Purchase_Order .xlsx

637 KB Posted

Attached to
Gutter Replacement at The Dalles
Solicitation number
S-63500-00017583
Issued by
Oregon

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Written by GovTribe AI ·

This file is a Purchase Order template issued by the State of Oregon, Department of Fish and Wildlife (ODFW), designed for procuring goods and services through various funding mechanisms. The template provides standardized formatting and instructions for completing purchase orders, including sections for PO number assignment, delivery dates, vendor information verification, item descriptions with quantities and unit pricing, and special instructions. The form accommodates multiple line items across continuation pages and requires detailed cost distribution coding by index, Program Component Account (PCA), and object code to track expenditures across different grants, phases, and projects.

The Purchase Order template establishes mandatory signature requirements from four parties: the person placing the order, the budgetary manager approving the expenditure, an authorized contracting agent with appropriate contract authority, and the receiving party verifying goods or services compliance. The form requires vendors to be verified through the Oregon Secretary of State website for business registration and the Federal System for Award Management (SAM) to ensure no exclusions apply, particularly when federal funds are involved. Special instructions must incorporate appropriate federal terms and conditions when federal funding is used, or standard Oregon state terms and conditions for state-funded purchases. The template requires identification of freight payment terms (FOB Destination or Destination Prepaid and Add) and the fiscal year, with the Bill To address directed to ODFW's Accounts Payable office in Salem. When purchasing under existing State Price Agreements, vendors must reference the specific price agreement or participating addendum numbers, with such agreement terms taking precedence over conflicting PO language. Contract Services staff must be consulted for non-federal grant fund purchases and whenever contractors will perform on-site services to ensure appropriate insurance requirements are included.

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Other files

File Type Posted
RFQ - Mandatory Bid Proposal Form ~6.pdf PDF
Gutter Replacement SOW .pdf PDF
Solicitation Bidding Instructions~5.pdf PDF
OregonBuys Registration Guide~32.pdf PDF

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Instructions Use of Purchase Order

Hover over a cell to see Comments and Instructions for that cell

1 Insert PO number from your Office's list of PO numbers.

2 Enter date PO is being written.

3 Enter the Delivery Date - date that the vendor/contractor promised delivery of Goods or completion of Services.

4Enter complete vendor/contractor information - legal business name, address, phone, etc.
Check Secretary of State website to verify business registration (for Oregon Businesses). http://egov.sos.state.or.us/br/pkg_web_name_srch_inq.login
Check Federal System for Award Management (SAM) website to make sure vendor/contractor has not been excluded (if using federal money for the purchase): https://www.sam.gov/SAM/pages/public/searchRecords/search.jsf

5 Enter your location where Goods or Services will be delivered.

6 Enter the item number, description, quantity, unit of measure, unit price and total price for each item being purchased. Use continuation sheet if necessary.

7SPECIAL INSTRUCTIONS: Use the appropriate federal terms and conditions (available on ASD/Contract Services Intranet page)
**Insert the following language in the "Special Conditions" cell: Attachment A - Federal Terms & Conditions is incoporated into and made a part of this Purchase Order. In the event of a conflict between the terms and conditions found in Attachment A and the Purchase Order terms and conditions, the Attachment A terms and conditions shall take precedence.
***Contact Contract Services when non-federal Grant funds are being used (ex: PSMFC, PSC, etc.) to get terms & conditions for the specific Grant, and whenever a contractor will be on site performing services to ensure appropriate insurance is requested.
8TERMS & CONDITIONS (Yellow highlighted area): If using State funding, select the first paragraph and use the standard PO T&C's. If purchasing off of a State Price Agreement, use the second paragraph and enter the Price Agreement, and Participating Addendum number(s). If using federal funding you must contact Contract Service to ensure the appropriate language and terms and conditions attachment are included with your Purchase Order.

