PO NUMBER
O4O54
VENDOR: 006980
WILLIAMS ZOGRAFOS & PECK
334 THIRD STREET
PO BOX 547
LAKE OSWEGO, OR 97034
FOB Point:
Terms: Net
Req. Del. Date: 03/06/2003
Special Inst:
SHIP TO: City of Ashland
(541) 488-6002
20 E MAIN STREET
ASHLAND, OR 97520
Req. No.:
Dept.: ADMINISTRATIVE SERVICES
Contact: Tina Gray
Confirming? NO
Q .u..antity Unit ' ...... De$cHption Unit Price Ext, Price
THIS IS A REVISED PURCHASE ORDER
BLANKET PURCHASE oRDER
Police Negotiations 10,000.00
Fire Negotiations 10,000.00
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PSK
Safety Labor Ne.qotiations
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Beginning date: March 6, 2003
Completion date: December 6, 2003
Revised purchase Order 06/30/2003 . 20,000.00
Increased po in the amount of $20,000
for PoliCe & Fire bargaining in 2003-04 '
budget vear.
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SUBTOTAL 40,000.00
BILL TO: Account Payable TAX 0.0.0
20 EAST MAIN ST FREIGHT 0.00
541-552-2010 TOTAL 40,000.00
ASHLAND, OR 97520
Account Number AmoUnt. Account Number " Amount '
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E 710.02.00.00.604100 40,000.00
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Signature
VENDOR COPY-
CITY OF
ASHLAND
REQUISITION FORM
Date of Request: I 7/6/ (/3 I
, I
Required Date of Delivery/Service: I
THIS REQUEST IS A:
"S Change Order( existing PO # D4t1CA-)
Vendor Name:
Address:
City, State, Zip:
Phone:
Fax Number
Deliver Location
J, V i /"L / fJ11'1 ~ Zru f~A Fi\~ ,f Pl:::(' ;C~
0/-3+ TH/e D {;7f!&l3T PC ?()X .L)47
Lfrr-G C/)/1I8bt;' ,I {*;( q7L~':?;4
Services Only
Description Total Cost
IN {f!e/rSf? T() PI? "if D4{25 -1 /Il/
.TH&AfJ1tZlAr( CF f2C/COO fZJf!-.
pt L 4fG t FTf&- I3lff<bl}-/N/N& ,
tAl -Z{io?7 --61 BtlDt7GT{1f!f11-J $20/f)~D
Solicitation Process:
o Exempt 0 3 Written Quotes
(copies attached)
o Sole Source 0 Invitation to Bid
(copies on file)
o Less than 0 Request for
$5000 Proposal (copies on file)
Account Number 110- {2. - (011) Ir!f21../f)/)
*Please attach the Original signed contract and Insurance certificate.
Materials Only
Item # Quantity Unit
Description
Unit Cost Total Cost
TOTAL COST OF
THE MATERIALS
Account Number
-
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Employee Signature: 0U1it r;I&f rtU(;, Supervisor/Dept. Head Signature: ')
NOTE: By signing this requisition form, I certify that e above request meets the City of Ashland Solicitation Process reqUIrements an
when necessary.
G:Finance\Procedure\AP\F orms\8_Requisition form. doc
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Updated on:07/15102