HomeMy WebLinkAbout2008-168 Agrmt - Assoc Business Systems
A \J g ,2'2 '
2D08
3:29PM
CSC RBS PORTLAND
No.2852
p. 2
"f2l ..... ~
-
. Associated
Fortland " S;a'em .. Eugene - ifosebllrg
Seattle .. Ta~m.. - Klam.th Falls
Ol'i!lJts Pass .. Medioni .. Bentl ,. Spokane
MAINTENANCE AGREEMENT
~7
C'I$1Dm8r PO 1#
ASS Cuslomer" - MD019S
'=,=oP
c .-. . ~ '-"" , ", -- . '. - ~ - . r
ASHLAND, CIn',OF
CU!llotnr::r Name:
Customer Nilme:
20 E MAIN ST
Slrget AGdI'U&:
20 E MAIN ST
Street Ad(lr~
ASHLAND
Clay:
541-552-2100
PI'w;Ine;
OR
97520
ZJp~
ASBLAND
CIty.
OR
. SIa1c:
54:1-448-5320
Far.
97520
Zip:
Slate:
541-44S.SS2.0
541-552-2100
Ptlone:
FOIl\.
KARl OLSrn
C\.l5tomD{ COI'II;:lc:t:
Cuslomer Can1::le\:
~sonrkari~a~~
Email AdGI'e$$:
arnan AddreS:.::
_intenance Agl'eeraent CDver=age:
For an annual. quar1etfy or rtlOl\U1Iy base ~ fiN:; overage ClWga, if any. AB$' factory 11'l"*' per'SOftnel Will AmCfcr MNice Ot\ the below ~ed equiPment
"during regu..,. bu;ineas I\C:IIa In accardance wldllhe te~ and condJlions set forth Qn the franl and rcVcnIIII elde at this ^9'"fTIent.
2
MODEL SERIAL NUMa~ Service 10 Start Meter Image Base Charge OVonagfs Charge
AUo~n~ (Per hr.age)
M6030 J3003531 6~'22 273.692 N/A NJA $ 0.00831
Cok;t' MeleJr Alktwanco
Comments:.
llilliv. SAII8cl OM 0pDr
r Quarterly Baso Bilr/l')g
c:- IVonthty 8ase Biting
r Annual Base ~g
r Otner
~ fWr.{j in Alrt>>lS
SaOC/ One CIpibn
r Ovarterly
~ Nbnlhly
r other
T'l:rlrl- SeIfI<< OJ. OptIon
r. 00 ~ths
r 48 tJmths
(' 39 Albnlhs
r 36 tIfonths
~.other
~ all filiI AppIJ
r:: BLAe< TOl'1or ht;lusiYe o,varage
(*" BLAO<Toner NQoo.I. heluslve Coverage
(" CDl...OR TonBl" hdusive Call8l'age
12M F' COLOR Ton.. NON - nckIsille Coverage
r: Ctum nclusive Co.verage
,.. NON - Drum hclJsive Coverage
A9"'ement Sta" Dat~
CU$tCllD8/'" ~gle$5 to pay 811 .dditional $19.95 pOI" month per mac:hine for InlUaI Nctwortc.lnstalI a
un mited rr Scrvic:e Labar. IT SaMCI:l L"bor covera on-:ate and Dhono aUDDOrt rar the ...,lpme
covered W1der tNs AgnI8menl IT $efVlce Labar;wl Network Insblq; &Ie ~ In
with 1ne Temu; and ConJiUona Bel fol1l'l In lhl& Agreernanl 'and stilted bonlln and on IJw ...ue,. sid
ho~f"
c.USlDmec- a~ to pay $39.95 per mqhth lor n CuatDmer agrcca iu pay for aUlDmaled mel
@Rcmot.eTN autolr\atJc rnelet eoUcctian servtce:&. Up coteclon tolll'Vlcn !)Or device. $0.99 per ~eviC8
1.0 ,OD device meters coIlI:c\ed 81.1'0 adrlltional fee.. wUl be charged por blllllRg r::yc:to, Agreed_I
number of device mehn 10 be
coUl!!CI!d: A;rwd IotaI fee:
~ ~ M~inf8nanc:e 4Q1'118me1l1 J. rro~A1ntJ.a01f:, non-lrarI3I8rBbte Snd non-aJlIOI:IiJblo.