9 Get appropriate signatures of person placing the order, approving the [budgetary] expenditure, authorizing the purchase (see ASD Policy ASD_250_01 for Contract Authority information), and person receiving the Goods or Services.

10 Enter complete funding information for all items being purchased.

Make sure you send the complete purchase order, including all terms and conditions, to the vendor/contractor.

PO

STATE OF OREGONPO No.PO Date:
PURCHASE ORDERP

Melody L Waight: Melody L Waight:

Insert PO number from list for your office.

Melody L Waight: Melody L Waight:

Date PO is issued

FOB:Fiscal YearPage No.
Delivery Date:Destination

Melody L Waight: Melody L Waight:

Leave as "Destination" or if payment of freight is allowed, use drop-down to select "Destination, prepaid and add"of
Vendor/Contractor:Phone:Agency Ship To Address:ODFW
Fax:Specific Site:

Melody L Waight: Melody L Waight:

Insert entire legal name of vendor and physical address.Street Address:
City/State/Zip:
BILL TO:Oregon Department of Fish & Wildlife, Accounts Payable
Contractor FEIN4034 Fairview Industrial Drive SE, Salem, OR 97302
ITEM #DESCRIPTIONQUANTITYUNITUNIT PRICETOTAL PRICE
$ - 00.00
$ - 00.00
$ - 00.00
$ - 00.00
$ - 00.00
$ - 00.00
$ - 00.00
$ - 00.00
$ - 00.00
$ - 00.00
$ - 00.00
$ - 00.00
$ - 00.00
$ - 00.00
SPECIAL INSTRUCTIONS:Page 1 Sub-Total$ - 00.00
Continuation Page Sub Total0.00

THIS PURCHASE ORDER AND THE TERMS AND CONDITIONS ON PAGE 2 CONSTITUTE THE ENTIRE AGREEMENT BETWEEN THE PARTIES. THERE ARE NO OTHER UNDERSTANDINGS, AGREEMENTS OR REPRESENTATIONS, ORAL OR WRITTEN.

Melody L Waight: Melody L Waight:

Use if standard PO terms and conditions apply (when NOT using a State Price Agreement). If using a State Price Agreement, DELETE THIS LANGUAGE.

When using federal funding you must consult with Contract Services staff and get instruction on the language to inser in the Special Instructions, and federal attachments to the PO.

SHIPPING 0.00

Melody L Waight: Melody L Waight:

Use ONLY when freight is Destination, Prepaid and Add

OR THIS PURCHASE ORDER IS PLACED AGAINST STATE OF OREGON PRICE AGREEMENT #

Melody L Waight: Melody L Waight:

Use this language is purchasing under an existing State price agreement or participating addendum. Enter the specific price agreement or participating addendum number(s). DELETE THIS LANGUAGE IF STANDARD PO TERMS AND CONDITIONS APPLY.

When using federal funding you must consult with Contract Services staff and get instruction on the language to inser in the Special Instructions, and federal attachments to the PO.

(or) PARTICIPATING ADDENDUM #GRAND$0.00
THE TERMS AND CONDITIONS CONTAINED IN THE PRICE AGREEMENT (or) PARTICIPATING ADDENDUM APPLY TO THIS PURCHASE AND TAKE PRECEDENCE OVER ALL OTHER CONFLICTING TERMS AND CONDITIONS, EXPRESS OR IMPLIED.TOTAL
ORDERED BY: (Print)

Melody L Waight: Melody L Waight:

Person placing the order.

Melody L Waight: Melody L Waight:

Use ONLY when freight is Destination, Prepaid and AddPhone #:
Signature:Date:
APPROVED BY:(Print)

Melody L Waight: Melody L Waight:

Budgetary Manger with authority for the cost code(s) being used. If multiple, all budgetary managers must sign.

Melody L Waight: Melody L Waight:

Insert required delivery date from solicitation or as negotiated with Contractor (for direct purchase) Melody L Waight: Melody L Waight:

Insert entire legal name of vendor and physical address.

