1-Exhibit B - EQUIPMENT PICKUP FORM 2026.docx

DOCX document 45 KB Posted

Attached to
Electric Motor and Pump Repair Services
Solicitation number
260169-B-AS
Issued by
Pinellas County, Florida

About this file

This is an Equipment Pickup Form related to the City of Tarpon Springs, Florida's Electric Motor and Pump Repair Services contract opportunity. The form is used by City of Tarpon Springs employees to document the pickup of equipment requiring repair services, including pumps, motors, gearboxes, drives, blowers, compressors, and related equipment. The form applies to equipment located at three City facilities: the WWTP at 201 E Pine Street, the RO Plant at 1624 L&R Industrial Boulevard, and Utility Maintenance at 200 Dixie Highway, all in Tarpon Springs, Florida. The form requires completion of contractor name, equipment description, serial/tracking numbers, equipment location, motor nameplate information, pickup date, and requested return date not to exceed 15 calendar days. The City employee must document equipment condition and the reason for repair, confirm whether a photo was taken prior to pickup, and obtain signatures from both the contractor representative and City representative with printed names and dates.

All equipment must be returned to OEM specifications upon completion of repairs. The form includes a critical note that contractors must remove all accessories prior to shipping equipment out. This standardized pickup form serves as the operational documentation mechanism for the as-needed repair services contract, which allows the City to award to multiple primary and secondary awardees for repair services across the water and wastewater utilities divisions with no guaranteed minimum or maximum order quantities.

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Text version

CITY OF TARPON SPRINGS

EQUIPMENT PICKUP FORM

WWTP

201 E Pine St Tarpon Springs, FL

RO Plant 1624 L&R Industrial Blvd Tarpon Springs, FL Utility Maintenance 200 Dixie Hwy.

Tarpon Springs, FL

AS-NEEDED PUMPS, MOTORS, GEARBOXES, DRIVES, BLOWERS, COMPRESSORS AND RELATED EQUIPMENT REPAIR SERVICES

(TO BE COMPLETED BY CITY OF TARPON SPRINGS EMPLOYEE)

Contractor Name:

Equipment Description: Serial/Tracking#:

Equipment Location:

Pump Motor Nameplate: Intact Nameplate Data:

Pick-up Date:Request Return Date:
(Not to Exceed 15 calendar days)

Other Equipment Description:

Equipment Condition (Describe condition of equipment and reason for repair):

NOTE: All equipment to be returned to OEM specifications.

Was a photo of this equipment taken before it was picked up?

The equipment described above was picked up for repair in accordance with City of Tarpon Springs Bid

Contractor’s Representative Printed Date (Signed)

City’s Representative Printed Date (Signed)

NOTE: REMOVE ALL ACCESSORIES PRIOR TO SHIPPING OUT

File details come from the government source that posted it. Updated .