HomeMy WebLinkAboutBUDGET AND FINANCE AGENDA 05-15-12Jl Central Contra Costa Sanitary District
SPECIAL MEETING OF THE
CENTRAL CONTRA COSTA
SANITARY DISTRICT
BUDGET AND FINANCE COMMITTEE
Chair McGill
Member Nejedly
Tuesday, May 15, 2012
3:00 p.m.
Collection System Operations Conference Room
1250 Springbrook Road
Walnut Creek, CA 94597
INFORMATION FOR THE PUBLIC
ADDRESSING THE COMMITTEE ON AN ITEM ON THE AGENDA
BOARD OF DIRECTORS:
JAMES A NEJEDLY
President
DAVID R WILLIAMS
President Pro Tent
BARBARA D. HOCKETf
MICHAEL R. MCGILL
MARIO 6f. MENESINI
PHONE: (925) 228 -9500
FAX: (925) 676 -7211
tivtivmcentralsan.org
Anyone wishing to address the Committee on an item listed on the agenda will be heard when the
Committee Chair calls for comments from the audience.—The Chair may specify the number of minutes
each person will be permitted to speak based on the number of persons wishing to speak and the time
available. After the public has commented, the item is closed to further public comment and brought to the
Committee for discussion. There is no further comment permitted from the audience unless incited by the
Committee.
ADDRESSING THE COMMITTEE ON AN ITEM NOT ON THE AGENDA
In accordance with state law, the Committee is prohibited from discussing items not calendared on the
agenda. You may address the Committee on any items not listed on the agenda, and which are within their
jurisdiction, under PUBLIC COMMENTS. Matters brought up which are not on the agenda may be
referred to staff for action or calendared on a future agenda.
AGENDA REPORTS
Supporting materials on Committee agenda items are available for public review at the Reception Desk,
5019 Imhoff Place, Martinez. Reports or information relating to agenda items distributed within 72 hours
of the meeting to a majority of the Committee are also available for public inspection at the Reception
Desk. During the meeting, information and supporting materials are available in the Conference Room.
AMERICANS WITH DISABILITIES ACT
In accordance with the Americans With Disabilities Act and state law, it is the policy of the Central Contra
Costa Sanitary District to offer its public meetings in a manner that is readily accessible to everyone,
including those with disabilities. If you are disabled and require special accommodations to participate,
please contact the Secretary of the District at least 48 hours in advance of the meeting at (925) 229 -7303.
Budget and Finance Committee
May 15, 2012
Page 2
1. Call Meeting to Order
2. Public Comments
3. Old Business
*a. Review staff's response to the question regarding check #34465 to the
State Board of Equalization in the amount of $22,952.52
Staff Recommendation: Review the response.
4. Risk Management
*a. Review Loss Control Report and discuss outstanding claims
Staff Recommendation: Review the report, discuss outstanding
claims and provide direction if needed.
5. Receive Fiscal Year 2012 -13 Operations and Maintenance Budget and Debt
Service Fund Budget (Item 10.a. in Board Binder)
Staff Recommendation: Recommend the Board receive the budgets.
6. Expenditures
a. Review Expenditures (Item 4.b in Board Binder)
Staff Recommendation: Review and recommend Board approval.
*b. Review Legal Expenditure Summary
Staff Recommendation: Review Legal Expenditure Summary.
*c. Review P -Card expenditures
Staff Recommendation: Review P -Card expenditures.
d. Discuss running expense invoices for the labor negotiations portion of the
Meyers Nave invoices
Staff Recommendation: Discuss the expense invoices and provide
direction to staff if needed.
Budget and Finance Committee
May 15, 2012
Page 3
7. Reports and Announcements
8. Suggestions for future agenda items
9. Adjournment
* Attachment
3.Q
Central Contra Costa Sanitary District
May 15, 2012
TO: BUDGET AND FINANCE COMMITTEE
FROM: THEA VASSALLO, PROVISIONAL FINANCE DIRECTOR
VIA: ANN FARRELL, GENERAL MANAGER
SUBJECT: SALES AND USE TAX PAYABLE TO STATE BOARD OF
EQUALIZATION FOLLOW -UP
At the April 16, 2012 Budget and Finance Committee meeting, staff was asked to
provide additional information on the following:
Check #34465 State Board of Equalization $22,952.52
The Committee asked why the District isn't exempt from sales and use tax.