Melody L Waight: Melody L Waight:

Insert PO number from list for your office.Phone #:
Signature:Date:
AUTHORIZED AGENT:

Melody L Waight: Melody L Waight:

Name and signature of person with Contract Authority for the purchase (see Policy ASD 150_01) Melody L Waight: Melody L Waight:

Leave as "Destination" or if payment of freight is allowed, use drop-down to select "Destination, prepaid and add" Melody L Waight: Melody L Waight:

Date PO is issuedDate:
Signature:
RECEIVED BY:

Melody L Waight: Melody L Waight:

Person receiving the Goods or Services and verifying they are in compliance with the Purchase Order requirements.

Melody L Waight: Melody L Waight:

Enter Vendor/Contractor's federal tax ID number Melody L Waight: Melody L Waight:

Enter Item number(s) 1, 2, 3, etc.

Melody L Waight: Melody L Waight:

Describe Goods, including part numbers. Describe Services to be performed - be specific Melody L Waight: Melody L Waight: Do not use PO Box Melody L Waight: Melody L Waight:

Enter Unit: Each, Pkg, Box, Ft, SF, CF, Yd, CY, Lump Sum, etc.

Melody L Waight: Melody L Waight:

Enter any special instructions or incorporate Federal Terms & Conditions, additional Insurance, etc. Consult with Contract Services staff for required insurance or federal terms.

Melody L Waight: Melody L Waight:

Use if standard PO terms and conditions apply (when NOT using a State Price Agreement). If using a State Price Agreement, DELETE THIS LANGUAGE.

When using federal funding you must consult with Contract Services staff and get instruction on the language to inser in the Special Instructions, and federal attachments to the PO.

Melody L Waight: Melody L Waight:

Use this language is purchasing under an existing State price agreement or participating addendum. Enter the specific price agreement or participating addendum number(s). DELETE THIS LANGUAGE IF STANDARD PO TERMS AND CONDITIONS APPLY.

When using federal funding you must consult with Contract Services staff and get instruction on the language to inser in the Special Instructions, and federal attachments to the PO.DATE RECEIVED:
COST DISTRIBUTION (Page 1)
ITEM #DESCRIPTIONINDEXPCAOBJ. CODEAMOUNTGRANTPHPROJECT
COST DISTRIBUTION TOTALS
PAGE 1 Sub-TotalCONTINUATION PAGE Sub-TotalCOST DIST. GRAND TOTAL
$0.00$0.00$0.00

&8&K00-019Revised Date: 03/07/13

Continuation Sheet

PURCHASE ORDERPO NO.PO DATE:
CONTINUATION PAGEPFrom Pg 1From Pg 1
VENDOR NAME:Page #
of
ITEM #DESCRIPTION CONTINUATION PAGEQTYUNITPRICETOTAL

Melody L Waight: Melody L Waight:

Item/line number. Continue from first page.

Melody L Waight: Melody L Waight:

Describe Goods, including part numbers. Describe Services to be performed - be specific Melody L Waight: Melody L Waight:

Enter Unit: Each, Pkg, Box, Ft, SF, CF, Yd, CY, Lump Sum, etc.0.000.00
0.000.00
0.000.00
0.000.00
0.000.00
0.000.00
0.000.00
0.000.00
0.000.00
0.000.00
0.000.00
0.000.00
0.000.00
0.000.00
0.000.00
0.000.00
0.000.00
0.000.00
0.000.00
0.000.00
ADDITIONAL NOTES:CONTINUATION SUB-TOTAL$0.000.00
Return to Page 1
COST DISTRIBUTION CONTINUATION PAGE
ITEM #DESCRIPTIONINDEXPCAOBJ. CODEAMOUNTGRANTPHASEPROJECT

COST DISTRIBUTION SUB-TOTAL $0.00 Return to Page 1

&8&K00-020Revised Date: 03/07/13 image1.png image2.emf image3.png

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