HomeMy WebLinkAboutMINUTES - 01261993 - 1.59 iro BOARD OF SUPERVISORS J 9
FROM: William F. Maxfield, Fire Chief ,`- \,.
• - . Contra:..
January 12 , 1993 <: .o Costa-
DATE: �•.a.�is •`�� (�!`'"^' "1
Approving Contract Documents Submitted by the � .� 'N
SUBJECT: West County Fire Protection District
AS EX-OFFICIO THE GOVERNING BOARD OF THE WEST
COUNTY FIRE PROTECTION DISTRICT
SPEC I F I C REQUEST S) OR RECOMMENDATION S) & 13AC193F UND APD JUSTIFICATION
The County Administrator having presented to the Board contract
documents (Notice to Contractors, Contract, Abatement Specifications,
Bid Proposal and Addendum) submitted by the West County Fire
Protection District for abatement of weeds, rubbish and other fire
hazard conditions within the District by discing and bulldozing. The
term of the contract shall commence on the date of execution and shall
. terminate on December 31, 1995; and
IT IS BY THE BOARD ORDERED that the aforesaid documents are
APPROVED and March 2 , 1993 at 11 : 00 a.m. is FIXED as the time to
received bid proposals for performance of said work; and
IT IS BY THE BOARD FURTHER ORDERED that the Clerk is DIRECTED to
publish the Notice to Contractors for the time and in such manner as
required by law.
CONTINUED ON ATTACHMENT; YES SIGNATURE:
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
APPROVE OTHER
SIGNATURE 5 :
ACTION OF BOARD ON APPROVED AS RECOMMENDED p OTHER
VOTE OF SUPERVISORS
1 HEREBY CERTIFY THAT THIS ISA TRUE "
UNANIMOUS (ABSENT AND CORRECT COPY OF AN ACTION TAKEN
AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD
ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN.
Contact: Bob Davis 930-5500 ATTESTED G
CC: County Administrator PHIL ATCHELOR. 0 RK OF THE BOARD OF
.Y�,Iest County Fire Dist"iict SUPERVISORS AND COUNTY ADMINISTRATOR
Contra Costa County Fire District
Auditor-Controller
County Counsel BY ,DEPUTY
M382
1 _..-5.9
CONTRA COSTA COUNTY ® FIRE PROTECTION DISTRICT
2010 GEARY ROAD •oo,c PLEASANT HILL, CA 94523-4694
(510) 930-5500
BUREAU OF FIRE PREVENTION
DIVISION OF EXTERIOR FIRE HAZARD CONTROL
January 12, 1993
Contra Costa County
Administrator' s Office
651 Pine Street
Martinez, CA 94553
Attn: Terry McGraw
SUBJECT: 1993-94-95 Discing and Bulldozing; AND Mowing, Rubbish and
Tree Removal Weed Abatement Contracts for Contra Costa
County Fire Protection District
Dear Mr. McGraw:
The Fire District requests the Board of Supervisors put the enclosed
weed abatement contracts out to bid at their January 26, 1993 meeting
with bids received at their March 2, 1993 meeting.
These contract documents have been approved by Diana Silver, Deputy
County Counsel . A copy of the contracts have been sent to County .
Counsel for their files .
If you have any questions, please contact the undersigned at 930-5500 .
Sincerely,
Robert L. Davis
Supervising Inspector
Division Chief Officer
RLD:ccr
cc: Diana Silver, County Counsel
Enclosures
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INSTRUCTIONS FOR PREPARATION OF REQUISITION r
Department: Name of department, not division or section.
Requisitioner I.D. No.: Your county assigned 3 digit requisitioner I.D. number, omit if unknown.
Requisition No.: Department's internal number or use preprinted .control number
for tracking.
Alteration No.: Use if making a change to existing P.O. and include P.O. No.
Date: Date requisition prepared.
Date Required: Date goods and/or services are 'needed.
Ship To: Use complete address for delivery location/or proper county 3 digit ship to code.
Vendor: Put suggested vendor, and/or county vendor No. /optional.
Line No.: Lines numbered 1-9.
CCC Item No.: Use 7-digit number from County item data base, omit if unknown -
buyer will add.
Item Description: Identify request by specific name and identification, such as
part number, i.e., beige, 4-drawer, locking file cabinet.
Quantity: Number of items on each line, i.e., .1, 2, or 6.
Unit of Measure (UOM): Use 2-character UOM from table, i.e., DZ, EA, BX.
Unit Price: Purchase price per each unit of measure; omit if unknown.
