HomeMy WebLinkAbout2008-167 Agrmt - Assoc Business Systems
Aug.22, 2008 3:29PM
CSC RBS PORTLAND u_____.._...'" _...n
No.2852
p, 3
~ UU.)
.Associated
Ponland . Salen, · Eugene.. Roseburg
Seattle · Tacoma .. Klamafh F:itl/s
G~I1~ Pass - Medford - Bend" SpcJca.ne
CllSIomcr PO JJ..
MAINTENANCE AGREEMENT
rwM>T
ASS CUS10met 11
Customer Na",.;
~
ASHLAND, ~ OF
Cu$Iomll!r Name:
MD01eo
20 E MAIN ST
20 E MAIN ST
s-.t AG~
Sln!el Addreu;
ASHLAND
City.
S4i-55z..210D
Phont:
OR 97520
State: ZIp:
541-448-5320
ASBLANn
City:-
541--552-2100
Phone:
OR
Sl:1te;
97520
Zlp:
Fa~:
54.1-448"';320
I<ARI OLSEN
Paz:
Customer CanlBC1:
CU&lamQr CoPltact
~...Qlsm [kacitEl>ashland.or us]
Small A.dClress:
CtnoNl Ad~li:
1ljII:alntenance Agreem~lIt COvet":lge:
For an aM&r.ll. quar1l;lrly or trI~ be8e cl\;ugE) pI~ overage chslVl:, if any, ABS" Ilacbry tnln8d PeI'$OMeI will rend" SSMt:e on the below II~ equillmenl
during regular b~ineS8 "ours in ac~11C8 witl'l the ter"'$ and candilions Sel tOlth DO ~ fronI. and l1M!rSe side I2f fhi& Aptt."Cl11ent
MODEL SERIAl NUMBER Service fO Start M..A.er ImaS!$ 8ase Char~ Overuge C~
AUowal'leQ (Per Image)
M6030 J30056S7 62043 29~1522 NJA NJA $ 0,00831
c%( MeJr:f AIIoW&l1CS
ComrncnlB:
31=A"'"fDlII~lto't!~lh ....aILow..l. ro3ll~nl"H,_~
a.elllllng . SIf<<:t 01r: QDfiIn ~ge lWlIIp .. Mt!cn
r Quarterly Baee Billing SeIaI:r 0rI& Option
(:" IVcmth/y Base Sffiing r Quarterly
r Annual Sase Billing (.' M:mlhly
r Other r01her
SItJejjj M. thBtkDly
(;' BLACK loner Inclusive Chverage
('" BLACKTol'\EIr NON. nt;lt.lSive CCJverage
(' CX)l,OR Toner ~ive O:>>verage
r: OJLOR Tnner N~ - IncllJBive Coverage
12M
~Orum Inclusive eo\rerage
(' ~.. Drum Inclusive CovlllAlge
AgfDe.ment Start Date
Tem!" SeIII!ct 0.. 0pfQn
r 60 M:Irlths
r 048 M:mlbs
r 39 ~ths
r 36 M:>nths
c:- other
Cu~tom9( Aen:os 10 ~y 6n adlJi(iOnal $18.95 per month per mlChl'M: for itllliel NIIIWoctc.II\st;;IR a
IJnJllnlled IT Service t..bor. IT Service l.abDJ' eoV8fS ol'>>oo$j\e &n4 >>hone ....,port far th. 'Guip
C;U.....d Qndw tIW; A&~l1t Ii Sotvtoe Labor and NeLwon; Inatalls 1ft ~ In .ceoi'd
wllb .. T8rm$ and CondIlfafL"; sel rarth ift this Agl8ement and staled herein al'ld 011 !he .ve~e &id
tlereaf..
o CUstomer :lg,... kJ pay $39.9.S pet month tor ~er -9'888 IA pay fat ~*' me~
@Remoten. ~utomaltc Inelercollecllofl servlecs, Up cion seMces perd~. $0-98 perdC'lice
ID 100 device IT\Qters collGaBd :It ne edditior1af Ice!!, will bill charged per bllilng C)'do. Agreed tDt:l1
numbet of ~ metel'$ ID be
eoLleded: 4 l'Bcd toblll8c;
<I 'IIi:;; ~~ncSl A~.ment ~ I/OtwelundabJe, n~ansfatabl8 alld no"-GllICfJlablfi.