Thi$ Agrdirl(:nf $haI/ 1Iol ~ r:rr.cove unlo= -inet1 lJy ClJ!:lOtJKlr
"nd A~jed Bu:dneaa SJ'S*mls Conl/'at:t M"".gamfllll.
January 1,2008
_1I>>fIVIQI
C...stDmer AccepQnoc.;
'tIiilo~
"d. ~ :t-
Sig~(In
r/
1..
P,4~F
DfIte
Date
-
UL 1l.4.N'e4.~
PIinIruI 101.",.
I .... ... __ ......... __....."' __ ... __ II1IIl ........ ..-..ed .... MIl .... ....
- ............. - .......,...............'" ............... NIo "'~-.b
IlA'Ir --..,...,..... - a... 11I..,.,...-...... ............lIIIIdtlI.
""'OIfO ~~Sc(;J ~~7
K1x ~~,c 15 / 1!77-216"'~ac
www aS~~dbu!'li~!:s OOm
Received Time Aug 22
3 ~ 1 ~PM
MAINTENANCE AGREEMENT
r e'l9liJ 7
T emlS Bnd Conditions
1. GENERAL SCOPE OF COVKRAGE: This Ap'eemeDt c:aowa"I for adjustments, repl1r and 10. TERM: This Agreemeot becomes effective upon the dale indicated in the "Agreement Stan
replllczments of putS as fUJuiled by ROI'I11IlI use of the equipmem.lUbject to die exceptioDl in.nd o.e" IpaCCI thereon, and shlllI conaiDuc for the period IS specified GO. the face
of this Apcemmt.
in accordaIIce with these _ ud COIIClilioaa. This AlJ1lClDICIIll docs DOt CO\'er characa for u.lca Cuatomer fumisbes ABS with thiny (30) daya adVIDC:e written notification of their desire
to
inat.llatioo of equipment or cle-inataIlalioo. of equipment if it is moved. DamIIIC to the equipment c-=d Ibis A.,-eemem it will .utomatically renewed for. period of one year lIDCC the
specified lent!
or its parta wina out of or caused by miauae, .buIe, nealiaenc:e. a1tacbmeat of uualllhoriB:d ... been exceeded
componeots, .c:ceuories or paItS, use of aubltaDdard paper or aubstndard aupplies or Olber
causes bcyoad the COIIwl of ASS are DOt COYel'Cd by this Aercemcutllld may aubjecl Customer
to . aun:barJe or 10 caaccllahOll of this Awecmc:nl. In addition, ADS may tcrmiaate the
Aareemeat if the equipment is modified, da.-Fd. aJtered or aerviced by perIOIIIIeI other tbaa the
ASS At60rizcd PcrIOIIDd, or if patti, acceaories or COmpoDllllII not meeting IIUICbiDe
apecif_tioaa are fJtlcd to the equipmeDt. This Aarecment does not cover cbartla for repairs to
print coawllen or ftpairs dne to Cuatomer or 1bird put)' moclificatioDa to IOftware or hardw_.
1. SERVICE CAU.s: Service calla uoder this AJreClIIICIlt will be made clurin.1IOI1Da\ buaineas
bolll'l, 8 LID. to S p.m. Mouday throuah Friday, at the iastaUation addn:a abowa 00 the reverae
aide of this Aareemeot. TravelllDd Jabor time for acrvir::c c.Us after normal busiDeaa boura, 00
wc:dtcDda and on holidays, if ad whco .vai18bIe, will be cIwacd at the JIlIblilbcd overtime rates
iu ~ _ d\g dmc chI;: ac:n4t;c CIlII IS ~ ^-II:>> ~~....YeI WW IlCR DallQICt OIICOmleCl or
repair 1IDaUIborized IU8CbmcoIl or ~; ClIStOIDCr is ICI)JOI1IIDIe for disc:onacctiDa and
recGIIDtlCtiDallDllllthorizecl IltKbmenIl or colllpODelltS. ClIItOIDeI' hereby indemaifiea aod bolds
ASS and ita Rcpn:Ic:ntatMs harm1caa for claims for u-,cs to any lID81IIhori2ied pans.
