Agency Procurement Request (Apr)
Agency Procurement Request (Apr)
Agency Procurement Request (Apr)
[ ] Please furnish with us the Price Estimate (for office equipment/furniture &supplementary items).
[ ] Please purchase for our agency/furniture/supplementary items per you Price Estimate
(PS RAD No. ______________ attached) dated _______________
[ ] Please issue common-use supplies/materials per price list as of __________________
[ ] Please issue Certificate of Price Reasonableness
[ ] Please furnish as with your latest/updated Price List
[ ] Other ( specify) _________________
IMPORTANT!! PLEASE SEE THE INSTRUCTION/CONDITIONS AT THE BACK OF ORIGINAL COPY
ITEM ITEM AND DESCRIPTION/SPECIFICATIONS/STOCK NO. QTY. UNIT UNIT PRICE AMOUNT
No.
TOTAL
FUNDS CERTIFIED AVAILABLE APPROVED
[ ] Please furnish with us the Price Estimate (for office equipment/furniture &supplementary items).
[ ] Please purchase for our agency/furniture/supplementary items per you Price Estimate
(PS RAD No. ______________ attached) dated _______________
[ ] Please issue common-use supplies/materials per price list as of __________________
[ ] Please issue Certificate of Price Reasonableness
[ ] Please furnish as with your latest/updated Price List
[ ] Other ( specify) _________________
IMPORTANT!! PLEASE SEE THE INSTRUCTION/CONDITIONS AT THE BACK OF ORIGINAL COPY
ITEM ITEM AND DESCRIPTION/SPECIFICATIONS/STOCK NO. QTY. UNIT UNIT PRICE AMOUNT
No.
TOTAL
STOCKS REQUESTED ARE CERTIFIED TO BE FUNDS CERTIFIED APPROVED
WITHIN THE APPROVED PROGRAM AVAILABLE
[ ] Please furnish with us the Price Estimate (for office equipment/furniture &supplementary items).
[ ] Please purchase for our agency/furniture/supplementary items per you Price Estimate
(PS RAD No. ______________ attached) dated _______________
[ ] Please issue common-use supplies/materials per price list as of __________________
[ ] Please issue Certificate of Price Reasonableness
[ ] Please furnish as with your latest/updated Price List
[ ] Other ( specify) _________________
IMPORTANT!! PLEASE SEE THE INSTRUCTION/CONDITIONS AT THE BACK OF ORIGINAL COPY
ITEM ITEM AND DESCRIPTION/SPECIFICATIONS/STOCK NO. QTY. UNIT UNIT PRICE AMOUNT
No.
TOTAL
STOCKS REQUESTED ARE CERTIFIED TO BE FUNDS CERTIFIED APPROVED
WITHIN THE APPROVED PROGRAM AVAILABLE