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-- PR# <br /> PUBL/C WORKS Po#�,Gt,Z'__/�n,p5� <br /> y� DP's In�ial __�� Date_�.��. <br /> REQUEST FOR G ODS & SERVICES <br /> TWays Date: _ '�-� ' `� ' � �—_ Date Needed: � <br /> Vendor Information Deliver To <br /> Name: �U ��c,nc`+v�`t�� — <br /> Address: — <br /> Ciry/State2ip: <br /> Phone: <br /> Atlention: <br /> FAX: <br /> Item ' Item Description' � PaN GL Code/Job Cost# Q�,. Unit Total <br /> � (be specific) Catalog# �� Price Price <br /> � �11�. �� –�IOU � LJCi– S� =110 ' il5 � i� `�fJ c) . G�j <br /> I �" n�. a , P�. ,�"� �,s - <br /> aet U3a� ' <br /> I � <br /> I <br /> I <br /> � <br /> Purpose/Comments: — <br /> 'Please use as many lines as yrou neetl hr the descnOfion,or attach a separate page. <br /> The dems will be oaseC on your description.Fnr purchases ot$1,000O�eese note purpose. <br /> �Y�C�vti. (8..��'-r�-e.�t�. �—a` — . <br /> Requester Approval Signature ', <br /> W�ite Copy-Procassor Green Copy-Requesror <br />