(For all service orders, regardless of the amount)
Department: Complete this form and forward to Purchasing Agent.
Today’s Date:_________________________ Date needed:_________________________
Check One:
__ STANDARD __ BLANKET __ CONFIRMING (for emergencies)
From: to:
A copy of both sides of the service order form must be provided to the Vendor prior to services being rendered.
Requesting Department: Suggested Vendor:
Ship to: (if different from above)
Description of service:
Cost: Material: $___________ Labor: $_____________ Total: $_________________
Account and line item#:
Quotations Received:
Vendor Contact Phone Service Date Price
2. ________________________________________________________________________
3. ________________________________________________________________________
(Attach any additional information stating items, source, quantity, price discounts, shipping, delivery
time and contact information).
If less than three quotes were obtained, or if this is a confirming service order, please explain:
Cert. of insurance attached? ______ Will vendor be rendering service on City property?_______
ALL SERVICE ORDERS: Vendor’s certificate of insurance must be attached or forwarded to
Purchasing Agent prior to services being rendered. Proof of general liability insurance (with the City
being listed as additional insured if services are being rendered on City property) and/or professional
liability insurance in the amount of at least $1,000,000 per occurrence is required for certain services.
Proof of worker’s compensation insurance is also required if services are rendered on City property.
Department Head or Designee
Is this reimbursable by: ____ Grant ____ Other
If so, please complete the "City Invoice Request
Form" found on our website under "Treasurer