HomeMy WebLinkAboutPaint, Repair Walls in City Hall (BPW approved 2/28/24) CITY OF JEFFERSONVILLE
PURCHASING CONTRACT COVER SHEET
Each purchasing contract (including lease)with the City for supplies,goods and equipment must include this cover
sheet to be completed by the Head of the Department making the purchase and presented to the Board of Public
Works and Safety(BPW)at the time of the contract approval. Note: Each department must comply with the City's
Procurement and Purchasing Policy. A copy may be obtained from either Finance or Legal. Purchases may not be
"artificially"divided to avoid the applicable purchasing thresholds.
Supply, Good or Equipment to be Purchased: Pasw\+" P cy_.i c Walls Q CA "cu—IL
Department: 13t�� Lpzt�1_ R(ATuOrtAT`z .
Are Funds Appropriated for the Purchase? 1/ Yes No
Contract Amount: V less than $50,000 $50,000-$149,999 Over$150,000
• If contract less than$50,000—may proceed without requesting bids/quotes
• If contract amount is between$50,000-$149,999:
Invitation for at least three (3)quotes was issued (attach invitation and quotes)
Mailed at least seven (7) days before the deadline to submit quotes
• If contract amount is over$150,000:
Invitation for Bids was approved by Law Department before it was issued
_ Invitation for Bids issued (attach invitation and received bids)
Invitation for Bids include requirements per Procurement and Purchasing Policy
_ Notice of Invitation for Bids published in paper and posted on city website at least seven (7) days
before deadline (attach notice)
• If contract was result for Request for Proposals (RFP):
RFP was approved by Law Department before it was issued
RFP published in paper and posted in city website at least seven (7)days before deadline
• If contract was result of Special Purchase and exempt from competitive bidding:
Prior approval of special purchase by Law Department
Law Department prepared written designation of Special Purchase to be approved by BPW
The undersigned hereby states he/she has complied with the City's Procurement and Purchasing Policy in
reference to the attached purchase.
Date: '2 f asJ'2O,�y
Signature
Printed Name: L or L&)f ar-e,
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DRiE YOUR WORK ORDER NO. OUR BID NO.
DESCRIPTION OF WORK PERFORMED
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All Material is guaranteed to be as specified,and the above work was performed in accord wit n i a d e ns provided for the above
work and was completed in a substantialworkmanlike manner for the agreed sum
Dollars
This is a ❑Partial 0 Full invoice due and payable by:
Month Day
in accordance with our❑Agreement ['Proposal No. Dated
a adorns-Vi;iyi2 Month - - ---- —._
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