components or accesaoriea resultiDa from .-vice performed 00 ASS equipIIlent. Labor pcrfonDlld
clurina . acrvic:c call includca lubriclltion and c:le8nina ofdle equipment and the acljustment, repair
or replacement of parta deacribed below.
3. VNLlMrrED I,T, SERVICE LABoR: IFTIDS 01"l'lONAL SERVICE BAli BEEN SELECTED AND
PAID FOR BY TIIF. CUSTOMIUI rr INCLUDJ!S; All DetWolt IIIbor directly \'elated to the equipment
Iiatcd on this a...-L "LT. Servicea Labor" ahall be defmcd u the following relatina to
SCIIIIIin&. PrintiDa. or other letwortcal functions of the equq...t: Buic initial lICllWork
iDatallation (if DOt iocludcd ia purc:llasc(1cuc of equipmmt liated above), iaataJlina/updating
driven, adcliog new worlcstltiaDs for DetWorIIed ftmctioas, rc-inatI1linallClWOric conncctiou if
cUllOmer'a network raila, trollblc:shootinau it rdatca to c:nvn cauacd by the equipment (Dot tbe
cllllOlDel"a netwodt). Servicea will 0IlIy be enliated .fter u ABS equipmeDt tcch.ic~
determiDcs IbM . DetWodc iIIw:. not die machine itaclf, c:auICI the enor. ADy scrvicc:a performed
outalde of the limiIs of the dcfinitiooa above (ex: DetWOdt coamltiDa DOl related 10 Ibe equipment
above) will be cbaqcable to t1Ie ClJItOmer at a rate of S9Wbour. This Optioaal I.T. Service is
oaly available for ~ with a tcnn that it 36 .-tha or JPUIer.
4. Rl:PAIR AJIlI) REI'I...\cDIENT OF PAR1S: All pans DeCeIIII)' to the opcralioa of the
equipmeot, due to Dormal wear lIDd tear, with the exceptioa of the parta liItocl below IDd aubject
to the JCDerallCOpe of c:overage. will be fumilbed free of c:\wJIe durina . acrvir::c call iDc:luded in
the mainlelWlce aervice provided by tbis AIP'flCIIICIIL Eaceptions an: ~00''lIl'Ct9n (i.e. copy
cInuIlI uaJca the copier or fax is covered by . FuU Coverqe Maia1eauce AJRlllIDODl) ualeu
othcrwiac ltated in this ApeeIIIClDl. ADS n:aervea the riabt to cltarae for pans, ~, baadlina
IDd tUel.
S. REcoNDmoNING: :Rebuildia. or ~or overhaula are Dot covered by Ibis Apeanent. In
.dditioo, when in its aole diacnrion ABS dc:tenaines that. ncoIIditioaia. ia aeceuuy, . I result
of expected wear IDd tell' of tn8teriala lIDd aae fac:tora caullld by normal offiee elW'oDJDeDt
usqe. in order to keep the equ/paalt in wortdD. COIIditioo, ASS will aut.rit 10 the CUlaOlDa' an
eatu.tc of aeeded repain IDd their COlt which will be in addition to the c:bap payable UDda'
Ibis Apeemeat. If the CusuImer does DOt IUIhoriz.e auc:h recoaditioaiDa. ASS may diKoDtimIe
acrvic:c of the equipmcat lIDdertbia Aareement (refUadiaa the UIIIIIOd ponioo of the ____
cbarJe) or may rcftIIc to I'ClICW this AIJ'CCI1IeIIl upon its cxpiratioa. 'I1Ir:reaftcr, lite ASS
Rcpraeatative may make ICrVice IVailable on . "Per CaIr' buia baed ~ publilbed ratca in
et1'ect at the tiBR of lel'Vice. .
