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Form last updated:11-2013 Submit form to Operations Services.
EQUIPMENT REQUEST FORM Date: 15May20
Light & Medium Duty VehiclesTAB to the next field. SHIFT-TAB to return to a previous field.
Dept Light & Power Division Electric Field Services
Domicile/
Dept Code M2200
Funding year 2020
Budgeted
Amount $37,966.00
Business Unit Acct # 501.15100000.565040.3980.15100000.
Funded as: Capital purchase Lease Purchase Touch the spacebar or
enter "X" to select the
Quantity requested: 1 correct check boxes
New
unit Used unit
Describe intended use and reason for purchase: Used for Transporting of Cable test equipment
Anticipated usage: Miles per year: 10,000 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:
Reason for replacement:
Description of vehicle requested:
Item: Make selection using drop-down boxes:
Vehicle Type Van
Body Style Full size
Cab Type Regular cab
Drivetrain All wheel drive
Engine Standard equipment
Transmission Standard equipment
Fuel Type Gasoline
Added Vehicle Information: Will need Racks and Trays in the back of Van to outfit
the Test equipment. Can't order until we have the test equipment
Requested options: (power windows/locks, cruise/tilt, towing package, opt. axle ratio)
Enter your requests:
Other accessories: (Snow plows, winches, tool boxes, utility body, crane, etc.)
Enter your requests: Tool boxes, Racks and Trays
Name of contact person in your department:
Name: Erik Anderson Phone/email: 970-482-3568/eanderson@fcgov.com
JR $36213.00
8/11/20