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HomeMy WebLinkAboutCORRESPONDENCE - PURCHASE ORDER - 9201023 (3)Fill out form template then SAVE AS a .doc file using a file name of your choice, such as Example.doc Close form template WITHOUT saving and it will be blank when you open it again. Form last updated:11-2013 Submit form to Operations Services. EQUIPMENT REQUEST FORM #2 Date: 4/1/2020 HD Truck & Equipment TAB to the next field. SHIFT-TAB to return to a previous field. Dept Streets Division Domicile/ Dept Code M Funding year 2020 Budgeted Amount $175,000.00 Business Unit Acct # Funded as: Capital purchase Lease Purchase Touch spacebar or enter "X" to select the Quantity correct check boxes requested: 1 New unit Used unit Describe intended use and reason for purchase below: For use to load truck with salt for streets snow removal. Also to unload salt orders from rail car. Anticipated usage: Miles per year: Hours per year: If this is a replacement unit, which unit(s) will be replaced? Unit # Model year of unit to be replaced: Current meter reading: Describe reason for replacement below: Current unit very old and inefficient. Description of vehicle requested: Item: Enter description below, including options, attachments, accessories, etc: RBT Model 4255 Mobile Salt Conveyor Name of contact person in your department: Name: Jeff Johnston Phone/email: 970-221-6764