Total: Quantity multiplied by unit price = Total for the line item.
Sub Total: Total of all line items.
Other Charges: Could include freight, set-up fee, delivery charge, etc.
Tax: Total tax on all items, if taxable, exclude freight and other charges in
computing tax.
Requisition Total Amount: Total of all charges for all line items.
Org/Task/Activity/Sub Obj/Opt: Org and Sub Obj. coding must be completed for
proper charging; Task/Activity/Opt are used only if applicable.
Reason for Purchases/Comments:' Provide all relevant information so buyers can
prioritize requests and assist in making cost effective purchases.
Requested By: Name and telephone extension number.
4.> Approved by Division Head: Complete if your department requires.
Authorized Signature: Final approval for request must be made by an authorized
representative of the department and have a signature on file
with Purchasing.
I
i
NOTICE TO CONTRACTORS
Notice is hereby given by order of the Board of Supervisors of
. Contra Costa County, as the Governing Board of the Contra Costa County
Fire Protection District, that Clerk of said Board will receive bids
for the abating of exterior fire hazards by mowing, rubbish and tree
removal within the Contra Costa County Fire Protection District
boundaries for 1993-94-95.
Each bid is to be in accordance with the Abatement Specifications
relating thereto which are on file at the Contra Costa County Fire
Protection District office, 2010 Geary Road, Pleasant Hill, California
94523-4694 . _
The Abatement Specifications and related contract documents may
be examined at and obtained by prospective bidders from the above-
mentioned District office.
Each bid shall be made on a Bid Proposal form to be obtained at
the District office and must be accompanied by a certified or
cashier' s check or checks, or bid bond in the amount of ten percent
( 10%) of the base bid amount, made payable to the order of "Contra
Costa County Fire Protection District" . The abovementioned bid
security shall be given as a guarantee that the bidder will enter into
a Contract if awarded the work, and will be forfeited by the bidder
and retained by the District if the successful bidder refuses,
neglects, or fails to enter into said Contract or to furnish the
necessary bonds after being requested to do so by the Board of
Supervisors of Contra Costa County, as governing Board of the
District. In lieu of the foregoing, the bidder may elect to deposit
securities of equivalent value with the District in accordance with
the provisions of Section 22300 of the Public Contract Code. Such
securities, if deposited by the bidder, shall be valued by the
District, whose decision on valuation of the securities shall be
final.
Bid Proposals shall be sealed and filed with the Clerk of the
Board of Supervisors, Room 106, County Administration Building, 651
_Pine Street, Martinez, California, 94553-1297, on or before
March 2, 1993 , at 11: 00 a.m. , and will be opened in public
and at the time due in the Board of Supervisors ' Chambers, Room 107, .
Administration Building, Martinez, Contra Costa County, California,
and there read and recorded. Any Bid Proposals received after the
time specified in this Notice will be returned unopened. No more than
one ( 1) bid will be accepted from any one individual or firm.
Bids will be presented to the Administrator of the Fire District
for review. The Administrator of the Fire District is the Fire Chief
of the Contra Costa County Fire Protection District, hereinafter
referred to as the Fire Chief. The Fire Chief will recommend to the
Board of Supervisors the contract be awarded to the responsible bidder
whose total aggregate bid on all of the estimated units is the lowest
and whose proposal complies with all the requirements prescribed.
All bids will be compared on the basis of the estimate of the
quantities of work to be done set out in the proposal and in the form
of contract. The right is reserved to reject any and all proposals .
The successful bidder will be required to furnish a payment bond
in an amount equal to one hundred percent of the contract price and a
faithful performance bond in an amount equal to one hundred percent of
the contract price, said bonds to be secured from a surety company
authorized to do business in the State of California.
Bidders are hereby notified that pursuant to Section 1773 of the
Labor Code of the State of California, the said Board has obtained
from the .Director of the Department of Industrial Relations of the
State of California the general prevailing rate of per diem wages and
A.0 93-94-95 - N pl of 2
the general prevailing rate for holiday and overtime work in the
locality in which the public work is to be performed for each craft,
classification or type or workers needed to execute the contract which
will be awarded to the successful bidder. The prevailing rate of
per diem wages is on file with the Clerk of the. Board of Supervisors,
and incorporated herein by reference thereto, the same as if set forth
in full herein.
For any classification not included in the list, the minimum
wage shall be the general prevailing rate for Contra Costa County.
The said Board reserves the right to reject any and all bids or
any portion of any bid and/or waive any -irregularity in any bid
received.