This Agtec:mell( .11 /ld b" elfedivf1 U1tl.~ _ed by r:u8101'fler
and '4aoclBfbd &AJnen S"m"s eol'tl",Cl MIJ""lIement,
.Iuly 1, .2QQ8
,..."D-r'......
Cl&8tomcr AQc:eptance;
Q~le
A9-~
~
L.E~
PriIIIMIItI;Jme
~
~
~~f
OllIe
<ihild:;
-
/ u AI ~611f6'1':..
Pl;a.ne 5i3o.2~~ , $C!L.5ij704Bo;r
~ :assorobtRdhusrinRRR I".rII'J1
FlU :s-'i3-1<i4-101~1877~
I "- .... _ ~ .. ~ ... __ .... .... ................. .... .... 1M tho
""'-..~ _.....,..........~... ~....... HIlflllllr..........
........ ............... -.................."'....---........
Received Time Aug22
3,' 18PM
I
MAINTENANCE AGREEMENT
reV9iU'r
Terms and Conditions
1. GENIlIlAI, ScoPE 01' COVUAGE: This Apccmcm covers for acljullmCl1ts, ~ IIIId 10. TERM: This A~t becomes effeetive upon the date indicated in the "Agreement Slart
replllcements of JIlIrU al requiJed by DOmI81 UIe of the equipment, subject to !be exceptiom ia III1d D8le" SpKe thereon. .-l sball continue for the period as specified on the face of
this Aarecment.
in accordance with tbcsc terms BDd coaditioaa. This A8fCCIIlCIIl doca DOC cover charpa for Uolca Customer ~s ABS with thirty (30) days advllDCC wrinen notification of their desire to
installatioo of equipmeDl or dc-iDstaUaioll of equipment if it is moved. Damaae to the cqWp.cnt caucel this A~ iir will automatically renewed for a period of ODe year ouce the specified
tenu
or its JIlIrU aria... out of or caused by misuse. abuse. ncaliJCRCC, lIUaCbmcDt of UDaUthorizcd has been cxcceded
compoDCDts, ac:cetIIOIicI or pets. use of substaDdard paper or lubstaDdarcl supplies or CJlber
cauleS bcyoad the CODh'DI of ADS arc DOt covcrccl by tbiJ Aarccmeot and may subject en..--
to a surcbarp or to cuc:el1atioa of this Apeemeol In additioa, ADS may tcnDiaat.e: the
Apecmeol if !be equipmeau is modiftcd, damqed. altCl'1ld or serviced by pc:noIJIICI othcrtb8 the
ADS AUIborizal PcnClIIDCl, or if parts, acceuories or colllpOllClltS DOt mllCtina macltiDc
spcc:if'u:atiam are fitted to the ~ This AJRlCIIICI1I doca DOt cover cbaraea for rcpaia to
print coatroUc:n or rcpain due to Customer or third panymoclific:aaioDs to IOftware or hMdw_.
2. Suvra CAIUl: Service caIIJ uocIcr tbia AJI'CClIIICIll win be made cluriftallormal busiMa
hoUl'l, 8 Lm. to S p.m. MoDda)' tJIrouF Friday, at the instaU8tion address shown OD the I'CMIll'IC
side of tbiJ Agn:cmcaL Tra"lCl BDd labor time for service calls after Dormal businesa hours" 011
weckencls and OD holidays, if IIDcI wheD available, will be charpd at the published overtime ..res
in effect at 1he time the service caD is made. ADS Rcpresent8tives will DOt handle, discoaDea or
repair IIIWI1borized attachmeDts or colllpOllCDtl; Customer is respoIIsible for disc01l1lectiD& ADd
rccollllClCtina IIDIUIhorized attKbmc:ats or coJ1lllODCDtl. CUItOIIIer hereby indeamifies and IIDlds
ABS ad its RcprcaeDtatives humlesl for clam. for cJau.acs to ay UlWlthoriJJlld "'1,
compoacntS or acceuories rcsuItiD, &om service performed OIl ABS equipment. Labor pcdJmIed
durinl a Iervicc call includel habricItioa BDd elan... of the equipment IIDcI the acljustmeat. repair
or replac:cmeat ofpms deacribccl below.
