Cooperative Purchasing Verification Form

COOPERATIVE PURCHASING VERIFICATION
{ATTACH TO COUNCIL ACTION)

Per ordinance § 30.27 COOPERATIVE PURCHASING - The City may participate in, sponsor, conduct, or administer cooperative, joint, group and
interstate cooperative procurement to establish contracts or price negotiations for goods, services, or construction services that use source
selection methods substantially equivalent to thase set forth in § 30.23.

SOURCE OF COOPERATIVE PURCHASE: Ofrte o -£ An LONG
SOURCE CONTRACT #/REFERENC # CTR 0 S$ 9 322.
aed Lon tecr-( oopve tue Qavement )
7 7

v
DEPARTMENT MAKING REQUEST! ry Nw Dept

REQUESTOR NAME; Char, Jy He Cm fer
DESCRIPTION OF ITEM BEING purichaseD] LO Ly Lar { bx in y)

FOR PURCHASING USE ONLY

IS CONTRACT VALID? (YES OR NO): YER

EXPIRATION OF CONTRACT: 3/ /@ / ZO LE

IS (ARE) ITEM(S) BEING PURCHASED COVERED.

IN SCOPE OR PRICING INCLUDED IN, Yes
woe ee we , CONTRACT?

VERIFIED BY (SIGNATURE OF PURCHASING
ADMINISTRATOR);

DATE; loltlzozd