6. un: OF ABS SOPPLDI: If the euaoa- _ other dIaD ASS uppIiea ad if I1ICh I1IppIiea
an clefClctive or v..c rn'* Ibr UICI in ASS IIIaI:hiaaa Md CIIIIO IbaDrmaUy fnqueat acrvice
calla or acrvice JlI"ObI-. lb. ADS _y, It ill optioo, __ . ~ or teI'lIIiDIItt; this
AJI'DClIDCDL I. tbis eveat, the Customer _y be o<<c:n:d aenic:c 011.1 .,... CaIr' buia baed IJIOII
publiabocI ratca. It is DOt . COllditioa of lbis A..-" however, that the C\IIlOI1IeI" \lie ooly ASS
.1IlboriIICd auppliea.
7. SUPPLY lHcUl5IVE CoNTRACTI: If au.ppIia are ineludod in tbe aervice pcovidcd uocIcr this
A.-eemeat, ASS wiD aupply black toaer, iDk ad developer, UllIeu otherwiae atated in thia
Aaraemmt to the CtIItOmer bucd upon uor.aI yields. TIle AJn=cment does Dot include
COIlIIIIIIIbIe IUpply items IUCb u paper ud 1tIp1es. AU IIOI'lDII priIIt yields are predicaIed OIl an
... ~ x II" abect widt .5% tcll1 cow:rqc. I f the ClIItoaIClr'a uuae of auppIic:a cxceeda the IIOI'IItII
yieJdI for the equipmeDt beiaa aervic:ecI, ABS wiD invoice and tbe ClIIlOtDa' .... to pay, for the
c:xcess auppUea at ASS' cum:aI retail pric:a tIIea ill efI'ect. ASS reserves the riahllo cbaI]Ie for
aupplia, hipt, hancIlinalDd fuel.
8. EI.Ecnuc.w III order to iaure optimum pcrfCll1lllDCC by the ASS equipmeDt, it is
tIIIIldatory that IpCCiflC modcla be pJuaed iDto . dedic:ated IiDe IIlCl Ibey -.at colq)ly with
1IlIDuClclurer electrical apecificaticma. Thcae power ItaDdIrda an required by UL lDdIor 10caI
lIfely nplatiooa.
9. CIL\&GI!Il: The iIIitia! DOD-n:faDdIb1e c:barF for tIIlIiateuDce vader tbis Apeemeat lllall
be the IIIIOlIDt Ie( for1Ia 011 die _ aide of tbia A......... ASS rarnes the riabt to iDcrcue
the BIle CharJe aad Overaae 0Iarp oftbia ..-1IpoIl racwal or lIIDually for I _lti-)'CII'
lpeemau. CuItomc:r shall pay all c:IIarJca witbiD 10 daya of iavoil:iq. Ih collcctioo -uer
occ:un. CUIlOIDIlI' ...- to pay court COllI ad ury n&IOIIIbIe IltclrD8ys feea. latenlIt will be
charaed.t I K % per mCIIlb after thirty (30) days OIllit)' uapaid balaac:c. ASS raem:s the ript
to withhold aervice or c:ancel Ibis Apeaaeat if . CUIID_'a ICCOUIIl it over aixty (60) cIaya
cIe1iDqllCDL If equipmmt is mcwCd to I new ASS MrVice len'iIoty, ADS ahaII have the opUoo 10
cbarp, IDd the CuItoma' .... to pay the cIi1hreace in pubIiaIIed maiataDlDl:e cbarJea '*-
Ibe c:urreat territory IIIId the new 1IlI1'itory (on I pro-mIC buia). If equipmeat it moved beyood
ADS'a.."ice territory, ADS J'IIClrvaI tbe ri(Jbt to GaDCeI or the eu.o.....-Io pay I fair ad
relMmable up-c:harJ= for CODtiluecllCMcc. tIIciDa iDt.o -.at the cIiIIIaace 10 CIIIIOlIIIi"a new
locatiOllIlld die published ntca of ABS far Ifn'ice OIl I ..,.. CaIr' baIia. ABS raem:slhc riaht
to charae fbr abippiq. hi... hIDCIliq ad fuel. ASS ~ the riabt to eharF for ana
lIlDually .t . rate of SO.OO25 per KIlL
Ii. EVENT 0.' DEPAU,T AND TIlRMINAnoN: The oc:currence of the followiDg thall coostitute an
