Attachment C-4 FTC-ADM-1A FLETC Purchase Requisition PRRev.pdf
PDF 665 KB Posted
- Attached to
- Student Support/Facilities Operation Maintenance Services Federal contract opportunity
- Solicitation number
- 70LCHS25RPFB00001
About this file
This is a blank purchase requisition form (FTC-ADM-1A Rev. 7-87) template used by the Federal Law Enforcement Training Centers (FLETC) in Charleston, SC. The form is labeled as "Attachment C-6" and includes fields for requesting office information, vendor details, item descriptions, quantities, pricing, justification, and approval signatures. The form contains 22 numbered sections including spaces for contract numbers, delivery terms, FOB points, and allows for up to 12 line items to be ordered with units, quantities and pricing. The form is associated with solicitation number 70LCHS25RPFB00002 which is part of a larger procurement for student support and facilities maintenance services at FLETC Charleston.
The template includes standard procurement form elements like a funds charge code field, activity code, dates needed, building/room numbers, and sections for both procurement authorization and receipt confirmation. The bottom of the form has spaces for imprest fund and stockroom activity tracking. As this is a blank template, no actual procurement information or pricing data is filled in.
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Text version
(1) REQUESTING OFFICE: (2) (a) REQUESTED BY: (3) DATE:
(b) DATE ITEMS NEEDED: (4) TELEPHONE NO.
(5) BUILDING NO. 1
(7) FUNDS TO BE CHARGED TO: (8) ACTIVITY CODE: (6) ROOM NO.
(9)(a) VENDOR: (10)(a) CONTRACT NO:
(b) ADDRESS (if available): (b) TERMS:
(c) TELEPHONE NO. (if available): (c) DELIVERY TIME:
(d) CONTACT PERSON (if known): (d) FOB POINT:
ARTICLE NO. DESCRIPTION QUANTITY
UNIT OF
ISSUE UNIT PRICE TOTAL
(11) (12) (13) (14) (15) (16)
1 ea ea ea ea ea ea ea ea ea ea ea ea
(19) SUPPLIES: ORDER PROVIDES MONTHS NEEDS
(20)(a) APPROVED BY: (21)(a)
(b) DATE: (c) TITLE: (b) DATE: (c) TITLE:
IMPREST FUND AND STOCKROOM ACTIVITY
(22)(a) RECEIVED BY: (b) DATE:
Attachment C-6
(b) POSTAGE/TRANSPORTATION COST (est)
(c) GRAND TOTAL
PROCUREMENT
AUTHORIZED BY:
(17) PURPOSE AND JUSTIFICATION
(18)(a) TOTAL FROM CONTINUATION PAGE
FTC-ADM-1A(Rev. 7-87)
(Materials, Supplies, Equipment, & Services)
PURCHASE REQUISITION
FLETC
PROCUREMENT USE ONLY
TC CONTROL NO.
DATE:
Federal Law Enforcement Training Centers Charleston SC Solicitation Number: 70LCHS25RPFB00002
Federal Law Enforcement Training Centers Charleston SC Solicitation Number: 70LCHS25RPFB00002
FRONT
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