HomeMy WebLinkAbout- - A.C.T. GIS Support Attachment 1 - 7/6/2010' CITY OF COSTA MESA, CALIFORNIA
Vendor ID:
Purchase Order
= Purchase Requisition
Ship To/Location:
Nuber
(Assigned by Purchasing)
Standard Comments: ACC - ALL - ARR - BLA - CON - DCP - DIS - FCA - FCI - FIX - INS - IS - IST - ORG -QTR - REM - SUB - T&C
FINANCE DEPARTMENT USE ONLY
Available Appropriation: ❑ Yes [-]No
As of:
Leave Blank for Time Stam
Business Unit: CITY Date Requisitioned: 6/15/10
® Request is for Budgeted item(s)
Department: Admin Sys Division: MIS
❑ Request is for UNBUDGETED item(s)-(Memo Attached)
Ship To Address:
❑ Item(s) Pending Budget Amendment Request #
Contact Person: Rick Phone Number: 5154
❑ Requesting Sole Source (Justification Form Attached)
Send Copy of P.O. to: ❑ Contact Person and / or Victoria
❑ Fixed Asset Tag Request
Item
No.Amount
Qty Unit
Items (Give Full Description: Size, Catalog No. Etc.)
Unit Price
Estimated
1
1 LT
Gis Assistance And Contract Support
$110,475.00
$110,475.00
On An "As Needed" Basis Includes Geoprise Software
If additional lines are needed, please attach a second sheet Sales Tax (8.75%):
Const./Prof. Svs. Agmt. Completion Date: Include Shipping Fee:
$110,475.00
Insurance Required: ❑ Yes (Certificate attached ❑ No Estimated Total Cost 1
Item #
Account
Fund
Dept./Org.
Program
Project
Amount
1
525702
101
14600
50710
$110,475.00
Comments:
Total 1 $110,475.00
Period of Coverage: 7/1/10 to 6/31/11. Amount not to exceed $110,475.00.
Proper approvals are required before requisition can be processed.
Suggested Vendor: A.C.T.
Address: US Bank Plaza Center, 16th Floor Ordered By: Department Director/Authorized Signature
City, State, Zip Code: 80 91h St., Sacramento, C
Phone: 866-422-2505 Fax: 866-422-2529 Approved By:
Vendor's Contact Person: Kyler Diershaw
Approved By:
Director of Finance/Purchasing Officer
City Manaqer (when required)
PURCHASING DIVISION USE ONLY
Vendor ID:
Buyer:
Insurance valid thru
Ship To/Location:
I Due Date:
Standard Comments: ACC - ALL - ARR - BLA - CON - DCP - DIS - FCA - FCI - FIX - INS - IS - IST - ORG -QTR - REM - SUB - T&C
FINANCE DEPARTMENT USE ONLY
Available Appropriation: ❑ Yes [-]No
As of:
Confirmed By:
2385-20 MW REVA/09
Rev FY/06