HomeMy WebLinkAbout2003-125 PO-Small Woodlands SvcCITY OF ASHLAND
20 E MAIN ST.
ASHLAND, OR 97520
(541) 488-5300
CITY RECORDER'S COPY
I
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03358
VENDOR: 001765
SMALL WOODLANDS SERVICES, INC.
2779 CAMP BAKER ROAD
MEDFORD, OR 97501
SHIP TO: Ashland Fire Department
('541) 482-2770
455 SISKIYOU BLVD
ASHLAND, OR 97520
FOB Point:
Terms: Net 15 days
Req. Del. Date: 06/10/2002
Special Inst:
Req. No.:
Dept.: PUBLIC WORKS
Contact: Keith Woodle¥
Confirming? NO
Quantity Unit Description unit Price Ext. price-
THIS IS A REVISED PURCHASE ORDER
,
BLANKET PURCHASE ORDER .
Ashland Forest Work Proiect 75,000.00
Not to exceed $75,000 for '~:~:
FY 2002-2003
RFP
Date of a.qreement: June'10, 2002 . '....
Insurance required/On file
,
·
..
Contract may be extended on an
annual basis Up to (5) years. .
Revised purchase order 06/30/2003 60,000.00
Renewal of Forest Work Project " '~"'. ,:.. '""
Appropriation for 2003-2004 FY of
,. Operations ...
,.
,.
..
SUBTOTAL 135,000.00
BILL TO: Account Payable TAX 0.00
20 EAST MAIN ST FREIGHT 0.00
541-552-2010 TOTAL 135,000.00
ASHLAND, OR 97520
Account'Number Amount Account Number Amount :,
E 670.08.29.00.604160 135,000.00
,
Auth~ed Signature
VENDOR COPY
a
CITY OF
ASHLAND
REQUISITION FORM
Date of Request: f &)..(tt~~~
~ REQUEST IS A:
'fJ' Change Order( existing PO # 03358)
Required Date of Delivery/Service:
Vendor Name:
Address:
City, State, Zip:
Phone:
Fax Number
Deliver Location
SMAil woonl ANnS SFRVIr.FS
2779 Carno Baker Road
Medford, OR 97501
(H) 535-3603 (CELL) 890-8609
Services Only
Description
RENEWAL OF FOREST WORK PROJECT
APPROPRIATION FOR 2003-2004 FY OF OPERATIONS
Total Cost
Solicitation Process:
o Exempt 0 3 Written Quotes
(copies attached)
o Sole Source D Invitation to Bid
(caRies on file)
.
Request for
raposal (copies on file)
o Less than
$5000
$ 60,000.00
Account Number 670-08-29-00-604160
*Please attach the Original signed contract and Insurance certificate.
Materials Only
Item # Quantity Unit
Description
Unit Cost Total Cost
Account Number
. . . ..
--- -- -- -- ------
*Please attach the quotes.
Employee Signature: Supervisor/Dept. Head Signature: r-:L-i..~1:I,- f i''1/l'f,~
NOTE: By signing this requisition form, I certify that the above request meets the City of Ashland Solicitation Process requ ements and can be provided U
when necessary.
G:Finance\Procedure\AP\Forms\Requisition Form 2003
;
Updated on:07/15/02