Form Center

2. Department of Public Works
   Equipment Specification Approval Sheet
4. Equipment Description
6. Equipment Reason/Purpose:
8. Specification Number
9. Approved:

   1. Yes
   2. No
11. As Written:

    1. Yes
    2. No
12. As Amended:

    1. Yes
    2. No
13. As per new specification:

    1. Yes
    2. No
15. Please attach specification to this approval sheet.
17. Quantity to be ordered:
18. Price per unit ordered:
20. Suggested vendor(s) if not on contact
22. Quantity ordered replaces equipment:
24. Unit#
25. Year/Make/Desription
26. CPI Adj. Pur. Price
27. Mileage/Hrs.
29.  
    1
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    2
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    3
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    4
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    5
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    6
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    7
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    8
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    9
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    10
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    11
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    12
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    13
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    14
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99. Approved by:
101.  
     Division Representative
102.  
      
     Date:
104.  
     Department Director or Designee
105.  
      
     Date:
107.  
     Director of Fleet Management or Designee
108.  
      
     Date:
110.  
     A-CAO or Designee (if applicable)
111.  
      
     Date:
113.  
     Assistant Public Works Director of Management & Finance
114.  
      
     Date:
116. 504.7902000.653 00.
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118. 1. Receive an email copy of this form.
119. Email address

     This field is not part of the form submission.

120. Submit

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