3. UNLDIrrP.D I,T, SERVICE L.\JIo.: IF TIllS OPnONAL lIEIlV1CZ IL\8 BUN SELBC'I'I!D AND
PAID PO. BY TDIt CUSTOMER rr INCWDU; AU network labor directly related to the c:qmpa.eat
lilted on this.......... "l.T. Servicca Label(' shall be defiued u the fol1owiDa re..... to
Samain.. PriaIiD&. or other IIIltWOrbcI l'unc:tioa of the equipment: Baic iuitial DetWat
iDsIallarioD (if DOt iDeluded ill pun:baac(Jeae of equipmaIt lilted above), instalJinWuPdlliDa
driven, lIddiaa new worlcltaaioaa for aatworIced fImeboas, re-iDstal1iDa network eOlllleClialla if
ellltOlller's network fails, troubIeIboodna u it relates to erron c:aUIed by the cquipDIllIIl (JIaI the
customer', DCltwOIk). Servicea will oaly be ealisted after a ADS equipmeat tcdIai&:iID
dctlll"llliMs tUl a netWOrk issue, DOl the l1lICbinc itself, causes the c:rror. Any scrvic:cs pcrJ'omM:d
outside of the limits ofthc defiaitioaa above (ex: network conaultiq DOl related to the ~
above) will be eharpable to the CUIIOmer at a rate of S99/hour. TIUs OptionaII.T. Scrvicic is
oaly available for A.--aa with a term !bat il 361D011ths or areater.
4. RuADl t\HD REl'LACEMJ!IIlT OF PAIl'I1I: All pats DCCllII8I')' to the opcll'lltiClla of the
cqu~ clue to norua.I war IIIcl teII', with the exception of !be partS listed below and IIII;clct
to the amcraJ scopo of ~ will be fiuuisbed he of eharp durinaa lIIlI'Vice call iDcJudId in
\he maintenlace acrvice provided by this Apeemeal Exc:epci0Dl arc PhotOCODduetora (i.c. copy
drums uaJeu the copier or fax is covered by a Full Covenp Mainteaancc Agreemeat) aIess
otberwile atated in tbiJ AJIftiCIIlCDl. ADS raena the right to c:harge for patS, hiaht, -...me
aod t1Ie1,
S. REcONDITIONING: RcbuiJdiDa or ~ ow:rbIuls arc DOl covered by tbiJ A.-, In
adcIitioIl. whee ill its IOIe cliacntioJI ADS cJetamiaa daat a rec:oaclltioaiDa is neceasuy, U a nauIt
of ClIqlected _ and tell' of IDIIcrials IIId .JIC fiaetan c:auacd by DOI'IDIII office eaw-m
usaae. ill order to kIIIlp die ecpaipnI&lal ia workiD. CODditioa, ADS will submit to the CuaIoaa' ...
estimate of -sed repairs IIDcIlbeir COlI whicb will be ill acIdiIioe to \he c:huae payIbIe -a
this Aar-t. If the Customer does DOt lIUtborizc la reeoaditioain.. ADS may di8caIdiaue
acrvic:e of !he equipmeDI UDder this Aan:emeat (refundiaa the wauaed ponioG of the -'-
eharp) or IDII)' refaae to renew tbiJ AJP'e8IIIflDt upoa its cxpiratiOlL Thereafter, the ASS
RcpreIeIltIt1ve may make service .vailable OIl a "Pc:r eau" buis baed apoa published ..... in
eft'ect at the limo of service,
6. Uu OP ABS SUPI'LIIlS: If the Cuatomer _ other th_ ABS supplica and if'D I1IJIIIIiea
are defectiw or WIICCClplIbIe for uses in ABS _hinea aod cause abnormally fhlqueaI sawice
calls or aenicc probJca.. thea ADS may, at its option, _ a IIU'Cbup or terDIiuaIc dais
A.-t. 10 thil eveat, the CuatDaB' may be ofl'ered service OIl . ''Per Calr' basis bued ...
publiabed raIeI. It is DOt a CODCfiIioa oftbia Aarcemeat. however. thaI the Customer use oaly ASS
authoriaecl nppliea.
7. SUl'l'LY lNcLuIm CON1'llACTS: If supplies are included in the service pI'OYided UDder this
Aarecmeat. ADS will npply bladt toner, ink aod developer, ualcu atberwile stated ia thia
Aarcemeat to the Customer baaed upon DOI'IMI yields. The Aareemeat does DOt iadude
c:onamable supply items sucb U paper ad atapIes. An normal print yields arc predjcated _ III
"8 ~ xiI" sbeet with 5% text COWI'IJII. If the Customer's uaaae of supplies exc:eeds the..-I
yields for the eqaipaeat bcina acrviccd, ADS will iIl\'Oiee lIDd the Customer aarees to pay, for die
- auppHea .. ADS' cumat rellIil prices thea ill effect. ABS reterVea the riJhl to chirp for
supplies. &eiJlbt, 1wxIl...1IIcl fuel.
