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1UNIVERSITY OF ALASKA
ACCOUNTING INFORMATION
FUND
ORG
OBJECT
AUTH. AMT.
PURCHASE REQUEST
(1)
(2)
CODE (3)
(4)
331352
64051
3774
$10,610.00
(Please circle your Unit’s initials below.)
FOR:
CES
SNRAS
331352
64051
3111
$7,744.80
R_________________ FP_________________
Jason W Theis
BF________________ P__________________
Request for (Name):________________________________
CES
E__________________
ID#: ________________________Dept:_______________
AHRB
110
Bldg:_______________________ Room No:____________
box 6180
Mailing Address:__________________________________
Date Entered
__________________________
________________________________________________
Check Number
__________________________
7269 / fnjwt@uaf.edu
Phone/Email: _____________________________________
Check Date
__________________________
EMERGENCY (NON-BUDGETED) REQUESTS MUST BE AUTHORIZED BY FISCAL OFFICE PRIOR TO PURCHASE
Item No
Complete Description
Quantity
U/M
Unit Price
Total Price
(5)
(6)
(7)
(8)
(9)
(10)
1
Xerox DocuColor12 digital Copier Lease (Acct 3111)
12
Month
$535.30
$6,423.60
Serial # FU2-051942, Located at:
$0.00
308 Tanana Loop, Fairbanks, AK 99775-6180
$0.00
Lease period: July 1, 2005 through June 30, 2006
$0.00
This is months 34 through 45 of a 60 month lease-
$0.00
purchase with a $1 buyout option on 9/30/2007
$0.00
(Reference PO: FP501475)
$0.00
$0.00
2
Maintenance/Supply Agreement (Acct 3774)
$0.00
Includes all operating supplies except staples
$0.00
Per-copy agreement at the following FY06 rates:
$0.00
Color: $0.1273 per copy
80000
Each
$0.13
$10,184.00
Grayscale: $0.0213 per copy
20000
Each
$0.02
$426.00
$0.00
Coverage period: July 1, 2005 through June 30, 2006
Estimated use is 100,000 copies, 80% color
$0.00
$0.00
3
Xerox Fiery X12 LAN controller/software (Acct 3111)
12
Month
$110.10
$1,321.20
Serial # LW0-768788, Interface system for DC12
$0.00
ESTIMATED WEIGHT
ESTIMATED FREIGHT COST
Please check method of shipping preferred (11)
18,354.80
Priority ______ UPS Blue ______ Surface ______ Book Rate ______
TOTAL $
TO BE USED FOR:
SUGGESTED SUPPLIER (please include address):
CES Color printing for newsletters,
publications, and misc print jobs.
(12)
(13)
Xerox Capital Services (Vendor ID X24008)
(ICO) Alaska Document Systems
Request by:_________________________________________
ATTN: John Roberts, 206 Barnette Street
Date
Fairbanks, AK 99701
Approved by:________________________________________
452-7220
451-8858
Phone:
Fax:
Date
Website:
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