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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 51,849.00$ Project Manager: Mark Goralka TOTAL 51,849.00$ 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 Walnut Creek, CA 94596 Contact: David Goldstone Denalect Alarm Comapny 1309 Pine Street CITY OF SAN LEANDRO REQUISITION P.O. NUMBER _________________ ENGR & TRANSP Please issue a Purchase Order for the following: 20-May-20 ATTACH QUOTES TO REQUISITION 210-52-123-5120PROJECT NAME: Farrelly Pool Replacement PROJECT NO.: 2016.0210 DESCRIPTION OF WORK: Provide low voltage alarm and access control system for the new facilties as described in Exhibit A - scope of services of the Consulting Service Agreement with Denalect Alarm Company Agreement No.: 3696