HomeMy WebLinkAboutbocc.con.249.2013 Rev. 08-30-11 j(s
COUNTY CLERK'S
CONTRACT COVERSHEET
CONTRACT #: 249-2013
ORIGINATING DEPARTMENT: FLEET
PROCUREMENT OFFICER: James Gilliam PHONE #: -9205765
PROJECT NAME: AP BROOM BRISTLE CONTRACTOR: MB BROOM
DOLLAR AMOUNT: $49,584.22 LINE ITEM# 505.52 00000 83754
CONTRACT EXECUTION DATE: 9/6/2013 CONTRACT END DATE:
AUTOMATIC RENEWAL: ❑ YES � NO TERM:
❑ BOCC AGENDA ITEM (Grants, IGA) � STAFF AUTHORIZED SIGNATURE
(Requires BOCC Signature) (Per Revised Procurement Code 7/2005)
❑ OVER$50,000 (Requires Section Leader& County Manager's Signature)
✓ CHECK PROCUREMENT TYPE:
❑ None � Informal ❑ Formal ❑ Sole Source ❑ Emergency ❑ Outside Agency/State Bid
❑ Compliance with C.R.S. 8-17-5-101, 102 as amended(Immigration Form) ❑ Exempt
❑ Contract Renewal � n� ��
✓ CHECK CONTRACT TYPE:
�
❑ Services/Maintenance ❑ Employment
❑ License/Use ❑ Intergovernmental Agreement(Resolution Required)
❑ Lease ❑ Non-Profit
❑ Construction ❑ Quasi-Public (e.g.-AVH)
� Goods, Equipment, Supplies ❑ Grant Agreements(Notify Finance & Resolution Required)
❑ Other(e.g. revenue) ❑ Change Order/Contract Amendment
(C/0: 10%or$25K�vhichever is the Icsser mus[have County Manager signawre)
All Contracts should be proofed and all exhibits and notices must be attached for the following:
✓ � No Pages Missing ✓� All Other Blanks Filled In
✓ � If Page Left Intentionally Blank—Note on Page ✓� All Exhibi[s Attached
✓ � Page numbered consecutively ✓� All Legal Descriptions attached (ifapplicable)
✓ � All Original Signatures Affixed ✓� Notice of Award/Notice to Proceed Attached ('f applicable)
✓ � All Dates Filled In ✓� Wasanty(if applicable)
✓ � Special Instructions for Finance Department PAID WITH P-CARD
✓ � Authorized Procurement Of'ticer's Name: JAMES GILLIAM
BY CHECKING AI30VE AND ENTERiNG NAME,THE AUTHORIZEll STAFF YERSON INDICATES THAT
THE ATTACHED DOCUMENT HAS BEEN PROOFED AND RF,ADY FOR SCANNING.
NOTE: CLERK'S OPPICE WILL KEEP ORIGINAL DOCUMENTS IN COMPLIANCE WITH COLORADO STATE
ARCHNES RETAINAGE SCHEDULE. ALL ATTACHMENTS MUST BE WITH THIS CHECKLIST!
mpanies Inc ���,� H' Phone: 1-800-558-5800
. sconsin Avenue CG N Fax: 920-898-4588
Holstein WI 53061 ��n /�
a � � - �
Invoice: 177509 ��'� � Page: i of i.
s�� �,�;INVOICE�a���-�.����:a.
Date: 9/6/2013
Sold To: Ship To:
JAMES GILLIAM
Pitkin County Fleet Management Aspen-Pitkin County Airport, Sardy Field
76 Service Center Road 1001 Owl Creek Road
Aspen CO 81611 Gate 11
Aspen CO 81611
Aemit To: ��!-S Companies, Inc. P:O.-Box 200 New Hoistein, WI �3061'-0200 l
PO Number: CHARGE Terms: Credit Card F.O.B: Dest. PrePaid i
� Sales Rep: Schulz, Aaron ` Ordered: 8/1/2013 Ship Via: Z Drop Ship (
� Packing Slip: 89809 Ship Date: 9/5/2013
„L'-ine ' 't �+: -�Quantity'. ;Part�Number/Description' ; : . Revision .: n � 1,;}�Umt;Price k "tExt Price.
1 7.00 907-166747 0 7,083.46000 EA ~ 49,584.22
Line Ref. 1 REFILL, 4620 WIRE CASSETTE KIT _' - -- '
` = Warehouae,Code A1 : . . .
. , � � .. . . . . . _ . . ' _ . �,c.�. � -
. �.��'-'"' —
�
�'45�, S�, 0400�, Fj37 ��f
�A �U �clJ/ �. Carr�
(
PavmentSchedule� ����.,;4 <;��.w Total: 49,584.22
i"F �a ,.DueDate�= nAmount' U.S. Dollars
1 9/6/2013 49,584 22
i Total 49,584.22�
ARFOrm:001:00 All pans orders are subject to a 30%restocking fee.
Thank you for your business. We Iook forward to serving you again.
For Terms and Conditions,log on ro our website www.m-bco.com and click on warranty.
Remit To: M-B Com anies Inc. PO Box 200 New Holstein WI 53061
FEIN 39-1208304
