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No Novelle MLA License Renewal Per attached: MLA Order Form/Contract #7126480 Novell Quote 1606413 16,046.24 BILL TO: Account Payable 20 EAST MAIN ST 541-552-2028 ASHLAND, OR 97520 SUBTOTAL TAX FREIGHT TOTAL 1 ~ ~-. .~.iJr ?4~7 Autho d Slgnatwre VENDOR copy ~~~ REQUISITION FORM ' C I "I' YO, ASHLA'N.D THIS REQUEST IS A: D Change Order(existing PO # Date of Request: Required Date of Delivery/Service: Vendor Name Address City, State, Zip Telephone Number Fax Number Contact Name SOLICITATION PROCESS Small Procurement o Less than $5,000 o Quotes (Not required) Sole Source Written findings attached Invitation to Bid (Copies on file) Intermediate Procurement o (3) Written Quotes (Copies attached) COODeratlve Procurement o State of ORN/A contract o Other govemment agency contract o Copy of contract attached o Contract # Reaum for ProDO.al (Copies on file) Soeclall Ex.mol o Written findings attached Emeraencv o Written findings attached Description of SERVICES o Per attached PROPOSAL Item # Quantity Unit Description of MATERIALS Unit Price Tota. Cost Project Number ______ - ___ lEt Per attached QUOTE Account Number7.t.O-~ Q5-.EO ~P.5.7to · Items and seNices must be charged to the appropriate account numbers for the financia/s to reflect the actual expenditures accuretely, By signing this requisition form, I certify that the information provided above meets the City of Ashland public contracting requirements, and the documentation can be provid upon request. ... Supervlsor/Dept. Head Signa e: Employee Signature' G: FinanceIProc:edurelAPlFonns\8_Requisition tonn revised.doc Updated on: 6f1.112OO7