The California Sales and Use Tax Law allow the State of California to impose a tax on
retail sales or on the use of tangible personal property. The California Sales Tax and
the California Use Tax are essentially the same. The distinguishing characteristic
between the two taxes centers mainly on how the tax is collected and remitted. For
example, when a vendor charges and collects the tax as part of the sale of goods, this
is referred to as a Sales tax. When a vendor fails to charge a tax on the sale of goods,
the retail customer is still liable for the tax and must remit the equivalent amount of
sales tax to the Board of Equalization. When the tax is handled in this fashion it is
referred to as Use tax. Use tax is imposed upon the purchaser. It generally applies to
purchases from out -of -state vendors who do not collect California tax on their sales.
Generally, if sales tax would apply when you buy a particular item in California, use tax
applies when you make a similar purchase from a business outside the state.
All exemptions and exclusions applicable to the Sales tax are also applicable to the Use
tax. Since the District is a California customer, it is not exempt from sales or use tax.
Consequently, the District is required to pay either sales tax or use tax on purchases
made, unless there is a specific exclusion in the California Revenue and Taxation Code.
N:\ADMINSUP\ADMIN \FINANCE MANAGER \Budget and Finance Committee \Fin Com Response Memo 5 -15 -12 sale &use tax.doc
CCCSD 2011 -12 Loss Control Report
New Incident
Ongoing Incident
Prior Fiscal Year Incident
Pending
OVERFLOWS AND PLUMBING REIMBURSEMENTS
Status
#
ID#
Loss
DOL Other Party
Address
City
City
Reserve
Paid to Date
Paid to
Typ
Typ
Closed
A
2011012
SSO
2/17/2011 La Tapaha
536 Man St.
Martinez
$
1190 Keaveny Cl.
$ 31,384.76
ServiceMaster
$ 965.48
Ron Roberson
Closed
2
2012004
GL
1/27/2011
Connie Easterly
$ 1.638.75
P -Cana
Closed
B
2011023
SSO
3/18/2011 Dennis Behllo
1310 Pine Street
Martinez
$
10/3/2011
$
4085 Legion CL
Closed
1
2012001
SSO
0/2011 Mike Vest
147 Fiesta Circle
Onnda
$
GL
$ 41.11
Margo Vest
Martinez
$
$
Closed
4
2012013
GL
S 165.00
ServiceMasler
Closed
2
2012005
PL
8118/2011 James Lawrence
1190 Upper Happy Valley
I- alayette
$
S 110.00
James Lawrence _
Closed
3
2012006
PL
8/10/2011 Jeff Hooper /Aulohaus
383 Rheem Boulevard
Moraga
$
_
$ 339.50
Jeff Hooper /Autohaus Stuttgart
Closed
4
2012008
PL
1 1/1 81201 1 Vitoria Paulsen
1064 Manzana Place
Lafayette
$
ID#
S 120.00
Virginia Paulsen
Closed
5
2012012
PL
1/9/2012 Sheri Cabral
1941 1st Avenue
Walnut Creek
$
$ 330.25
Sheri Cabral
Closed
6
2012014
PL
21512012 Manuel Pinlo
60 Linda Court
Danville
$
Open
$ 300.00
Manuel Pinto
Open
7
2012015
SSO
3/912012 Ra Bohaine
144 Hall Lane
Walnut Creek
S
750.00
$ 7.74
P Card - Mt D. Landscape
Closed
8
2012016
PL
1/26/2012 Thomas Lile & Assoc
22450 Morello Ave
Pleasant Hill
$
-
$ 735.75
Roto Rooter_
Closed
9
2012017
PL
2/2512012 Tim Smith
1560 Westwood Court
Walnut Creek
$
-
$ 150.00
Tim Smith
ID#
Loss
DOL
Other Party
Location
Open
10
2012018
SSO
4/3/2012 Diane Simon
2031 Ellnora Dr.
Pleasant Hill
$
153.55
$ -
Closed
11
2012019
SSO
4/12/2012 Rebecca Turnbull
175 Saranap
Walnut Creek
C
_
$ _ 531.13
51901011
Open
12
2012020
SSO
411312012 Donavan Tom
116 Glorletta Blvd.
Orinda
$
5,000.00
$ 1,712975
Roto Rooter
8/3/2011
Drew Gaylord
Lafayette
#245
$
$ 1,659.79
$ 1,149.13
Restoration Mgt Co.