By Order of the Board of Supervisors
of Contra Costa County as the
Governing Body of the Contra Costa
County Fire Protection District
Phil Batchelor
Clerk of the Board of Supervisors and
County Administrator
/JG-pU
By:
DATED:
PUBLICATIO DA ES:
(Pub. , Contra t Section 20812)
� y �
f
W A�. r:'�93-94-95 NC 2 of 2
l
I
i
NOTICE TO CONTRACTORS
Notice is hereby given by order of the Board of Supervisors of
Contra Costa County, as the Governing Board of the Contra Costa County
Fire Protection District, that Clerk of said Board will receive bids
for the abating of exterior fire hazards by discing and bulldozing
within the Contra Costa County Fire Protection District boundaries
for 1993-94-95 .
Each bid is to be in accordance with the Abatement Specifications
relating thereto which are on file at the Contra Costa County Fire
Protection District office, 2010 Geary Road, Pleasant Hill, California
94523-4694 . _
The Abatement Specifications and related contract documents may
be examined at and obtained by prospective bidders from the above-
mentioned District office.
Each bid shall be made on a Bid Proposal form to be obtained at
the District office and must be accompanied by a certified or
cashier's check or checks, or bid bond in the amount of ten percent
( 10%) of the base bid amount, made payable to the order of "Contra
Costa County Fire Protection District" . The abovementioned bid
security shall be given as a guarantee that the bidder will enter into
a Contract if awarded the work, and will be forfeited by the bidder
and retained by the District if the successful bidder refuses,
neglects, or fails to enter into said Contract or to furnish the
necessary bonds after being requested to do so by the Board of
Supervisors of Contra Costa County, as governing Board of the
District. In lieu of the foregoing, the bidder may elect to deposit
securities of equivalent value with the District in accordance with
the provisions of Section 22300 of the Public Contract Code. Such
securities , if deposited by the bidder, shall be valued by the
District, whose decision on valuation of the securities shall be
final .
Bid Proposals shall be sealed and filed with the Clerk of the
Board of Supervisors, Room 106, County Administration Building, 651
Pine Street, Martinez, California, 94553-1297, on or before
March 2 , 1993 , at 11:00 a.m. , and will be opened in .public
and at the time due in the Board of Supervisors ' Chambers, Room 107,
Administration Building, Martinez, Contra Costa County, California,
and there read and recorded. Any Bid Proposals received after the
time specified in this Notice will be returned unopened. No more than
one ( 1) bid will be accepted from any one individual or firm.
Bids will be presented to the Administrator of the Fire District
for review. The Administrator of the Fire District is the. Fire Chief
of the Contra Costa County Fire Protection District, hereinafter
referred to as the Fire Chief. The Fire Chief will recommend to the
Board of Supervisors the contract be awarded to the responsible bidder
whose total aggregate bid on all of the estimated units is the lowest
and whose proposal complies with all the requirements prescribed.
All bids will be compared on the basis of the estimate of the
quantities of work to be done set out in the proposal and in the form
of contract. The right is reserved to reject any and all proposals .
The successful bidder will be required to furnish a payment bond
in an amount equal to one hundred percent of the contract price and a
faithful performance bond in an amount equal to one hundred percent of
the contract price, said bonds to be secured from a surety company
authorized to do business in the State of California.
Bidders are hereby notified that pursuant to Section 1773 of the
Labor Code of the State of California, the said Board has obtained
from the Director of the Department of Industrial Relations of the
State of California the general prevailing rate of per diem wages and
W.A.C. 94-95 - NC pl of 2
I
I
I
the general prevailing rate for holiday and overtime work in the
locality in which the public work is to be performed for each craft,
classification or type or workers needed to execute the contract which
will be awarded to the successful bidder. The prevailing rate of
per diem wages is on file with the Clerk of the Board of Supervisors,
and incorporated herein by reference thereto, the same as if set forth
in full herein.
For any classification not included in the list, the minimum
wage shall be the general prevailing rate for Contra Costa County.
The said Board reserves the right to reject any and all bids or
any portion of any bid and/or waive any-irregularity in any bid
received.
