HomeMy WebLinkAboutCORRESPONDENCE - PURCHASE ORDER - 9201230 (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 Date: 06/26/2020
Light & Medium Duty VehiclesTAB to the next field. SHIFT-TAB to return to a previous field.
Dept Utilities Division Wastewater
Domicile/
Dept Code M1756
Funding year 2020
Budgeted
Amount $50,000.00
Business Unit Acct # 503.344000.565050
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: This unit will be used in the daily operation of the
wastewater collection and maintenace activites.
Anticipated usage: Miles per year: 6,000 Hours per year:
If this is a replacement unit, which unit(s) will be replaced? Unit # 27027
Model year of unit to be replaced: 2005 Current meter reading: 83,471
Reason for replacement: This pickup is reaching the end of it's life expectancy in the utility.
Description of vehicle requested:
Item: Make selection using drop-down boxes:
Vehicle Type Pickup
Body Style Intermediate
Cab Type Extended cab
Drivetrain All wheel drive
Engine Standard equipment
Transmission Standard equipment
Fuel Type Gasoline
Added Vehicle Information: This unit will be used as a back up on snow duty, so all
wheel drive is desired.
Requested options: (power windows/locks, cruise/tilt, towing package, opt. axle ratio)
Enter your requests: power windows/locks, cruise,air condioning, am/fm radio,antilocks
Other accessories: (Snow plows, winches, tool boxes, utility body, crane, etc.)
Enter your requests: toolboxes
Name of contact person in your department:
Name: Ray Fisher Phone/email: 970-218-4633 rfisher@fcgov.com