Open
13
2012022
PL
3@012012 Lena &Lawrence Medina 1509 Mission Drive
_ Danville
$
$ 179.75
Lena & Lawrence Medina
Total - OF/PR $ 5,903.55 $ 5,872.11
LIABILITY INCIDENTS - OTHER
Status
#
ID#
Loss
DOL
Other Party
Address
City
Reserve
Paid to Date
Paid to
Typ
Closed
1
2012002
GL
7/16/2011
Ron Roberson
1190 Keaveny Cl.
Walnut Creek
$
$ 965.48
Ron Roberson
Closed
2
2012004
GL
1/27/2011
Connie Easterly
15 Green Street
Martinez
$
$ 2,500.00
Closed
3
2012007
GL
10/3/2011
Bob Hansen
4085 Legion CL
Lalayette
$
$ 6,300.00
Bob Hansen
Open
F
2011017
GL
1011- 15/10 Kathleen Daly
025 Green Street
Martinez
$
$
Closed
4
2012013
GL
1/6/2012
Mark Frazier
2090 Rockspring Place
Walnut Creek
$
$ 563.50
Block Environmental Svcs
Total - Liab.
$
$ 10,328.98
PROPERTY
INCIDENTS
Status
#
ID#
Loss
DOL
Other Party
Address
City
Reserve
Paid to Date
Paid to
Typ
Open
1
2012021
PD
3/29/2012
Wood Group
SCB
$
$
Total - Property
$
$
AUTO INCIDENTS
Status
#
ID#
Loss
DOL
Other Party
Location
Veh#
Reserve
Paid to Date
Paid to
Type
open
C
2011022
AL
51901011
Louis Phrientel
41 Lost Valley _
#252 Rodder
unknown
$ 2,418.75
Closed
1
2012003
APD
8/3/2011
Drew Gaylord
Lafayette
#245
$
$ 1,659.79
$ (1,659_79)
Closed
2
2012009
AL
1/3/2012
United Cleaning Supply
Lafayette_
#237
$
$ 250.00
Closed
3
2012010
AL
1/4/2012
Lisette Gonzales
Lafayette
#196
$
$ 5,406.97
•
Open
4
2012011
AL
1/6/2012
Ali Alaee
Martinez
#199
$ 5,000.00
A
Total - Auto
$ 5,000.00
$ 8,075.72
•
5/10/2012
Expenditure Summary
SELF
INSURANCE
FUND
Vendor Name
Jarvis Fay Doporto &Gibson, LLP
Roto- Rooter Sewer Service
Jarvis Fay Doporto & Gibson, LLP
Account #
Account
L #
Case # - Case Title
Check #
Check
003 - 0000 - 993.14 -21
$1,987.31
lChevron Property Tax Refund
1
11030591
$1,987.31
003 - 0000 - 991.14 -22
$1,712.75
12
Donavan (Orinda) Overflow - Sewer Line Clean
2
103060
$1,712.75
003 - 0000 - 993.14 -21
$1,127.29
Chevron Property Tax Refund
3
103061
$1,127.29
CL# - Claim Log Number
FY - Previous Fiscal Year
GL - General Liability Claims
P - Property Claims
AC - Auto Claims
v
Printed: 5/10/2012
'.ENTRAL CONTRA COSTA SANITARY DISTRICT PROCUREMENT CARD TRANSACTION LOG
IONTHNEAR: �6, IiPl qP -G lot 'I- PAGE � OF
ARDHOLDER NAME : f-,Q /) Z2.ot a 1) DEPARTMENT /DIVISION 1%% 141j' J/%O ' APPROVING OFFICIAL t ��
rEM
DATE
VENDOR NAME
DESCRIPTION OF PURCHASED ITEM
PROJECT NUMBER
OR JOB DESCRIPTION
RECEIPT
NUMBER
PURCHASE
AMOUNT
ACCOUNT NUMBER
PHONE
INTERNET
DISPUTED
E55 o
2
a 1 f
SaS o0L
o/c. Pam 3o A �JQ6dD//W.
