CSG Consultants - CSA - (05/28/2020)

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REQUEST FOR:DELIVER CHECK TO: CHECK P.O.X RETURN TO DEPT. CHANGE ORDER MAIL TO VENDOR DATE OF REQ.DEPARTMENT DATE OF DELIVERY NEEDED DEPARTMENTAL REQUISITION NUMBER DELIVER GOODS TO: CITY HALL 835 E. 14TH STREET WILL PICK UP PUBLIC WORKS SERVICE CENTER, HAVE PICKED UP WATER POLLUTION CONTROL PLANT, 3000 DAVIS STREET GOODS ALREADY DELIVERED COMMUNITY LIBRARY CENTER, 300 ESTUDILLO AVENUE CONFIRMS PHONE REQUEST MARINA OFFICE MARINA COMMUNITY CENTER OTHER CHARGE T0 ACCOUNT CODE QTY/UNIT DESCRIPTION OF SERVICES OR ITEMS ACTIVITY UNIT PRICE EXTENSION FUND ITEM 1 LS 132,000.00$ Project Manager: Austine Osakwe TOTAL 132,000.00$ An approved budget item. Not an approved item, appropriation Accounting Approval transfer within budget. City Manager Approval Not an approved item, requires additional appropriation. City Manager Approval F.O.B.APPROVAL VENDOR DESTINATION I hereby certify that the items requested NO. 1 o are necessary for the operation of this FACTORY department. VENDOR NO. 2 o SAME, FRT ALL'D QUOTED PRICE $_______________________ OTHER VENDOR AUTHORIZED SIGNATURE NO. 3 o QUOTED PRICE $_______________________ DELIVERY DATE ATTACH QUOTES TO REQUISITION 141-38-413-5240PROJECT NAME: Annual Street Overlay / Rehabilitation 2017-18 PROJECT NO.: 2018.0050 DESCRIPTION OF WORK: Street Maintenance and Rehabilitation as described in scope of services of exhibit A of the Consulting Service Agreement with CSG Consultants Inc Agreement No.: 3699 CITY OF SAN LEANDRO REQUISITION P.O. NUMBER _________________ ENGR & TRANSP Please issue a Purchase Order for the following: 28-May-20 Pleasanton, CA 94588 Contact: Hatem Ahmed CSG Consultants Inc 6200 Stoneridge Mall, Suite 300