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DocuSign Envelope ID: 5F881 E6C-3715-4901-B7F9-F45E3B6F822A <br /> P.O. REQUISITION REQUEST FORM <br /> DATE: 11/17/15 Contract Floor Work <br /> REQUESTED BY: Freddy Brooks <br /> VENDOR NUMBER: 60940 <br /> VENDOR NAME: Nice & Green Flooring Solutions <br /> Account Number: <br /> Supplies 10240520-620000 <br /> Contract Services 10240520-630000 <br /> Capital Equip. 10240520-800000 <br /> DESCRIPTION Address QUANT$/UNIT $TOTAL <br /> #81-Social Services/Dollar Tree 113 Mayo St 1 $1,596.50 $1,596.50 <br /> #82-West Campus Office Bldg. 131 W. Margaret Ln. 1 $5,991.00 $5,991.00 <br /> #83 -West Campus Library 137 W. Margaret Ln. 1 $4,125.00 $4,125.00 <br /> #84 -Robert & Pearl Seymour Ctr. 2551 Homestead, CH 1 $7,320.00 $7,320.00 <br /> #85 -Central Orange Senior Ctr. 103 Meadowlands Drive 1 $3,075.00 $3,075.00 <br /> #86 -Florence Gry Soltys ADH Ctr 103 Meadowlands Dv. 1 $1,100.00 $1,100.00 <br /> #87 -Southern Human Services 2501 Homestead, CH 1 $750.00 $750.00 <br /> #88 -Court Street Annex 109 Court St. 1 $1,475.00 $1,475.00 <br /> $0.00 <br /> $0.00 <br /> $0.00 <br /> $0.00 <br /> $0.00 <br /> $0.00 <br /> $0.00 <br /> $ TOTAL $25,432.50 <br /> NOTES: <br /> Nice&Green Various FY2016.xls <br />