po.doc

DOC document 98 KB Posted

Attached to
OVC Video Project to Help Persons with Disabilities Recognize, Report and Respond to Abuse
Solicitation number
S111708-vCurrent
Issued by
Norfolk County, Quincy City, Massachusetts

About this file

This document is a Commonwealth of Massachusetts Purchase Order for Commodities and/or Services. The purchase order confirms an order that was previously placed and provides details on the item(s) or service(s) being procured. The order includes a description of the commodities or services, the unit of measure, quantity, unit price, and total price. Delivery details are also specified, including the requested delivery date and whether a delivery appointment is required. The vendor information, ship-to department, and bill-to department are provided.

The purchase order includes instructions to the vendor, such as requirements for the vendor's invoice and packing list. For services, the purchase order requires a brief description of the services, the dates of service, the number of hours, and the hourly rates. The vendor must sign the form for service engagements. The purchase order also includes a department approval signature and a vendor approval signature (if required for service engagements).

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Text version

Commonwealth of Massachusetts

Purchase Order for Commodities and/or Services

*
FORMCHECKBOX

Commodity/Equipment

FORMCHECKBOX

Service this purchase order confirms an order that was previously placed. please do not duplicate.

*Purchase Order Issue Date:

FORMTEXT

*Purchase Order Number:

FORMTEXT

FORMTEXT

Contract Number:

FORMTEXT

FORMTEXT

Requested Delivery Date:

FORMTEXT

Call to Schedule Delivery Appointment:

FORMCHECKBOX

yes (tel.

FORMTEXT

) FORMCHECKBOX

no Freight Terms:

FORMCHECKBOX

Freight on Board - Destination

FORMCHECKBOX

Other (Specify)______________

Vendor Information

*Name:

FORMTEXT

FORMTEXT

*Address:

FORMTEXT

FORMTEXT

*City, State, Zip Code:

Contact Person:

FORMTEXT

Telephone:

FORMTEXT

Fax:

FORMTEXT

Email:

FORMTEXT

Quote Number (if applicable):

FORMTEXT

Department Information

*Ship to Department Name:

FORMTEXT

*Contact Person:

FORMTEXT

*Address:

FORMTEXT

*City, State, Zip Code:

FORMTEXT

*Telephone:

FORMTEXT

Email:

FORMTEXT

Delivery Instructions:

FORMTEXT

FORMTEXT

*Bill to Department Name:

FORMTEXT

*Contact Person:

FORMTEXT

*Address:

FORMTEXT

*City, State, Zip Code:

FORMTEXT

FORMTEXT

FORMTEXT

FORMTEXT

Telephone:

FORMTEXT

Email:

FORMTEXT

Prompt Payment Discount (Terms & %):

FORMTEXT

Instructions to the Vendor:

1. The vendor’s invoice must include the following minimum information: Purchase order number, quantity and description of item(s) shipped, unit of measure, unit price, total dollar amount of any discount, total price and the vendor’s invoice number.

2. The purchase order number must appear on the vendor’s packing list.

3. See attached specifications, if any, related to this purchase order. If this purchase order is for services, please see the section entitled Engagement of Services below. Additional specifications are not necessary if the details of the performance are covered in the contract.

4. Vendor assumes risk of loss for commodities in transit. All commodities are subject to inspection upon delivery. Commodities delivered after the Requested Delivery Date above may be rejected. Rejected commodities will be returned at the vendor’s expense.

* Engagement of Services (may be required for services): If this Purchase Order is for the provision of services which have been negotiated with the vendor, provide a brief description here of those services (attach detailed specifications, if appropriate). Also, include the dates of service, the number of hours and the hourly rates associated with this engagement. The vendor must sign this form for the engagement of services. Note: This form or additional specifications are not required if the RFR and contract contain all of the required Purchase Order information.

Line #
Vendor Item Number
Item

Description

Unit of Measure
Quantity
Unit Price
Subtotal (Quantity x Unit Price)
** Discount
Total Price (Subtotal minus Discount)
1
2
3

Department Approval

Signature: _________________________________ *Printed Name:

FORMTEXT

FORMTEXT

FORMTEXT

*Date:

Subtotal:

Shipping and Handling:

Total Order Amount:

* Vendor Approval (only required for the Engagement of Services) *Signature: ________________________________ *Printed Name:

FORMTEXT

*Date:

* Indicates required field.

** Discount includes any Prompt Payment Discounts.

File details come from the government source that posted it. Updated .