By Order of the Board of Supervisors
of Contra Costa County as the
Governing Body of the Contra Costa
County Fire Protection District
Phil Batchelor
Clerk of the, Board of Supervisors and
County Administrator
7'1),'
B v �
y:
DATED
PUBLICA ION D TES:
(Pub. Co ra t Section 20812 )
� y 3
-2/// 3
-2-
4-95
24-95 - NC p2 o
• TO** BOARD OF SUPERVISORS
FROM:
William F. Maxfield, Fire Chief la
DATE*
January 12, 1993 'a Costa
CourtApproving Contract Documents Submitted by the
SUBJECT; ,
' 1O`
Contra Costa County Fire Protection District
AS EX-OFFICIO THE GOVERNING BOARD OF THE CONTRA
COSTA COUNTY FIRE PROTECTION DISTRICT
SPECIFIC REQUESTS) OR RECOMMENDATIONS) & BACKGROUND APD JUSTIFICATION
The County Administrator having presented to the Board contract
documents (Notice to Contractors, Contract, Abatement Specifications,
Bid Proposal and Addendum) submitted by the Contra Costa County. Fire
Protection District for abatement of weeds, rubbish and other fire
hazard conditions within the District by discing and bulldozing. The
term of the contract shall commence on the date of execution and -shall
terminate on December 31, 1995; and
IT IS BY THE BOARD ORDERED that the aforesaid documents are
APPROVED and March 2, 1993 at 11 : 00 a.m. is FIXED as the time to
received bid proposals for performance of said work; and
' IT IS BY THE BOARD FURTHER ORDERED that the Clerk is DIRECTED to
publish the Notice to Contractors for the time and in such manner as
required by law.
CONTINUED ON ATTACHMENT, YES SIGNATURE:
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
APPROVE OTHER
SIGNATURE S :
ACTIONJIM
OF BOARD ON APPROVED AS RECOMMENDED OTHER
VOTE OF SUPERVISORS
I HEREBY CERTIFY THAT THIS IS A TRUE
UNANIMOUS (ABSENT ) AND CORRECT COPY OF AN ACTION- TAKEN
AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD
AB.11
SENT: ABSTAIN: OF SUPERVI S ON THE DATE SHOWN.
Contact: 3ob Davis 930-5500 �2� /9i3
ATTESTED �� _ __
CC:: County Administrator PHIL BATCHELOR. CLERK OF THE BOARD OF
Contra COSI_ County l�C District SUPERVISORS AND COUNTY ADMINISTRATOR
Auditor-Controller
County Counsel
BY ,DEPUTY
M382
CONTRA COSTA COUNTY FIRE PROTECTION DISTRICT
2010 GEARY ROAD o PLEASANT HILL, CA 94523-4694
(510) 930-5500
BUREAU OF FIRE PREVENTION
DIVISION OF EXTERIOR FIRE HAZARD CONTROL
January 12, 1993
Contra Costa County
Administrator' s Office
651 Pine Street
Martinez, CA 94553
Attn: Terry McGraw
SUBJECT: 1993-94-95 Discing and Bulldozing; AND Mowing, Rubbish and
Tree Removal Weed Abatement Contracts for West County Fire
Protection District
Dear Mr. McGraw:
The Fire District requests the Board of Supervisors put the enclosed
weed abatement contracts out to bid at their January 26 , 1993 meeting
with bids received at their March 2 , 1993 meeting.
These contract documents have been approved by Diana Silver, Deputy
County Counsel . A copy of the contracts have been sent to County
Counsel for their files .
If you have any questions, please contact the undersigned at 930-5500 .
Sincerely,
Robert L. Davis, Supervising Inspector
Division Chief Officer
Contra Costa County Fire Protection District
RLD:ccr
cc : Diana Silver, County Counsel
Bill Sousa, West County ,Fire District
Enclosures
asK
NOTICE TO CONTRACTORS
Notice is hereby given by order of the Board of Supervisors of
Contra Costa County, as the Governing Board of the West County Fire
Protection District, that Clerk of said Board will receive bids for
the abating of exterior fire hazards by discing and bulldozing within
the West County Fire Protection District boundaries for 1993-94-95.
Each bid is to be in accordance with the Abatement Specifications
relating thereto which are on file at the Contra Costa County Fire
Protection District office, 2010 Geary Road, Pleasant Hill, California
94523-4694.
The Abatement Specifications and related contract documents may
be examined at and obtained by prospective bidders from the above-
mentioned District office.
