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Home My WebLink AboutPublic Restroom Company Lakeview Golf Course Restrooms Site C and D CITY OF MERIDIAN Purchase Requisition CiWE IDIAN—- Purchasing Department ®- DATE OF 10/24/2024 33 E BROADWAY AVE,STE 106 CITY OF MERIDIAN REQUEST 7 MERIDIAN, ID 83642 Parks and Recreation PURCHASE ORDER NUMBER MUST APPEAR ON • TEL: (208)489-0417 SLIPS,CARTONSAND CORRESPONDENCE RELATED TO THIS ORDER FAX: (208)887-4813 AVAILABLE BUDGET AMOUNT $850,000.00 IS BUDGET AMENDMENT REQUIRED? SUGGESTED VENDOR Public Retsroom Company No 2567 Business Parkway Minden, NV 89423 CITY SUPPORT TICKET NO. PROJECT MANAGER PAYMENT TERMS FREIGHT TERMS- F.O.B. REQUESTOR Mike Barton NET 30 PREPAID DESTINATION Mike Barton PROJECT NAME: Lakeview Golf Course Restrooms Site C and D Description of Purchase Quantity and Pricing ACCOUNTINGCODES DESCRIPTIONPART NUMBER/ • QTY UNIT UNIT PRICE FUND OR PROJECT/ TOTAL AMOUNT TASK ORDER/CONTRACT/PROJECT DESCRIPTION I I Per Sourcewell contract and quote 2 $ 168,975.00 1 5390 93408 $ 337,950.00 Proprietary Installation 2 $ 17,292.00 1 5390 93408 $ 34,584.00 $ - $ - NOTES: Council Approval Date: 10/1/2024 $372,534.00 AUTHORIZED DEPARTMENT SIGNATURE How to fill out the Purchase Requisition. Fill in the SHIP TO DEPARTMENT NAME. This is the name of the requesting department and where the product will be shipped If the Ship To location is somewhere other than the department location, please enter that address in the lines below the department name and highlight it. Fill in the DATE OF REQUEST located in the box on the right hand side of the form. Fill in the amount of budget available for this commitment. Is a budget amendment required to fund this request? Answer YES or NO. Enter the name of the SUGGESTED VENDOR. Please check with FINANCE to verify that the City of Meridian has the vendor set up as an account. If the vendor is not set up, request that a W-9 form be submitted to FINANCE before placing the order. If PURCHASING receives this Purchase Requisition and the vendor is not set up,an order processing delay occurs If vendor will be determined by procurement process,enter"TBD" CITY SUPPORT(JITBIT)TICKET NO is entered by purchasing staff. Enter the PROJECT NAME,TASK ORDER NAME AND NUMBER and/or PROJECT/COMMITMENT NUMBER Enter the name of the PROJECT MANAGER and REQUESTOR. Under"PART NUMBER/DESCRIPTION/COMMITMENT NAME /TASK ORDER/CONTRACT/PROJECT DESCRIPTION Enter the COMMITMENT NAME,TASK ORDER or PROJECT DESCRIPTION, Part Number or Description of Item being purchased If you have more than one item,enter each on a separate line. Enter the QUANTITY for each line item. Enter the UNIT and UNIT PRICE for each line item. (Task orders and contracts should be listed as CITY 1 and UNIT EA. Unit price and total will be equal.) ACCOUNTING CODES Enter the FUND that you want the expense to impact 1) The FUND number will be either: (a) 01,07,08, 20,55,or 60 depending on what FUND the budget is in Enter the DEPARTMENT CODE you want the expense to impact 1) The DEPARTMENT CODE is a 4 digit number that corresponds to your department Enter the GL ACCOUNT NUMBER(Expense Account)for each item. 1) The GL ACCOUNT NUMBER(Expense Account) is the 5 digit number where the budgets are located Enter the PROJECT CODE/COMMITMENT#you want the expense to impact 1) The PROJECT CODE/COMMITMENT is an alpha numeric code that identifies a specific project or commitment to charge all expenses to INFORMATION ONLY The FUND, DEPARTMENT CODE,GL ACCOUNT NUMBER,AND PROJECT CODE make up the accounting code for your request. The accounting code will hold the budget dollars and actual expenses for your PO request. Accuracy is important as the resulting PO encumbers this accounting code(budget line item). Not all requests will have a project number. Call Purchasing if you are unsure. This form will automatically total your request. In the NOTES field add any information that you feel is significant. AUTHORIZED DEPARTMENT SIGNATURE Each department has a list of employees and amounts that they are authorized to sign for. Please make sure that the authorized department personnel signs the form. The completed and signed form must be submitted to Purchasing, along with the required support documents via a CITY SUPPORT(JITBIT)ticket. PRINT AND SUBMIT ONLY PAGE 1(NOT THESE INSTRUCTIONS) City Of Meridian Statement of Revenues and Expenditures - Rev and Exp Report - Sandra 01 - General Fund 5390 - Lakeview Capital Projects From 10/1/2024 Through 9/30/2025 Budget with Current Year Budget Amendments Actual Remaining Capital Outlay 93408 Golf Course improvements 3,815,147.04 22,228.00 3,792,919.04 Total Capital Outlay 3,815,147.04 22,228.00 3,792,919.04 DEPT EXPENDITURES 3,815,147.04 22,228.00 3,792,919.04 TOTAL EXPENDITURES 3,815,147.04 22,228.00 3,792,919.04 Date: 11/13/24 02:24:48 PM Page: 1 PUBLIC RESTROOM COMPANY Building Better Places To Go."' No modifications to this offer shall be authorized unless confirmed in writing by the President of Public Restroom Company. Offered by. Public Restroom Company by Charles E. Kaufman IV, President This provides conditional acceptance of this preliminary purchase order for this building subject to acceptance of the submittals, furnished by Public Restroom Company. Once you accept the preliminary submittals,this shall become a final purchase agreement or at your discretion the final purchase order or a contract may be substituted with this attached. Accepted by: Authorized Signature 12-3-2024 Date Signed Robert E.Simison City of Meridian, Mayor Printed Name Legal Entity Name and Address Attest: Chris Johnson, City Clerk 12-3-2024 Lakeview Golf Course Installations- Meridian, ID 1 10.4.24 1 Reference#11688-8/9/2023-1 2587 Business Parkway I Minden, NV 89423 1 www.PublicRestroomCompany.com I p: 888-888-2060 1 f: 888-888-1448 9of9