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i <br /> I <br /> `.� PR# ____._ ���: <br /> PUBLIC WORKS Po��__�_—'�-G_� 'i <br /> � (�� DP's Initial I <br /> i <br /> REQUEST FOR GOODS & SERVICES I <br /> � _ � _ 1 3---_—_ Date Needed:_ <br /> y- I� — I�—___ <br /> Today's Date: - Deliver To <br /> Vendor In_fo�matw^ ��{5� 5� ' <br /> _ � �,zk �ic4 � <br /> � 1 � �r;�- 11 n,,� __-----�— <br /> Name: C\��,,,� i\t�l�ns95 <br /> _�____ h st 5 '^-� 4.,.cJT <br /> Address: — �— 2� � � �`�T �,^V -- <br /> �,� �Y`0.Y�-' I. H.VV-1�4�1 <br /> , CirylStateiZip: Cv���-�- <br /> 1 �`� J� <br /> Phone: Atten:ion: ��aS "a� - 3 <br /> ._/ � Unit Total <br /> F1� ParU Qb• Pric Price <br /> Item Description' Catalog# GL Code/Job Cost!Y <br /> ��# I (be specific) <br /> S� S _ gL � io� - 5-'7 ;o - ii�t � � Lto <br /> ' S _1 5 ' � �-' �,-�S- _ t,��i � ---_- <br /> Ju...�� i- k�o5-e-- • �p� o3a- 1 . <br /> U� <br /> ia � o��d' V��Ix <br /> Q�.2 1�`""�' ' � � � � <br /> ,l 57 i -2 - <br /> � V��1t \� rX 3s� � <br /> _. _ <br /> . I�v <��- � �i,P. .. - ;f�— <br /> �. � ; <br /> � � �: <br /> ' .\� ca1__—t �H'u' r�e�•,'� , <br /> Purpose/Comments: — <br /> � <br /> •Please use as many lines as you neetl io��he descripfion,or attach a sepa�ete page. _�J <br /> rhe irems will be base0�n your descdp�ion.For purchases ot$7,000 piease note purpose. <br /> /.� _ �� p.��•�` �- = val S' naWr .. <br /> ���-� <br /> ��. Requester � <br /> 1 White Copy-Processor Green Copy-Requestor <br /> I <br />