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Form last updated:11-2013 Submit form to Operations Services.
EQUIPMENT REQUEST FORM Date: 3/22/2020
Light & Medium Duty VehiclesTAB to the next field. SHIFT-TAB to return to a previous field.
Dept Parks Division Parks
Domicile/
Dept Code M1530
Funding year 2020
Budgeted
Amount $47,000.00
Business Unit Acct # 703010.565100.6197.1000.A
Funded as: Capital purchase Lease Purchase
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enter "X" to select the
Quantity requested: 1 correct check boxes
New
unit Used unit
Describe intended use and reason for purchase: Mower hauling and winter plowing along with general
maintenance work
Anticipated usage: Miles per year: 3,800 Hours per year:
If this is a replacement unit, which unit(s) will be replaced? Unit # 2514
Model year of unit to be replaced: 1998 Current meter reading: 81,741
Reason for replacement: Age and Miles meets the 15 point max of system
Description of vehicle requested:
Item: Make selection using drop-down boxes:
Vehicle Type Pickup
Body Style Full size
Cab Type Regular cab
Drivetrain Four wheel drive
Engine Optional - specify below
Transmission Standard equipment
Fuel Type Other
Added Vehicle Information: 3/4 ton, CNG fuel, 4x4
Requested options: (power windows/locks, cruise/tilt, towing package, opt. axle ratio)
Enter your requests: power windows and locks, towing package, light package #2,
Other accessories: (Snow plows, winches, tool boxes, utility body, crane, etc.)
Enter your requests:
V-type Snow Plow, weather guard standard depth (127-5-02) tool box,
OEM Bed Liner, OEM Running Board, WeatherTech liners
Name of contact person in your department:
Name: William Cooksey Phone/email: bcooksey@fcgov.com