8. ELIlC'I'RlCAt.: In order 10 inaure optimum perCOl1IlIIICe by the ASS cquipmeat, it is
IlI8Ildatory tbat spec:j('1C models be Plulled into a dedicated liDo ad they must coJl1)ly with
DllDufIctunr elec:trica1 apccific:atioos.. ThcIe powa' standards arc required by UL audfor Iacal
safely reaul8tions.
9. CIIAJlGES: The initial DOD-m1IDdable ehlrp for IDIiDtealDee UDder this Apeemeat sIIaII
be the UIIOUDt let forth oa the nmne aide of this Aareemcm. A8S reaeMlI the riJht to iDenaIe
the Base Cbar8e IIDcI 0wr8ID ChIqe of this aar-t upon RlMWal or mDUally for a muJb..yar
..-L ClIIlOIIICI' IlbaII pay all eHraes within 10 da)'I of iuvoicina. If a col1ecdoa ....
0CClIl'I, eualllaa' ...- to ~ court COltS IIId any l'CUOII8bIe IIttor'Deys fees. 10__ wiB be
ehanl8d III I K '" DIll' _111 a8ar tbirtv 130\ davs oa IDY _id hool_ ASS __ the rilml
to withholcJ lIIlI'Vice or CIDCCI tbia Apeemeat if . eualomer'S ICCOUDl it over lixty (60) cItIya
deliDqueDt. If equjpmeat is IIlCMld to a DeW ADS service territory, ADS ahall haw the opriaa to
c:huJC, aod !be Cuatomer .... to ~ the dift'CnlIICC ia pubIiIbed maialClla1lCC e..... bctwaea
the eunent territory .wi the _ territory (011 a ~rate buia). If equipment is moved ~
ADS'llIIlI'Vi:o territory, ADS resenea the rilbt to cancel or the Cuatomer a..- to pay a fair ad
nlUOIUIbIe ~ for coatiaued 1II'Yice, talciDa "'to ICCOUIlt the diatIIIcc to Customer's _
1ocatioo and the publiahed '*' of ASS for scnicc oa a "Per Call" basis. ADS I'llIIlI'YeS the riPt
to eharp for ahippiaa. hi"" haadliaa IIDcI fael ASS reaerva the ri8l1t to cJwp for -=-s
lDDually at I nue of $0.002.5 per ICIIL
11. EVENt' OF DEPAa-T AND TERMlNAnON: The oc:eurrenc:c of the following shall cODstitute au
E~ of Default: Tbe alStomer fails to pay lilY portiOll of the charges for maintealll1ce of pans. lIS
provided WIder the AanEment when cJue. or Customer fails to duly pcrfonn lilY covenant, eonditiOll
of limitaIioo of this A.-meal Upon the Event of Defau'" ASS may; (i) refuse to service the
equipmr:at; (ii) 6amisIa IlaVice on C.O.D. "Pc:r Call" basis bucd Dpon published rates in effect at the
time of service; (iii) aen.ioate this Agreement. Within 60 days of the eltpiraaioD or terminatiOD of this
Agn:cmeat, ADS shall .-bmit to Customer an itemized invoice for ay fees of Cltpet1SCS, includinll
ay Per Call fees, tben:Iofore accrued UDder this A8JeIlIDIlIlL Except as otherwise provided herein.
Customer. upou pa)'lllClll of accrued UIIOIUlt 10 in\'Oiced, shall thereaftc:r have DO further liability or
obliptiou to ADS w~ver for any further fees or expet1SCS wina hereunder. In the event ASS
tc:mDnales \he A~ because of the breach of Customer, ADS shan be etltitled to paYlllCl1t for
work in prolnlll plus rcimbunemcats for out of pocket expcIIlIeI.
12. INDDOIlI'Y: CuIIomer ahaD indemnify, save and hold ASS, it's affiliates, of1ic:crs, directors,
shueboJdera, employees. aaents and RpreICDtati~ ad their successors and auipl them (ASS
Partiea) bannlcsa &0. ..cl apinat any liability, lou, COil, expense or damaae whatsoever caused by
reaon of any hreac:lt of this Aarcement by Customer or by rcasoa of ay injury whether to body,
property, buaiDesa, eUr.cter or reputation sustained by ASS Parties or to lilY other perIOII by nlllIOn
orany IICl, uealcct. ~ or def.ult by Customer. Customer shaD defend any action to which this
iocIemoity Ihall apply. la the evcat Customer fails to defead such aelioa ADS may do 10 ad recover
&om CuIIomer in addilitJD. all COIlSBDd expIlDICS iueludina attorney's fees in CODDCClUlD therewith.