E_ of Default: The clll10mer f.i1s to pay auy ponioo of tbe cbarp for maintcDllJlce of pans, IS
~ under the Aareemeat wbell due, or ClISIOmcr fails to duly perform any covenant, coaditiOll
of' limitation of this A.-cement. UpOIl the Event of Default, ABS may; (i) refuse to aervice the
cqIIIipaIeDt; (it) furaiah service 011 C.O.D. '"Per Call" basia baaed upon publisbecl rates in effect.t the
tw.e of acrvicc:; (iii) terminate this AgreemmL WithiD 60 daya of the expiration or termination of this
~t, ADS thall aubmit to Customer u iIemizecl invoice for any fees of expeasea, including
...,.Per Call fees, theretofore .ccnacd Wlder tbis AareemeoL Except.s otherwiae provided be\'ein.
c..o.er, lIpOII payment of ac:cruc:d lIIDOlIDt 10 invoicocl. ahaII tbcrcaftcr have no further liability or
oIIIiptioD to ADS whatsoever for uy fvrtheI' fees or expc:nses ariaing bereunder. In the event ABS
~ the Aareemeat because of tbe breacIt of Customer, ABS sball be eatitled to payment for
--.: _ proJP'Clll ptUl mmtlllnclDellll tOr out ot pocket expeuec.
12. blDEMNm': Customer IllaU iodetnnity, save and bold ABS, it's afliliatea. offIceR, directors,
~ employcca, qeDII and repraentativca and their SllCCClllOl'l and aaiJPlS them (ABS
PJ.tiea) harmless from and lpiut uy liability, loa, coil, expenae or damage wbataoever caused by
I'C8OD of any breach of this Asrccmcnt by ClIIlomcr or by reaaoa of any injury whether to body,
~, buaineas, character or reputatioD lRIlJtaiDed by ABS Panies or to uy other penon by nuon
oC.., act., nealec.. omiaaion or detllult by ClIStomer. Cull10Dler th.1I defead any action to whicb this
......ity abaIl apply. In lhe eveat Cuatomer fails to deflll1d such actioD ADS m.y do so and m:over
~ Customer in .dditiOD, .11 COSIIIDd expeaaes includiag.ttomey's fees in collDCCtion Iberewith.
ABS abaIl be cotitled to recover from Customer .n COlli aDd expea-. including. witbollt limitation,
lIIIlI'IIe)"a fees ud diabursc:maJts. incurred by ASS in connection with actions taken by ABS or it's
~ea (I) to enforce any proviaion of thia A.-t; (11) to .ffect uy pa)'1lllll1ts or
~ provided for herein; (111) 10 institute, maintain, preserve. cofan:e ud foreclose on ABS'
aeaurily iuterat in or lien on the aooda. whether tbroupjuclicial procccdinp or othc:rwiae: or (IV) to
dd:aId or prosecute uy proceedinas aria.. out of or rdalina 10 uy ABS traMIctiona with
C....... The forclOina provWooa of Ibis ParIwaPh II ahal1 aurvive the tcnniDation or expiration
of'" Aareemeat.
13. FUL AGREEMENT: This AlJ'OClIICIlt conatitutes the eat1re qra:mcnt betweea the panics
pc:IfIaiaiaa to the aubjcct matter bc:rcof and aupercedea .U prior qreel1lellll, uaderataDdinll5,
MpIIiariona ud dia_iooa, wbetber oral or writtlll1, of the paniea, and may not be added to,
D*Iificd. aupplel1lelltocl or w.ivocI ill uy w.y except in writinaaiped by both panics (other than
priciDa cbaaaa provided for baein).
