NYC 9/11 Public Portal Document
2g 5. 430
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D2
1-2
D3
1-2
01
DO NOT FORWARD COPY #1 OF THIS FORM WHEN
PO ACCOUNTING CODE DISTRIBUTION FORM IS USED!
THE CITY OF NEW YORK
PURCHASE ORDER
FISA No. ACECF 200 (Rev. 9/89)
Thidem Checked Below Determines
type of Order
(0B)
OMPA
MARKET
OPEN
3.4
OPEN
MARKET
7R.C
BLANKET
SUPPLIES
EABOR
TITLE OF BID
PAGE
CONTRACT
MO DY
LYR
TERMS
PROC. CL
SHIP
NST. No
8-10
FUND
001
MO. DY
Check One)
(E)
ENTRY
OMPA Contract No
13
MO. DY
LYR
DATE
BID
BID
LYPE
OPEN
DATE
YR
(N)
INCREASE
22 25-27
AGCY
CODE
YR
82b
MO
DATE
SENT TO :
DY
VENDOR
(D)
DECREASE
Order ID
28:34
ORDER
NO
YR
CANCEL
MO DY
YR
D
DATE:
PREP
11-800-248-8335
WAMEBRANdLvebDe ANAupINg (TeOhNION)
4-28 103 FAIRVIEW PARK DE
STREET ADDRESS ELMSfORD 48-49
STATE NY
ZIP (0523-1500
37.42
SMO
DY
DATE
LAPPROVED
DELIVERY:
BATE
TYPE OF ORDER
(VENDOR TO NOTIFY INSPECTION DIVISION 24 HRS PRIOR TODELIVERY)
INSPECTION DIV. TEL NO.
For A Single Account
Only Complete This:
emne
For Multiple Accounts
Complete Accounting
Code Distribution Form
ACEC-2010
Trans:
18.f8
REQUISITION
RERUISEEON EUL
Agcy
Req.No.
{8°%2
23-29
INFORMATION
DMS Req No:
32-39
NVEDER KENSKO LAB
COPNEE OF WESINARE De AGolUnBUs Ave
NOTIEYANE ZP VALHALIA,NY.
ATTENTION OF TOM TIa
CIf Same As Above Indicate "Same")
AGENCY. NYC DEP AUDITS d AcCONTS
ROOM NO QTHFL
ATTENTION OF 1: MiKAelian
ADDRESS: 346 BROADIORY
CITY & STATE:
NY NY
COMPTROLLER USE ONLY
Apency
GOde
45-47
Budget
Code
50-53
Sub
Reporting
Object
56-58
:Ob1
Category
:68
67
TOTAL ORDER
AMOUNT
60-61
62:62
$
RQE
1006026
Check One)
Partial/Final
F45
Partial
Final
F
826
0234
33
doscos
8as
DESCRIPTION
QUANTITY
UNIT
UNIT PRICE C
AMOUNT
C
01-503-09:5
4 HEATeRCOiL
ea
825º0
825
80
GeNUNe PARIS TO INTeRMEMBER W/EyISTINg EQUPMENT
FMergeNay. P.O.
DO NOT SHIP
CERTIFICATE OF NECESSITY
11 certify that the items herein are needed and will be used by the agency for the purpose stated
TOTAL AMOUNT $
825
on tie hudaat appropriation or modification.
PREPARED BY.S
VOM 1IPA
LTITLI
Dacapa, NAresStoRs
CERTIFICATE OF ACCEPTANCE INTO IFMS
*1 certify that sulficient funds are available
and have been encumbered in the above
named accounting codes
APPROVED BY.
TITLE
AGENCY CERTIFICATION
cortify that the items herein have been charged to the correct accounting codes listed above
which are under the iurisdiction of this department.
NYC-WTC_000070825
DATE
ACCEPTED
BYIEMS
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NYC-WTC_000070825Source: NYC Law Department, mirrored locally