ADS shaD be eatitled to ncover &om Customer aD COltS ad expenses, ineludin.. withOUllimUtioD,
attomey's fees and ~ts, iDcamlCI by ADS in t:onIICCrion with actiODllala:D by ASS or it's
rcpI'CXIIbIlivea (1) to caforee ay provision of this Aareement; (11) to affect any paymeats or
colledioas provided for bercia; (D1) to institute, maiDtaiD, pnl!ler\le, enforce BDd foreclose 011 ADS'
sec:urity iIltercll ill or 1- on the aoocJs, whdhcr throupjudicial proc:cedinp or otherwise: or (IV) to
defeDcl or pIVICCUte .-y proeeedinp aria... out of or relatiDa to any ADS tJ'IIIUCriODl with
Cuatomer. The ~ provisions of this Parqraph 11 ahall survive the IcrmiDatiOll or expiration
of this Apeemeal
13. If1ILL A~: This Apameat cooltitutea the eatire apecment bc1wecn the panies
pertaiajq to the subja:t matter hereof IIId lupcn:cdea aD prior aarcements. UDdcntandinJll,
Deaotiations 8Dd d~ whether oral or writteu, of the panies, ad may DOl be added to,
IIIDdifiod. sLlpp"'~ or waived in any way except in writina lilDed by both panics (other thlll
priciDa eJumaa prvvidetI for herein).
14. SUCCllllORS.u. ASSIGNS; TERMlNAnON: This Aareement shall be biodio. on the partiea
hereto. tbeir heirs, IIIICCaISIXS. ad UlillDS. HowlMll', Customer may not assip this AJRlCIDCDt
without the ~ of ARS.
IS. SBPAIIAIIIUTY CIF PJlOVlSIONI: Each provisioa of this Aareemcat shall be cooaidered
~ SlId. if fbr... reason any provilion that il DOt esICIItial to the ctTec:tuation of the basic
purpoaea of this A...-eal il cJetermiDed to be invalid BDd coatrary to any exiatina or future law,
such iIlvalidity sballllOf impair the operatjon of or .ffect those provisions of tbiJ Apeemeot that arc
valid.
16. COUN11tIlPAR'I1I .vm F ACS1M1LE S1oNAT1lRES: This A&J"lCIIIetlI may be executed in sevc:ral
countel]MltS, each of wIlicb shaD be deemed to be a original IIld all of which toaether shan
COIIItilutc ODe A~ bindiDa oa aD partiea hereto, notwithataDdina that all the pulis have not
lianed the same CODII&eIJIItrt. A fued lipaturc of thil Agreement beariDa autbori2ed sipaturea may
be treIIted u a oriPaL
17. WAIVER OF .ItIRY TRIAL: ALL PARTIES HEREm HEREBY IRREVOCABLY
WAIVE (a) THE RIGHT TO TRIAL BY JURY; AND (b) nlE RIGHT TO INTERPOSE ANY
AND ALL COUNTERa..A.1MS IN ANY ACTION, PROCEEDING OR CLAIM ARISING OUT
OF OR PERTAINING ro THIS AGREEMENT.
18. JDUlDICTION: All paniea hereby CODICDt ad voluntarily submit to pcrsooal juriadietiOll in
the Stale of Oreaon and in the courts ill aucb Slate located in WasbiDltGD County in lilY procccdina
ariaina out of or relldia&1O lbia Acr-anL
19. Bald Barml..: In DO eveat shan ADS be liable for ay clamaaes whatsoever, iIlcludina
without limitation, special, incideatal, coascquential. or indirect damqc:a for pcnaoal i'\iury, loss of
busineas profits, buaiDc:8 iaterruptiou, loss of business informatiOll win, out of or inability to use
thil product. ADS is aot tiabIe for III)' claim made by a third party or made by you for a third party.