14.. SOCCDlORI AND AssIGNS; TDIMINA'QOtl: This Apeement aball be biDdina on the parties
beRto. their beira, IIIICCCIIO.... aod usillDS. However, Cuatomer may DOl aaian tbis Aarccmeot
wiIIIout tho COIIICDt of ADS.
15.. SF.PAJtABILI1'Y OF PROvtllIONS: Each provisioo of this Apecmeat abaU be coosidered
~ aad. if for 111)' R:IIOD uy provWOII that it nOl eslClltial to the efi:ctulltion of die basic:
~ of thisAareemeat is determined to be invalid and c:oatrtuy to uy exiatina or fUture law,
... invalidity ahall DOt impair the operation of or .ffect those proviaioas of thia A.-eemeot that are
VIIIid.
16. COUN'IEIU'ARTS AND FACSIMILE 8tGNATUUtS: This ~t may be execnted in aeveral
c:c.mIIIpIm, each of which shall be deemed to be an orilinel and IU of wbich toaether ahall
~ ODe AJII'CIllIlIeId biadiDa 011. .U puties hereto, notwithstaadina that aU die partiea have DOt
ai.-ed the IlI1DC COUDIerpII't. A faxocI aipaturc of lbis Apeemeat beariDa allthorizcd sipatures may
be ilnIled u u ori,iDal.
1'7. WAIVER OF JURY TRIAL: ALL PARTIES HERETO HEREBY IRREVOCABLY
WAIVE (.) THE RIGHT TO TRIAL BY JURY; AND (b) THE RIGHT TO INTERPOSE ANY
AND ALL COUNTERa..A1MS IN ANY ACTION, PROCEEDD'IlG OR CLAIM ARISING OUT
OF OllPER.TAlNING TO THIS AGREEMENT.
I L JUlUSDICTION: All parties bereby conseot aDd YDIUllwily aubmit to peraonal juriadic:tiOll in
the Slate of 0...- and in the c:ouna in such State located in W.abiDatoa Cowuy in uy proceediaa
__ira, out of or JelatiDa to this AjJreement.
19. Hold Hanal_: lu DO event Ib.n ABS be liable for uy cIamaan whal&OeVel', iDcIuding
wiIboullimitatioo. special, iIlc:ideatal, COIIIeqIIefttiaI. or iDdirect daDllpl for penoaal auury. lou of
INAIea profits, busiDeas inlemlptiOll, loas of businea informatioa ariaia, out of or inability to \tie
this product. ASS is DOt liable for 111)' cl.im made by . tbinI party or made by you for. tbird party.
ne Customer acICIlowledFs that tbe aervice covcnae is auch that the equipmeat may coatiDue to
pI8Yide copies but DOt fbacticm u I printer. The CultOmer abaIl be liable for tbeae types of repairs
waIaa coverecI by I DCtWorit CODIICIClivity maiD&eaaac:e aareemeat. Specif'JCalIy, this AJr-t is
applicable to print volume 0DIy aervicea and exc1ucIea beIp desk auppclrt. aetWorIc aupporI, IOftware
........ auppon ad IUY other coanectivity aupport aerviccs.
20. FORCE MAJEURE: ABS aball not be liable to Customer for lilY f'ailun: or delay cauacd by
ewaII beyond ABS' coatrol, includin.. without limitation, ClIstomer'a failure to furnish necessary
ildilrmatioo; sabotqc; railun: or c1c1aya in trIIIIIpclrUtion or COIIIIDIlIIication; boycotts; embaraoes;
faiIuIa or aubltilutiooa of equipmeat; labor cIiapates; lICCicIeDts; ahortqea of labor, fuel, rlIW
~ machinery, or equipment; tecbnical failtu'es; fire; ItOnD; flood; cartbquakc; exploaion; acts
oldie public eDeIII)'; war; iaaunec:tioD; riot; public cIiaorder; epideIIIic; qt*IDtiae reatrictioua; acta of
Oed; acta ofury IOYCnIIIICDt or any quui-aovaumeatal authority, iDItrumeDulIy or qeacy.
