HomeMy WebLinkAbout26 - CC-15 - Attachment 2 - 1/7/2014FAW
ATTACHMENT 2
= CITY OF COSTA MESA, CALIFORNIA
Purchase Requisition
Vendor ID:
(Leave Blank for Time
Stam
Purchase order
Number
Assigned by Purchasing)
Business Unit: CITY Date Requisitioned: 12/19/13
Department: Finance Division: I.T.
Ship To Address: _
Contact Person: Steve El v Phone Number: 4891
Send Copy of P.O. to: ❑ Contact Person and / or Victoria
® Request is for Budgeted item(s)
❑ Request is for UNBUDGETED item(s)-(Memo Attached)
❑ Item(s) Pending Budget Amendment Request #_
❑ Requesting Sole Source (Justification Farm Attached)
❑ Fixed Asset Tag Request
Item
No
-
O+y Unit
- - -
Items (Give Full Description. Size, Catalog No. Etc.)
Unit Price
Estimated
Amount
1
448 ea
Office Pro Plus (Lic/SA) Mdterm under the Microsoft Enterprise
Agreement
405.56
$ 181,690.88
Electronic Software delivery only
if addif/onul lines are needed,, please attach a second sheet
Const./Prof. Svs. Agmt. Completion Date:
Insurance Required: ❑ Yes (Certificate attache ® No
Sales Tax (8.00%):
Include Shipping Fee:
Estimated Total Cost: 1
0.00
0.00
$ 181,690.88
Item #
Account
Fund
Dept./Org.
Program
Project
Amount
1
590803
101
14600
50710
$ 181,690.88
Comments:
Total$ 181,690.88
Please refer to the attached vendor's quote for details.
Proper approvals are required before requisition can be processed.
Suggested Vendor: ComouCom Systems
Address: 7171 Forest Lane Ordered By:
City, State, Zip Code: Dallas, TX 75230
Phone: 818-988-2195 Fax: 800-366-9994 Approved By:
Vendor's Contact Person: Sam Andrews
Approved By:
Department Director/Authorized Signature
Director of Finance/Purchasing Officer
ON Manager (when reouired)
PURCHASWGDIVISION :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 EI No
As of:
Confirmed By:
2385-20 MW REV, 3/10
Rev FYI 2111,