Sign_Order_3_7100631a 2 .docx

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Attached to
Sign Materials Federal contract opportunity
Solicitation number
AG-84N8-S-14-0086
Issued by
Department of Agriculture Forest Service R4-Intermountain Region

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Sign Order 3

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Text version

Form FS-7100-63-1a

RETROREFLECTIVE SIGN REQUISITION

(Signs to be constructed in full compliance with Forest Service EM-7100-15)

TO BE COMPLETED BY A.S.

1. Purchase Order Number

Office Location Guide

5. Appropriation Code

CMRD19

6. Required Delivery Date 06/30/2014

2. Region R-4 Intermountain

3. Forest Uinta-Wasatch-Cache

4. District S.O./Engineering

7. Name & Address of Ordering Unit (Include Zip Code) Name Uinta-Wasatch-Cache National Forest USFS Address 1729 West 500 South City, ST Zip Code Salt Lake City, UT 84104

8. Ship To (Include Zip Code) 1729 West 500 South Salt Lake City, UT 84104

9. For Technical Assistance Contact Shane Yarrington

10. Telephone No.

435-760-7047

11. Fax No.

801-908-1951

12.Sign Identification
13.Sign Message and Special Instructions
14.Materials
Substrate
Sheeting & Misc.

Line Item

|_| HDO plywood

|X| Aluminum .080 |_| Aluminum composite |_| Fiberglass FRP

|_|Corrugated plastic
|_|Wood plastic composite

|_| Other (Specify)

|X|Pre-drill holes,
standard spacing
|X| Retro reflective sheetinggrade (Specify)
Type III Prismatic Sheeting
|_|Edge finishing film
|_|Graffiti film
|_|Other (Specify)
|_|Other (Specify)
|_|Layout drawing and sizeto be approved prior tomanufacture

Sign No.

W1-2L(Left Turn)

Est. Sq. Ft.

30”x30”

Quantity/Unit Price

$ Line Item Total

Line Item

|_| HDO plywood |X| Aluminum .080 |_| Aluminum composite |_| Fiberglass FRP

|_|Corrugated plastic
|_|Wood plastic composite

|_| Other (Specify)

|X|Pre-drill holes,
standard spacing
|X| Retro reflective sheetinggrade (Specify)
Type III Prismatic Sheeting
|_|Edge finishing film
|_|Graffiti film
|_|Other (Specify)
|_|Other (Specify)
|_|Layout drawing and sizeto be approved prior tomanufacture

Sign No.

W1-2R(Right Turn)

Est. Sq. Ft.

Quantity/Unit Price

$ Line Item Total

Line Item

|_| HDO plywood |X| Aluminum .080 |_| Aluminum composite |_| Fiberglass FRP

|_|Corrugated plastic
|_|Wood plastic composite

|_| Other (Specify)

|X|Pre-drill holes,
standard spacing
|X| Retro reflective sheetinggrade (Specify)
Type III Prismatic Sheeting
|_|Edge finishing film
|_|Graffiti film
|_|Other (Specify)
|_|Other (Specify)
|_|Layout drawing and sizeto be approved prior tomanufacture

Sign No.

W1-5

Est. Sq. Ft.

Quantity/Unit Price

$ Line Item Total

15. Submitted By (Signature)

/s/Shane Yarrington

16. Title

Construction/Maintenance Supervisor

17. Date

18. Technical Approval By Sign Coordinator (Signature)

19. Date image1.emf image2.jpeg image3.emf

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