21. NO WARRANTY: ADS DISClAIMS AU. WARRANTIES, EXPRESSED OR IMPUED,
INCLUDING ANY IMPlJED WARRANTIES OF MERCHANTABIUl"Y, TECHNlCAL
COMPATADn.rry, FITNESS FOR USE, OR FITNESS FOR A PAR1'ICUL\R PURPOSE.
CUSTOMER. AGREES mAT ADS IS NOT RESPONSIBLE FOR DIRECT, INCIDENTAL OR
CONSEQUENTIAL DAMAGES INCWDING, BUT NOT UMlTED TO, mE LOSS OF USE OF
TIlE EQUIPMENT.
22. INSURANCE: ClIItotllCl' ahaIl obtaiIIad maiDtaira, It it'a own expeue. m- relating to
c.... tor qury andI9r property damalC (iDcludilla co-.cial JeOCralliability inanrancc) based OD
ill _ oftbc: ~t, aoods ad machiacry.
'CITY RECORDER
Page 1 / 1
r~'
CITY OF
ASHLAND
20 E MAIN ST.
ASHLAND, OR 97520
(541) 488-5300
rS!~=a, r~,
VENDOR: 011717
ASSOCIATED BUSINESS SYSTEMS, AMERICAN (
7440 SW BONITA RD
PORTLAND; OR 97224
SHIP TO: Ashland Finance Deartment
(541) 488-5300
20 E MAIN STREET
ASHLAND, OR 97520
FOB Point:
Terms: Net
Req. Del. Date:
Speclallnst:
Req No'
Depl: CITY RECORDER
Contact: Bryn Morrison
Confirming? No
Kyocera 6030, Serial #J3oo3531
Service 10 #62122
Cost per imaQe $0.00831
(Copier located downstairs City Hall)
1 ,350.00
BILL TO: Account Payable
20 EAST MAIN ST
541-552-2028
ASHLAND, OR 97520
SUBTOTAL
TAX
FREIGHT
TOTAL
1
E 710.03.07.00.60110
E 710.03.08.00.60110
E 710.03.09.00.6011
E 710.04.00.00.60110
L4( ~~-~ ~W-
A rlzed Signature
VENDOR COpy
A request for a Purchase Order
REQUISITION FORM
CITY OF
ASHLAND
THIS REQUEST IS A:
o Change Order( existing PO #
Date of Request: tr~~~.
Required Date of Delivery/Service:
Vendor Name
Address
C~, State, Zip
Telephone Number
Fax Number
Contact Name
A~~~il:ltAl"l RIIClinA~Cl ~y~tAm~
7440 SW Bonita
Portland, OR 97224
(503) 244-1096
(503) 244-10015
SOLICITATION PROCESS
Small Procurement
o Less than $5,000
o Quotes (Optional)
Intermediate Procurement
o (3) Written Quotes
(Copies attached)
Invitation to Bid
(Copies on file)
Contract I
Reauest for ProDo,.1
(Copies on file)
Soeclall ExemDt
Written findings attached
Quote or Pro al attached
Emeraency
Written findings attached
Quote or Pro al attached
Copy of contract attached
Description of SERVICES
Photocop ,maintenance of machine for ear $.008310 per cop
X Per attached PROPOSAL
Item # Quantity Unit
Description of MATERIALS
Unit Price
Total Cost
o Per attached QUOTE
Project Number ______. ___
Account 710.04.00.00.601100 30%
710.03.07.00.601100 30%
710.03.08.00.601100 20%
710.03.09.00.601100 20%
* 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: ~ ~ -! i7 cloy Supervisor/Dept. Head Signature: # ~-
G: Finance\Procedure\AP\Forms\Requisition form for ASS.doc
Updated on: 812012008