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<br />..uA Metropolitan Council <br />"'2.Il Putchase/Check Requisition <br /> <br />Process as: <br />Purchase OrderO <br />Fill out Sections 1 & 3 <br />Check Requisition~ <br />Fill out Sections 2 & 3 <br /> <br />Date: I-;;?{j -66 <br />P.R. No: 322695 <br /> <br />P.D.No: <br /> <br /> <br />SPECIAL INSTRUCTIONS/COMMENTS: <br /> <br />::jt4jj1i::U41!fil&l;trY:1l~IJVishtQsiiggest a;veridor(ot thisP.R., fill in the information below (attach more sheets If necessary) <br />Vendor name: Vendor Code: <br />Address: Have you requested a quote from this vendor? No Yes <br />Address If yes, was it written verbal <br />City/ST/Zip: Attach quote copies and form 4004 (verbal) or 4006 (written) <br />Contact: If Purchasing selects a vendor other than the one suggested, do <br />Phone: Fax: you want to be involved? Yes <br />",. >},':;j':. .., ':> :SToCKNUMBEilJD~CRInlb~ ORDER Ql"\' .. UOM . UNIT PRICE ExT. PRICE <br />$ <br /> <br /> <br />SUB-TOTAL $ <br />SALES TAX $ <br />FREIGHT $ <br />TOTAL $ <br /> <br />DEPT: <br />mN 5S(}3~ <br /> <br />T c; :;:;~~j2~~lS2:i::)i{nir <br /> <br />,;Liii~,:OO~t:. <br />$ <br />/75.06 <br /> <br />5"\~\0I\ '?\Df€-('~ <br /> <br />" ~e'"\ \\\~ \ CheLt. G \ <J~ ChOCt:... <br />\D o' \~It. ' \', <br /> <br />(J1... <br />WHITE: PURCHASlNO <br /> <br />YELLOW: AlP <br /> <br />PINK: REQUlSlTIONER <br /> <br />Cll'-lI-ID330~CDD-%o-1,0800-5;;?1'I <br /> <br />Form 4010IRcv 3/980717 <br />