27ROB0172 Purchase Request.pdf
PDF 358 KB Posted
- Attached to
- Release State Use/Facilities for Persons with Severe Disabilities IL|25-416CMS-BOSS4-P-75647
- Contract number
- 25-416CMS-BOSS4-P-75647
- Issued by
- Illinois
About this file
Document Summary
This is a Purchase Request form issued by the Illinois Department of Corrections for Robinson Facility/Division dated September 1, 2026. The document serves as a procurement request for items under $2,000 and includes vendor comparison information across six potential suppliers. The form is part of the standard purchasing process for the state of Illinois Department of Corrections, with distribution to the Business Office.
The purchase request is for 224 cases of C-Fold Paper Towels (D.O. Code 1391). Vendor #1, Shelby Co., submitted the sole bid at a unit price of $31.89000 per case, resulting in a total contract price of $7,143.36000. Vendors #2 and #3 did not submit pricing, while Vendors #4, #5, and #6 were not solicited or did not respond. The justification for this purchase notes that the facility currently maintains 50 cases in stock with an average issuance of 24-26 cases per week, and the requested 224 cases will provide approximately 8 weeks of supply. The purchase was requested by James Hicks (Extension 5431) and approved by Department Head Amy Beverlin and Chief Administrator Chad Jennings.
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Text version
Distribution: Business Office Printed on Recycled Paper DOC 0143 (Rev. ) Page of 2
ILLINOIS DEPARTMENT OF CORRECTIONS
Purchase Request
Facility / Division OFD / Req. # Object Code Date
Item Requested Vendor #1 Vendor #2 Vendor #3 D. O.
Code
Description of Item(s) Qty.
Unit Size
Unit Price Total Price Unit Price Total Price Unit Price Total Price
NOTE: This form is for purchases under $2,000.
Freight
Total
Justification:
Item Requested Vendor #4 Vendor #5 Vendor #6 D. O.
Code
Description of Item(s) Qty.
Unit Size
Unit Price Total Price Unit Price Total Price Unit Price Total Price
NOTE: This form is for purchases under $2,000.
Freight
Total
Justification:
Distribution: Business Office Printed on Recycled Paper DOC 0143 (Rev. ) Page of 2
Vendor #1 Vendor #2 Vendor #3
Name:
Vendor #:
Address:
Phone #:
Address:
Person:
Comments:
Awarded Written Verbal Awarded Written Verbal Awarded Written Verbal
Vendor #4 Vendor #5 Vendor #6
Name:
Vendor #:
Address:
Phone #:
Address:
Person:
Comments:
Awarded Written Verbal Awarded Written Verbal Awarded Written Verbal
Awarded Vendor’s FEIN#: If not low bidder, state justification in “comments.”
Ordering Procedure (check one): Mail OFD FAX OFD Contract Order #
Requester will phone in: Other:
Name of Contact
Deliver to:
Facility/Division
Department
Attention (Print Name)
Address
City State Zip Code
Requested by:
Print Name Extension
Approved by:
Department Head’s Signature Date
Business Administrator’s Signature Date
Chief Administrator’s Signature Date
Check Function Code
01 Satellite #1 04 Security 07 Warehouse/Dietary
02 Satellite #2 05 Programs 08 Clothing
03 Medical 06 Maintenance 09 Administration
File details come from the government source that posted it. Updated .