Combined Purchase Form.pdf
PDF 1 MB Posted
- Attached to
- Water Line Replacement Items Federal contract opportunity
- Solicitation number
- V5F10004
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| OTV_2D5F_RFP_Rovanco_05192020_Contracting.pdf |
On GovTribe
Work with this file on GovTribe
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
CCcccCCR
BP-A0611 CDFRM REQUEST FOR PURCHASE Page ____ of ____ JUN 10 PURCHASE CARD ACQUISITION (Not for Personal use Items)
U.S. DEPARTMENT OF JUSTICE FEDERAL BUREAU OF PRISONS
Item No.
GSA/Other Stock No.
DESCRIPTION QTY UNIT UNIT
PRICE
AMOUNT
Bureau of Prisons Tax ID: #53-0205705 TOTAL AMOUNT $
Price Quotes Item 1 Item 2 Item 3 Item 4 Item 1 Item 2 Item 3 Item 4 Item 1 Item 2 Item 3 Item 4
Source/Vendor Name
Street
City, State, Zip
Contact Name/ Phone
APPR
ACCOUNT CLASS
(Accounting Code for purchase cards)
PROJ SUB OBJECT
Date Required Deliver To Requested By
Approving Official/Cost Center Manager Date
TO BE COMPLETED BY PROCUREMENT STAFF
Institution/Facility Requisitioning Department Date of Order
Requestor Name/Telephone Number Receiving Report # (Warehouse Use) Warehouse Signature:
Vendor/Address: IG PO NUMBER
Payment Terms
OriginFOB (check one) Destination
FSS
Price List Internet IFB RFP RFQ No:______________________________
QUOTE SOURCE (check one) Telephone Catalog
TIN YREGDOC# RP#
SUPPLIES ONLY: Excess and rehabilitated sources have been screened and the property is not available from these sources.
CONTRACTING OFFICER DATE
WARNING! AMMUNITION/WEAPONS/HAZARDOUS MATERIAL FOR PENAL
INSTITUTION – DELIVER TO ARMORY/SPECIFIED STAFF ONLY
CARDHOLDER (For Purchase Card acquisitions)
DATE
BOP00425
Typewritten Text
DUNS
BOP00425
Typewritten Text
BOP00425
Typewritten Text
BOP00425
Typewritten Text
BOP00425
Typewritten Text
/CARDHOLDERS
BOP00425
Typewritten Text
BOP00425
Typewritten Text
BOP00425
Typewritten Text
BOP00425
Typewritten Text
CCR
BOP00425
Typewritten Text Contact Name/Telephone/Fax
BOP00425
Typewritten Text
BOP00425
Typewritten Text
BOP00425
Typewritten Text
BOP00425
Typewritten Text
BOP00425
Typewritten Text
BOP00425
Typewritten Text
BOP00425
Typewritten Text Special Authorization APPROVED
BOP00425
Typewritten Text
BOP00425
Typewritten Text
BOP00425
Typewritten Text
BOP00425
Typewritten Text
BOP00425
Typewritten Text
BOP00425
Typewritten Text
BOP00425
Typewritten Text bop45087 Received
UNITED STATES DEPARTMENT OF JUSTICE Page ___ of ___
FEDERAL BUREAU OF PRISONS
REQUEST FOR PURCHASE
PURCHASE CARD ACQUISITION (Not for Personal Use Items)
CONTINUATION PAGE
Institution/Facility Requisitioning Department Date of Order
Requestor Name/Telephone Number Receiving Report # (Warehouse Use) _________________
Warehouse Signature ________________________________
Item No.
GSA/Other Stock No.
DESCRIPTION QTY UNIT UNIT
PRICE
AMOUNT
TOTAL AMOUNT-Page 2Bureau of Prisons Tax ID #53-0205705
Contracting Officer / Cardholder YREGDOC / RP #
| BP_A0611_PCAF and RP combined Rev1 test.pdf |
| RP and PCAF combined p2 |
| Page: |
| of: |
| Requestor NameTelephone Number: |
| Receiving Report Warehouse Use: |
| Item 1: |
| GSA/Stock#1: |
| Description1: |
| QTY 1: |
| Unit1: |
| Unit Price1: |
| Amount1: 0 |
| Item 2: 1 |
| GSA/Stock#2: |
| Description2: 8 Inch Schedule 40 A106B Seamless Domestic Steel in a 12" HDPE Casing |
| QTY 2: 330 |
| Unit2: FT |
| Unit Price2: |
| Amount2: 0 |
| Item 3: |
| GSA/Stock#3: |
| Description3: w/ Joint Kits in 40 Foot Double Random Lengths |
| QTY 3: |
| Unit3: |
| Unit Price3: |
| Amount3: 0 |
| Item 4: 2 |
| GSA/Stock#4: |
| Description4: 8 Inch x 12 Inch Pre-Insulated 90 Degree Elbow |
| QTY 4: 10 |
| Unit4: EA |
| Unit Price4: |
| Amount4: 0 |
| Item 5: 3 |
| GSA/Stock#5: |
| Description5: 8 Inch x 12 Inch Pre-Insulated 45 Degree Elbow |
| QTY 5: 2 |
| Unit5: EA |
| Unit Price5: |
| Amount5: 0 |
| Item 6: 4 |
| GSA/Stock#6: |
| Description6: 8 Inch x 12 Inch Pre-Fabricated Anchor |
| QTY 6: 4 |
| Unit6: EA |
| Unit Price6: |
| Amount6: 0 |
| Item 7: 5 |
| GSA/Stock#7: |