The CUItoDtc:r ac:Jmowlllllaes that the service eoverage is such that the cquipIMIII ->' continue to
provide coplea but DOt ftIac&ioD u a printer. The Customer shaD be liable for these types of repain
walcas eovered by a 1ldIrork conaectivity maiateDaDcc aarcement. Specifically, this Agrccmeat is
applic:abIe to priD& ~ oDly services ad excludes help desk suppon, netWorlt support. software
appJicatioa support ud _yother connectivity support aerviees.
20. FmlCE MAJa1Ja: ADS shall DOt be liable to Customer for III)' failure or delay caused by
events beyond ADS' ~I, incJudina. without limitation, CIIIto1IIer'S failurc 10 furnish IICCCIIIU')'
infOl1ll81ioll; aabotaJl; liIilure or delaya in trMsportation or coDIIIIUDication; boycotta; embargoes;
fail_ or lubatituUaas of equipmeat; Jabor dilpUtea; accidents; shortages of labor, fuel, raw
materiala. IIlKhiDcry. or ClQuipmeat; technical failures; ('Ire; storm; flood; earthquake; exploaioa; acts
of the pubIie enemy; war; iDaw1ec:tion; riot; pubtie clisordcr; epidemic; quarantiDe restrictions; acts of
rwnd:- lM!h nf~ ~f nr ~ ~...Lru_........t.l .......---:~. :....-.-..--.."1. w ~.-~
21. NO WARRANTY: ADS DISClAIMS ALL WARRANTIES, EXPRESSED OR lMPUED,
INCLUDING ANY JlilPLIED WARRAN11ES OF MERCHANTADlLlTY, TECHNICAL
COMPATABD.ITY, Fn'NBSS FOR USE. OR fTI'NBSS FOR A PARTICULAR. PURPOSE.
CUSTOMER AGREES THAT ABS IS NOT RESPONSIBLE FOR DIRECf. INCIDENTAL OR
CONSEQUENTIAL DAMAGES rNCLUDING, Bur NOT UMlTED TO. TIlE LOSS OF USE OF
THE EQUJPMENT.
22. ~ Cuatamcr shall obtain BDd maintain, at il"l own expense, iosunacc relatiDa to
Claillll for il\iury ..cIIw property cIamqe (ioc:ludiDa commercial aeneralliabitity instmmce) bucd OD
its use oftbc ~ FUds IDd madliDCly.
r~'
eFfV RECORDER
CITY OF
ASHLAND
20 E MAIN ST,
ASHLAND, OR 97520
(541) 488-5300
Page 1 / 1
r~1 :=;1 ~i E~f~'
VENDOR: 011717
ASSOCIATED BUSINESS SYSTEMS, AMERICAN (
7440 SW BONITA RD
PORTLAND, OR 97224
SHIP TO: City of Ashland
(541) 488-6002
20 E MAIN STREET
ASHLAND, OR 97520
FOB Point:
Terms: Net
Req. Del. Date:
Speclallnst:
Req. No.:
Depl: ADMINISTRATION
Contact: Diana Shiplet
Confirming? No
THIS IS A REVISED PURCHASE ORDER
Kyocera 6030, Serial #J3005667
Service ID #62043
Cost per imaQe $0.00831
(Copier located upstairs City Hall)
1 ,000.00
BILL TO: Account Payable
SUBTOTAL
TAX
1
541-552-2028
ASHLAND, OR 97520
.~~~~~
Authorl Signature ~
VENDOR COPY
1
request a Purchase Order
REQUISITION FORM
CITY OF
ASHLAND
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 (Optional)
Intermediate Procurement
o (3) Written Quotes
(Copies attached)
Sole Source
o Written findings attached
o Quote or Pro aI attached
Coooerative Procurement
o State of ORlWA contract
o Other government agency contract
o Copy of contract attached
o Contract #
Invitation to Bid
(Copies on file)
Description of 8ERVlCI!S
CofitK"" MaiJ\.+e~ft~ ~if ID#~'~(),J~043
@ ~8fcoro
. cx:83
o Per attached PROPOSAL
To_I Cost
Item # Quantity Unit
DellCrlptlon of IlATI!R1AL8
Unit Price
Total Cost
Project Number ______. ___
o Per attached QUOTE
Account Number '1LQ- QI-Oa- 9Q-60J(00
* Items and services must be charged to the appropriate account numbers for the financia/s to reflect the actual expenditures accurately.
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 provided upon request,
Employee Signature:
Supervisor/Dept Head Slgnature~1
G: Finance\Procedure\AP\Forms\8_Requisition form revised.doc
Updated on: 7/1412008