Sample - Purchase Order.pdf
PDF 540 KB Posted
- Attached to
- Bird Repellent Laser
- Solicitation number
- S-63500-00016146
- Issued by
- Benton County, Oregon
About this file
This is a Purchase Order template from the State of Oregon, Department of Fish & Wildlife (ODFW). The document serves as a standardized form for procuring goods and services, with designated fields for contractor information, itemized descriptions of products or services, quantities, unit prices, and delivery specifications. The purchase order includes sections for project descriptions and special instructions, with a designated ship-to address at 4034 Fairview Industrial Drive SE, Salem, OR 97302. The form accommodates multiple line items with corresponding cost distribution codes and allows for continuation pages to capture additional items or cost allocations as needed.
The document establishes that terms and conditions are governed by either a referenced State of Oregon Price Agreement or Participating Addendum, which take precedence over any conflicting terms. Pricing is calculated on a per-unit basis with subtotals, shipping charges, and a grand total. The form requires signatures from the ordered-by party, authorized agent, and approval authority, along with corresponding dates. Receiving documentation is captured through a receipt signature section with the date received. All pricing fields are shown as placeholder values of $0.00, indicating this is a blank template rather than a completed purchase order with specific contract values or vendor information populated.
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Text version
P Fiscal Year
Delivery Date: of Phone: Agency Ship To Address: ODFW
Fax:
BILL TO:
ITEM # QUANTITY UNIT UNIT PRICE
GRAND
TOTAL
Phone #:
Date:
Phone #:
Date:
ITEM # INDEX PCA OBJ. CODE AMOUNT GRANT PH
STATE OF OREGON PO No. PO Date:
PURCHASE ORDER
DESCRIPTION
Contractor FEIN
Page No.FOB:
Vendor/Contractor:
Destination
Specific Site:
Street Address:
City/State/Zip:
4034 Fairview Industrial Drive SE, Salem, OR 97302 Oregon Department of Fish & Wildlife, Accounts Payable
Page 1 Sub-Total
TOTAL PRICE
0.00
Continuation Page Sub Total
$0.00
COST DIST. GRAND TOTAL
$0.00
COST DISTRIBUTION TOTALS
PAGE 1 Sub-Total
$0.00
SHIPPING
Date:
RECEIVED BY:
Signature:
0.00
$0.00
DATE RECEIVED:
PROJECTDESCRIPTION
SPECIAL INSTRUCTIONS:
ORDERED BY: (Print)
CONTINUATION PAGE Sub-Total
COST DISTRIBUTION (Page 1)
Signature:
AUTHORIZED AGENT:
APPROVED BY:(Print) Signature:
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.
OR THIS PURCHASE ORDER IS PLACED AGAINST STATE OF OREGON PRICE AGREEMENT #
(or) PARTICIPATING ADDENDUM #
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.
Revised Date: 03/07/13
| PO |
| Instructions |
| Continuation Sheet |
File details come from the government source that posted it. Updated .