Odot Public Transit Grant Purchase Order

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[Enter agency name here]
P.O. #
OdOt PUBliC trAnsit GrAnt
PUrChAse Order
Show thiS number on all paperS and ShipmentS
pertaining to thiS order
name of ordering agency
po date
delivery date
vendor contract number
VendOr name and addreSS
Bill tO name and addreSS
vendor contact perSon name and phone
agency contact perSon name and phone
shiP tO
odot / ptd grant agreement number
termS
30
comment
tOtAl
tOtAl
seAts
VehiCle
item
sUB-
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AdA
w / AdA
VehiCle
OPtiOns
nO. CAteGOry
CAteGOry
desCriPtiOn
seAts
stAtiOns
dePlOyed Qty
BAse PriCe
tOtAl
tOtAl COst
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GrAnd
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VehiCles
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2.7.3 mandatory purchase order language.
0
this purchase is submitted pursuant to State of oregon Solicitation no. 102-2041-14 and price agreement no. 0000.
the price agreement including contract terms and conditions contained in the price agreement are hereby incorporated by
reference and shall apply to this purchase and shall take precedence over all other conflicting terms and conditions, expressed
or implied. Visit the ODOT-RPTD Web site, , to access ORPIN
authorized agent print name
authorized agent Signature
Signature date
X
revised 04/10
734-2762a (2762agency) 0410

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