LSJ
Approval/Purchase Items/Payment Request Form
Date of Request: 5-8-07
Status: Urgent: XXXX
Inventory:
Item/Items Requested: Tile for Cabana Floor
360 pcs. 12"x12" Mexican Santillo Tile S788.40
76 pcs. Pool edging-Mexican Santillo tile $604.20
Purchase Price: $1,392.60
shipping, tax and
all related costs. Ship on our boat
Total Expected Cost: $1,392.60
Deposit Required? Yes: Pay upon receipt.
No:
List Dept:
Purpose/Description: Tile Floor at Cabana
Purchased From: Floor Factory
Company Name & St. Thomas
Address or Web Site
Requested By: Dan Chipman
Time Frame for
Purchase/Repair:
Special Instructions:
Attach Quote: Yes:
No: XX Can fax a copy if needed
Were Competitive Quotes Obtained? Yes:
No:
If No, Why Not:
Authorization:
EFTA00616350