HomeMy WebLinkAboutCORRESPONDENCE - GENERAL CORRESPONDENCE - 4400780Service Quotation Please Sian and Return this Page
October 29, 2003
Reference: Estimated Service Information
Site Number: 48029102/MA0062391 Sales Rep: LORETTA BEAUVAIS
Site Address: FT COLLINS CITY WATER QUAL LAB Terms: Net 30 FOB: PPD/ADD
4316 W LAPORTE
FORT COLLINS, CO 80521
Contact: MARTIN, SUE or Purchaser/ Buyer
Contact Phone: MARTIN, SUE
Purchase Order Number: 3300578
PO Expiration Date: 12/31/03
Estimated Service Quote - System Configuration -This is NOT a Bill
Est.Srv.DAYS
YEARLY
Part #
Description
Q_yt
Price/Ea.
Frequency
Est. Total
FCPXF0901
CART 9.75' 1um NO SURFACTANT
1
$
6.94
As Req'd.
CUL009CARFG04
EXCH 1.4 C.F. CULLIGAN 9- FG
1
$
186.00
180
$372.00
CUL009MBl FG04
EXCH 1.4 CU. FT. 9' FG TYP I
1
$
157.00
180
$314.00
CUL009MBI FG04
EXCH 1.4 CU. FT. 9- FG TYP 1
1
$
167.00
As Req'd.
CUL009CATFG04
EXCH 1.4 CU. FT. CULLIGAN 9'
1
$
78.00
180
$156.00
CUL009ANI FG04
EXCH 1.4 CU. FT. 9- FG ANION
1
$
78.00
180
$156.00
Exchange frequency per year will vary due to water usage and feed water quality; this quote may not reflect the actual
number of exchanges that will be needed during the service year. The above is based on the minimum exchange
frequency.
Payment Options for future service: IF TAX- EXEMPT, PLEASE ATTACH EXEMPTION CERTIFICATE
❑ Visa / Master Card/Amex: Service will be performed at the estimated frequency above or sooner and an invoice
referencing the credit card number will be mailed to you. (Circle one)
EXP.DTE:
Name on card:
CARD#
Blanket PO: Service will be performed at the estimated frequency above or sooner and an invoice referencing the
blanket purchase order will be tm1ailed to you. Starting Date: DI • t7I • 20d Y
Blanket Purchase Order: q 7 OO�7 1� O Expiration: _ tc. 31, a o Qq
IF
❑ No P.O. Required: Service will be performed at the estimated frequency above or sooner. An invoice will be mailed
to you. (None Needed) Our company does not Issue Purchase Orders, my signature and title represents
acceptance of the above quote.
Authorized Representative Signature / Title / Date / Print Name
❑ New PO At Each Service: Service will be performed at the estimated frequency indicated above or sooner. A new
purchase order must be provided prior to the service. An invoice will be mailed to you. (NEW EACH TIME)
Please specify a payment option, sign, and return this quote to the address below or fax to (303) 287-3402, attention
Purchase Order Dept. If applicable, please mail your blanket purchase order with this quote; include Site Number and
MA Number. We agree to all terms and editions of UUS ' ter.
� 9% A
USFilter
13100 E. Albrook Dr, Ste. 600
Denver, CO 80239
303-287-3367
303-287-3402 Fax
Customer Signature
Print Name / Date
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