HomeMy WebLinkAbout- CC-7 - Attachment 2 - 7/15/2014�1Fs94'--
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:
Department: Police Division: Field Ops
Ship To Address: 99 Fair Dr., Costa Mesa.CA92626
Contact Person: Bryan Glass, Lt. Phone Number: 714.754.5603
Send Copy of P.O. to: M Contact Person and 1 or
❑ Request is for Budgeted item(s)
❑ Request is for UNBUDGETED item(s)-(:11emo Attached)
® Item(s) Pending Budget Amendment Request #15-002
❑ Requesting Sole Source (Justification Form Attached)
❑ Fixed Asset Tag Request
Item
No
�
Qty Unit
Items (Give Full Description: Size, Catalog No. Etc.)
Unit Price
Estimated
Amount
1
1 ea
Outside Duty Lockers through OI in Group, Inc.
77,402.00
$ 77,402.00
If additional lines are needed, please attach a second .sheet
Const./Prof. Svs. Agmt. Completion Date: 7115114
Insurance Required: ❑ Yes Certificate apache ❑ No
Sales Tax (8.00%):
Include Shipping Fee:
Estimated Total Cost:
5,359.36
$ 82,761.36
Item #
Account
Fund
Dept./Org.
Program
Project
Amount
1
590800
217
15400
10127
$ 82,762.00
Comr,1 ur.s:
Total$ 82,762.00
Purchase of outside duty lockers for Patrol Services.
Proper approvals are required before requisition can be processed.
Suggested Vendor: Olpin Group, Inc.
Address: 3.520 Enterprise Drive Ordered By:
Department DirectorlAuthohzed Signature
City, State, Zip Code: Anaheim, CA 92807
Phone: 714.970.2299 Fax: 714.970.7572 Approved By:
Vendor's Contact Person: Sarah Shelter
Approved By:
Director of Finance/Purchasing Officer
Citv Mana er when re uired
PURCHASING DIVISION USE ONLY
Vendor ID:
Buyer.
Insurance valid thru
Ship To/Location:
Due Date:
Standard Comments: ACC — ALL — ARR — BLA — CON — OCP — DIS — FCA — FCI - FIX — INS — IS — IST — ORG —QTR — REM — SUB — T&C
FkWACE DEPARTMENT USE ONLY
Available Appropriation: ❑ Yes El No
As of:
Confirmed By:
2385-20 MW REV 3110
Rev FY09110