NO. REQUEST FOR PURCHASE FTDSC4701480047 INSTALLATION DATE Dukrit Air Base Today TO: CONTRACTING OFFICER CLASS Contracting THROUGH: CONTRACT, PURCHASE ORDER Finance OR DELIVERY ORDER NO. FROM: (Insert RC/CC, If applicable) Civil Engineering IT IS REQUESTED THAT THE SUPPLIES AND SERVICES ENUMERATED BELOW AND IN THE ATTACHED LIST, BE PURCHASED FOR FOR DELIVERY TO NOT LATER THAN Civil Engineering Dukrit Air Base ASAP ESTIMATED ESTIMATED ITEM DESCRIPTION OF MATERIAL OR SERVICES TO BE PURCHASED QUANTITY UNIT UNIT PRICE TOTAL COST 001 Porta-Potty Claim 1 $26,000 $26,500 SUGGESTED SOURCE: RENTAL CONTRACTOR ASSUME: EVERYTHING IS 100% CORRECT TOTAL $26,500.00 PURPOSE Reimburse Porta Potty Contractor for 5 damaged portpotties, lost rental wages and wages. Rajiv’s DATE SIGNATURE TYPED NAME AND GRADE OF REQUESTING OFFICIAL TELEPHONE I. B. POTTYMASTER, , USAF xxx-xxx-1234 SIGNATURE DATE TYPED NAME AND GRADE OF APPROVING OFFICIAL TELEPHONE JOHNSON B. , USAF xxx-xxx-4321
REQUEST FOR PURCHASE NO. FTDSC4701480047 INSTALLATION Dukrit Air Base DATE Today TO: CONTRACTING OFFICER Contracting CLASS THROUGH: Finance CONTRACT, PURCHASE ORDER OR DELIVERY ORDER NO. FROM: (Insert RC/CC, If applicable) Civil Engineering IT IS REQUESTED THAT THE SUPPLIES AND SERVICES ENUMERATED BELOW AND IN THE ATTACHED LIST, BE PURCHASED FOR Civil Engineering FOR DELIVERY TO Dukrit Air Base NOT LATER THAN ASAP ITEM DESCRIPTION OF MATERIAL OR SERVICES TO BE PURCHASED QUANTITY UNIT ESTIMATED UNIT PRICE ESTIMATED TOTAL COST 001 Porta-Potty Claim SUGGESTED SOURCE: RENTAL CONTRACTOR ASSUME: EVERYTHING IS 100% CORRECT 1 $26,000 $26,500 TOTAL $26,500.00 PURPOSE Reimburse Porta Potty Contractor for 5 damaged portpotties, lost rental wages and Rajiv’s wages. DATE TYPED NAME AND GRADE OF REQUESTING OFFICIAL SIGNATURE I. B. POTTYMASTER, , USAF TELEPHONE xxx-xxx-1234 DATE TYPED NAME AND GRADE OF APPROVING OFFICIAL JOHNSON B. , USAF SIGNATURE TELEPHONE xxx-xxx-4321
PortaPotty%20Claim.docx