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Document C <br /> R E Q U I S I T I O N <br /> TO: Orange County Purchasing and Central Services Department <br /> FROM; .41,1,_d____z_c_Zb--rnmiss/49-7 - ,. .,I,Xr/c,57 <br /> (Department) (Date) - <br /> TYPE OF REQUISITION: ACCOUNT(S) TO BE CERG-c.D: - <br /> A) Standard Purchase Order 0 Account - Z Amount <br /> B) Pick-=up Purchase Order /Q -/-//C' -.i 3 - <br /> C) Blanket Purchase Order 1 _ <br /> D) Confirming Purchase Order I ,--.•�.�_ <br /> (Purchase Order i ) • ---- - <br /> E) Central Stores Order M - <br /> Previous or possible yendors: - - <br /> . COMPANY <br /> ADDRESS <br /> CITY i <br /> - <br /> ITEMS TO BE PURCHASED: <br /> QTY 1 UNIT DESCRIPTION <br /> I STOCE # UNIT • I ire_________ <br /> C05�= <br /> j ! C Y. STORES PRICE <br /> ��d ,T' ,,__ — c�/ --71 / 4 i �. '' ! 3 �, 7 3 <br /> I Gam- - �.. <br /> 1.3 I :.� i�_ / r �- <br /> . , • 3. Sl 975 <br /> 1 rik 0,4.-> 1 <br /> I <br /> _ I I t <br /> E <br /> 1 ► I , <br /> I <br /> I I <br /> • I <br /> I I - • - <br /> . , I <br /> i <br /> t I• <br /> These ice= are needed by: _5. TOTAL I <br /> APPROVED: . - -~� <br /> (Departmen .e d) <br /> O <br /> FOR PURCHASING USE: <br /> OK <br /> DID tis.�r:D - WRITTEN TELEPHONE ENTERED: <br /> 4( 61A) - PiLtaa.,- A-g--- CAdL4A' — --:- I I( 0 tit ild2U- if-C AP (Art. Wutc Kije_t.,1", . <br /> TELEPHONE P.O. # <br /> • <br />