Each bid shall be made on a Bid Proposal form to be obtained at
the District office and must be accompanied by a certified or
cashier' s check or checks, or bid bond in the amount of ten percent
( 10%) of the base bid amount, made payable to the order of "West
County Fire Protection District" . The abovementioned bid security
shall be given as 'a guarantee that the bidder will enter into a
Contract if awarded the work, and will be forfeited by the bidder and
.retained by the District if the successful bidder refuses, neglects,
or fails to enter into said Contract or to furnish the necessary bonds
after being requested to do so by the Board of Supervisors of Contra
Costa County, as governing Board of the District. In lieu of the
foregoing, the bidder may elect to .deposit securities of equivalent
value with the District in accordance with the provisions of Section
22300 of the Public Contract Code. Such securities, if deposited by
the bidder, shall be valued by the District, whose decision on
valuation of the securities shall be final .
Bid Proposals shall be sealed and filed with the Clerk of the
Board of Supervisors, Room 106, County Administration Building, 651
Pine Street, Martinez, California, 94553-1297, on or before
March 2, 1993_, at 11:00 a.m. J. and will be opened in public
and at the time due in the Board of Supervisors' Chambers, Room 107,
Administration Building, Martinez, Contra Costa County, California,
and there read and recorded. Any Bid Proposals received after the
time specified in this Notice will be returned unopened. No more than
one ( 1) bid will be accepted from any one individual or firm.
Bids will be presented to the Administrator of the Fire District
for review. The Administrator of the Fire District is the Fire Chief
of the West County Fire Protection District, hereinafter referred to
as the Fire Chief. The Fire Chief will recommend to the Board of
Supervisors the contract be awarded to the responsible bidder whose
total aggregate bid on all of the estimated units is the lowest and
whose proposal complies with all the requirements prescribed.
All bids will be compared on the basis of the estimate of the
quantities of work to be done set out in the proposal and in the form
of contract. The right is reserved to reject any and all proposals.
The successful bidder will be required to furnish a payment bond
in an amount equal to one hundred percent of the contract price and a .
faithful performance bond in an amount equal to one hundred percent of
the contract price, said bonds to be secured from a surety company
authorized to do business in the State of California.
Bidders are hereby notified that pursuant to Section 1773 of the
Labor Code of the State of California, the said Board has obtained
from the Director of.-thzlepartment of Industrial Relations of the
State of Calif�nla the g eral prevailing rate of per diem wages and
i
-C' g3-94-95 - NC of 2
the general prevailing rate for holiday and overtime work in the
locality in which the public work is to be performed for each craft,
classification or type or workers needed to execute the contract which
will be awarded to the successful bidder. The prevailing rate of
per diem wages is on file with the Clerk of the Board of Supervisors,
and incorporated herein .by reference thereto, the same as if set forth
in full herein.
For any classification not included in the list, the minimum
wage shall be the general prevailing rate for Contra Costa County.
The said Board reserves the right to reject any and all bids or
any portion of any bid and/or waive any irregularity in any bid
received.
By Order of the Board of Supervisors
of Contra Costa County as the
Governing Body of the West County
Fire Protection District
Phil Batchelor
Clerk of the Board of Supervisors and
County Administrator
G' Tl�/_= ff D 'P U7-'Y
By: _ _
DA 1Q D:
PUBL CATIO DATES:
-(Pub. Cont act Section 20812)
e3
W.A.C. 9 . 4-95 - NC 2of 2
NOTICE TO CONTRACTORS
Notice is hereby given by order of the Board of Supervisors of
Contra Costa County, as the Governing Board of the West County Fire
Protection District, that Clerk of said Board will receive bids for
the abating of exterior fire hazards by mowing, rubbish and tree
removal within the West County Fire Protection District boundaries for
1993-94-95 .
Each bid is to be in accordance with the Abatement Specifications
relating thereto which are on file at the Contra Costa County Fire
Protection District office, 2010 Geary Road, Pleasant Hill, California
94523-4694.
The Abatement Specifications and related contract documents may
be examined at .and obtained by prospective bidders from the above-
mentioned District office.
Each bid shall be made on a Bid Proposal form to be obtained at
the District office and must be accompanied by a certified or
cashier' s check or checks, or bid bond in the amount of ten percent
(10%) of the base bid amount, made payable to the order of "West
County Fire Protection District" . The abovementioned bid security
shall be given as a guarantee that the bidder will enter into a
Contract if awarded the work, and will be forfeited by the bidder and
retained by the District if the successful bidder refuses, neglects,
or fails to enter into said Contract or to furnish the necessary bonds
after being requested to do so by the Board of Supervisors of Contra
Costa County, as governing Board of the District. In lieu of the
foregoing, the bidder may elect to deposit securities of equivalent
value with the District in accordance with the provisions of Section
22300 of the Public Contract Code. Such securities, if deposited by
the bidder, shall be valued by the District, whose decision on
valuation of the securities shall be final .