| Description7: 8 Inch x 12 Inch Field Applied Shrink End Seal - IPEC 8.625 - 2.0 |
| QTY 7: 2 |
| Unit7: EA |
| Unit Price7: |
| Amount7: 0 |
| Item 8: 6 |
| GSA/Stock#8: |
| Description8: New York State Professional Engineer Stamp |
| QTY 8: 1 |
| Unit8: EA |
| Unit Price8: |
| Amount8: 0 |
| Item 9: 7 |
| GSA/Stock#9: |
| Description9: One Day of Rovanco Field Service Representative |
| QTY 9: 1 |
| Unit9: EA |
| Unit Price9: |
| Amount9: 0 |
| Item 10: |
| GSA/Stock#10: |
| Description10: |
| QTY 10: |
| Unit10: |
| Unit Price10: |
| Amount10: 0 |
| Total: 0 |
| SourceVendor Name1: |
| Street1: |
| City State Zip1: |
| Contact Name Phone1: |
| Item 1_2: |
| Item 2_2: |
| Item 3_2: |
| Item 4_2: |
| SourceVendor Name2: |
| Street2: |
| City State Zip2: |
| Contact Name Phone2: |
| Item 1_3: |
| Item 2_3: |
| Item 3_3: |
| Item 4_3: |
| SourceVendor Name3: |
| Street3: |
| City State Zip3: |
| Contact Name Phone3: |
| Date Required: |
| Deliver To: |
| Requested By: |
| APPR: |
| ACCOUNT CLASS: |
| PROJ: |
| SUB OBJECT: |
| Approving OfficialCost Center Manager: |
| Date: |
| TIN: |
| DUNS: |
| IG: N |
| PO NUMBER: |
| Payment Terms: Credit Card |
| Ship Via: Best Means |
| Origin: Off |
| Destination: On |
| FSS: On |
| Price List: Off |
| Internet: Off |
| IFB: Off |
| RFP: Off |
| RFQ: Off |
| Number: |
| YREGDOC: |
| RP#: |
| CONTRACTING OFFICER: |
| DATE: 5/14/2020 |
| Warning: Off |
| CARDHOLDER For Purchase Card acquisitions: |
| DATE_2: |
| Page #: |
| Total pages: |
| REQUEST FOR PURCHASE: Off |
| PURCHASE CARD ACQUISITION Not for Personal Use Items: Off |
| InstitutionFacility: FCI Otisville |
| Requisitioning Department: |
| Date of Order: |
| Name and Phone: |
| Receiving Report #: |
| Item 11: |
| GSA/Stock#11: |
| Description11: |
| QTY 11: |
| Unit11: |
| Unit Price11: |
| Amount11: 0 |
| Item 12: |
| GSA/Stock#12: |
| Description12: |
| QTY 12: |
| Unit12: |
| Unit Price12: |
| Amount12: 0 |
| Item 13: |
| GSA/Stock#13: |
| Description13: |
| QTY 13: |
| Unit13: |
| Unit Price13: |
| Amount13: 0 |
| Item 14: |
| GSA/Stock#14: |
| Description14: |
| QTY 14: |
| Unit14: |
| Unit Price14: |
| Amount14: 0 |
| Item 15: |
| GSA/Stock#15: |
| Description15: |
| QTY 15: |
| Unit15: |
| Unit Price15: |
| Amount15: 0 |
| Item 16: |
| GSA/Stock#16: |
| Description16: |
| QTY 16: |
| Unit16: |
| Unit Price16: |
| Amount16: 0 |
| Item 17: |
| GSA/Stock#17: |
| Description17: |
| QTY 17: |
| Unit17: |
| Unit Price17: |
| Amount17: 0 |
| Item 18: |
| GSA/Stock#18: |
| Description18: |
| QTY 18: |
| Unit18: |
| Unit Price18: |
| Amount18: 0 |
| Item 19: |
| GSA/Stock#19: |
| Description19: |
| QTY 19: |
| Unit19: |
| Unit Price19: |
| Amount19: 0 |
| Item 20: |
| GSA/Stock#20: |
| Description20: |
| QTY 20: |
| Unit20: |
| Unit Price20: |
| Amount20: 0 |
| Item 21: |
| GSA/Stock#21: |
| Description21: |
| QTY 21: |
| Unit21: |
| Unit Price21: |
| Amount21: 0 |
| Item 22: |
| GSA/Stock#22: |
| Description22: |
| QTY 22: |
| Unit22: |
| Unit Price22: |
| Amount22: 0 |
| Item 23: |
| GSA/Stock#23: |
| Description23: |
| QTY 23: |
| Unit23: |
| Unit Price23: |
| Amount23: 0 |
| Item 24: |
| GSA/Stock#24: |
| Description24: |
| QTY 24: |
| Unit24: |
| Unit Price24: |
| Amount24: 0 |
| Item 25: |
| GSA/Stock#25: |
| Description25: |
| QTY 25: |
| Unit25: |
| Unit Price25: |
| Amount25: 0 |
| Item 26: |
| GSA/Stock#26: |
| Description26: |
| QTY 26: |
| Unit26: |
| Unit Price26: |
| Amount26: 0 |
| Item 27: |
| GSA/Stock#27: |
| Description27: |
| QTY 27: |
| Unit27: |
| Unit Price27: |
| Amount27: 0 |
| Item 28: |
| GSA/Stock#28: |
| Description28: |
| QTY 28: |
| Unit28: |
| Unit Price28: |
| Amount28: 0 |
| Total Page 2: 0 |
| Contracting Officer/Cardholder Name: |
| YREGDOC/RP Number: |
| RP: On |
| PCAF: Off |
| Telephone: Off |
| Catalog: Off |
| CCR: |
| Contact Name/Telephone/Fax: |
| Vendor Name/Address Line 1: Solvix Solutions |
| Address Line 2/City/State/Zip: |
| SA Approved: Off |
File details come from the government source that posted it. Updated .