Exhibit 12 - 500 Request.pdf

PDF 43 KB Posted

Attached to
Operations and Mantenance of Water, Wastewater and Water Treatment Systems on the Umpqua National Forest
Solicitation number
AG-04T1-S-12-0010
Issued by

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Exhibit - 12. Request for Equipment Repair or Replacement to Exceed 500

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Approved Denied Notes:

Approved Denied Notes:

Request for Equipment Repair or Replacement to Exceed $500 Request

COR Approval

Requested By:

Item:

Which Plant?:

Date:

Cost:

COR Signature:

Date:

Briefly Describe the Need for this Item:

COR Approval

COR Signature:

Date:

Briefly Describe the Need for this Item:

Request for Equipment Repair or Replacement

Requested By: Date:

to Exceed $500 Request

Cost:Which Plant?:

Item:

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