Bid Proposals shall be sealed and filed with the Clerk of the
Board of Supervisors, Room 106, County Administration Building, 651
Pine Street, Martinez, California, 94553-1297, on or before
March 2, 1993_, at 11:00 a.m. , and will be opened in public
and at the time due in the Board of Supervisors' Chambers, Room 107,
Administration Building, Martinez, Contra Costa County, California,
and there read and recorded. Any Bid Proposals received after the
time specified in this Notice will be returned unopened. No more than
one (1) bid will be accepted from any one individual or firm.
Bids will be presented to the Administrator of the Fire District
for review. The Administrator of the Fire District is the Fire Chief
of the West County Fire Protection District, hereinafter referred to
as the Fire Chief. The Fire Chief will recommend to the Board of
Supervisors the contract be awarded to the responsible bidder whose
total aggregate bid on all of the estimated units is the lowest and
whose proposal complies with all the requirements prescribed.
All bids will be compared on the basis of the estimate of the
quantities of work to be done set out in the proposal and in the form
of contract. The right is reserved to reject any and all proposals.
The successful bidder will be required to furnish a payment bond
in an amount equal to one hundred percent of the contract price and a
faithful performance bond in an amount equal to one hundred percent of
the contract price, said bonds to be secured from a surety company
authorized to do business in the State of California.
Bidders are hereby notified that pursuant to Section 1773 of the
Labor Code of the State of California, the said Board has obtained
from the Director of the Department of Industrial Relations of the
State of California the general prevailing rate of per diem wages and
-1
W.A.C. 93-947-9.5 --NC of 2
the general prevailing rate for holiday and overtime work in* the
locality in which the public work is to be .performed for each craft,
classification or type or workers needed to execute the contract which
will be awarded to the successful bidder. The prevailing rate of
per diem wages is on file with the Clerk of the Board of Supervisors,
and incorporated herein by reference thereto, the same as if set forth
in full herein.
For any classification not included in the list, the minimum
wage shall be the general prevailing rate for Contra Costa County.
The said Board reserves the right to reject any and all bids or
any portion of any bid and/or waive any irregularity in any bid
received.
By Order of the Board of Supervisors
of Contra Costa County as the
Governing Body of the West County
Fire Protection District
Phil Batchelor
Clerk of the Board of Supervisors and
County Administrator
C /?fig 7-7'1-11 S D /_-PUT�
By: -!' - — -
DATED:
PUBLICATION D TES:
(Pub. Con ra Section 20812 )
� y 3
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W.A(" C93-94-95-'-= NC p2 o'f2
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INSTRUCTIONS FOR PREPARATION OF REQUISITION
Department: Name of department, not division or section.
Requisitioner I.D. No.: .Your county assigned 3 digit requisitioner I.D. number, omit if unknown.
Requisition No.: Department's internal number or use preprinted controlnumber
number
for tracking.
Alteration No.: Use if making a change to existing P.O. and include P.O. No.
Date: Date requisition prepared.
Date Required: Date goods and/or services are needed.
Ship To: Use complete address for delivery location/or proper county 3 digit ship to code.
Vendor: Put suggested vendor, and/or county vendor. No. /optional..
Line No.: Lines numbered 1-9.
CCC Item No.: Use 7-digit number from County item data base, omit if unknown -
. buyer will add.
Item Description: Identify request by specific name and identification, such as
part number, i.e., beige, 4-drawer, locking . file cabinet.
Quantity: Number of items on each line, i.e., 1, 2, or 6.
Unit of Measure (UOM): Use 2-character UOM from table, i.e., DZ, EA, BX.
Unit Price: Purchase price per each unit of measure; omit if unknown.
Total: Quantity multiplied by unit price = Total for the line item.
Sub Total: Total of all line items.
Other Charges: Could include freight, set-up fee, delivery charge, etc.
Tax: Total tax on all items, if taxable, exclude freight and other charges in
computing tax.
Requisition Total Amount: Total of all charges for all line items.
Org/Task/Activity/Sub Obi/Opt:. Org and Sub Obj. coding must be completed for
proper charging; Task/Activity/Opt are used only if applicable.
Reason for Purchases/Comments: Provide all relevant information so buyers can
prioritize requests and assist in making cost effective purchases.
Requested By: Name and telephone extension number.
Approved by Division Head: Complete if your department requires.
Authorized Signature: Final approval for request must be made by an authorized
representative of the department and have a signature on file
with Purchasing.