ao 0
4;L9, 94
3
963
Lft OA)-G
Ga_5- ' M A TZA I L Yq i C f)
1+5
4
Z a-z
P - FIrr1NG5
5
a
SL SA/ uPPi_j
W,4Sj&_ *5
111450 1
_3_-L1;l_
6
a/ag
Gkau)&L� R.
s pkA 6 G e-116 w G 7-
3"10. 690
7
2q
? iAll ow
YF r r,a_ Str l) rovwP
o a
0b - 1-
8
a
6,6W &C 3- e15
j9&&7
97, DID
9
3611
ftu Fo:'C`
Yoe_"wc
I 9
152
10
3
WlVN tl0t,)
Pipe i'rr°r-ld(.5
64$1�,F
"�&oE
11
S
uj /tviv r: L ot)
F a6r✓ , 67-
/43, )L-49
12
3
l_") olv'
6,4S x . T
M t7 ., -7 -�1
151- 7L-
13
3/9
n QHS
G S/ 0 WrrN r
M a4t017LI
S (0
14
31
l -Ajlrl 01vS
110-1 � e T
7 ,FZ2
1 _,o0 • r79
15
r -
X► x n/ 6 (_ j5 6
0 -4 7
7 00
16
3/i
hJ�
N111-0,V S L_ m)
1112%.L50.
`7 • o
17
3 I
Na,
IM -rd V c [--�
112217-2434-
3-51;,1414
18
/
,SC AND r
C -Sc-k
-7
Cr. -7 Lp
19
�/ �
�1rjN L LSO V
gEW
r� 13► (. Jp i-, ✓ES
Q48�7
uL4- I
!0
'fi
Wr "itoev -S00
4X-1 GALL eusHI:)G
5 H.4
i
TOTAL:
Z
(Total must match the total on the monthly
statement, less any disputed items)
;COUNT #: ()0j 0 440 3 7/PURCHASE SUMMARY: EN c2 f% L R►g I S J MA-1417-
f A/r
;COUNT #:
:COUNT #:
:COUNT #:
AMOUNT
AMOUNT.
AMOUNT.
TOTAL
arges for the assigned Cardholder have been verified All charge slips receipts and credit receipts have
:n matched and charges properly coded to the correct general ledger account. The billing statement has
m reviewed with the Cardholder and all charges and /or credits are correct as billed. Any disputed items are
on the attached Statement of Questioned Item form. All materials, goods and supplies have been
ewed inspected and used for official District business All purchases have been made in compliance with
District's Purchasing Policies and procedures and competitive sealed bids or proposals or quotations were
required for any of the listed purchases .
telephone or Internet orders, check "Phone /Internet' column and attach Telephone /Internet
ier /Credit Receipt Form in lieu of a receipt
PURCHASE SUMMARY:
PURCHASE SUMMARY:
PURCHASE SUMMARY:
(Total must match the total provided above and the total on monthly statement, less any disputed items)
CARDHOLDER SIGNATURE Date 4- 1 0- -La
APPROVING d I^
OFFICIAL SIGNATURE — Date
CENTRAL CONTRA COSTA SANITARY DISTRICT PROCUREMENT CARD TRANSACTION LOG
MONTHNEAR: February 2012 — March 2012
CARDHOLDER NAME,
Jim Kneis
PAGE 1_ OF
DEPARTMENT /DiVISION: Plant Operations/ Maintenance APPROVING OFFICIAL: David Robbins
ACCOUNT #: 00104408200603
ACCOUNT #: 00104408200604
ACCOUNT* 00104408201103
AMOUNT:
4,471.25
VENDOR NAME
DESCRIPTION OF PURCHASED ITEM
PROJECT NUMBER
OR JOB DESCRIPTION
RECEIPT
NUMBER
PURCHASE
AMOUNT
ACCOUNT NUMBER
PHONE
INTERNET
DISPUTED
ITEM
DATE
1
2/29
Battery Specialist
Modicon CPU Batteries
Operating Supplies
95499
835.98
00104408201103
1
2
2/29
Support Product Services
Aux. Boiler ECOM Analyzer Repair
Outside Repairs
2482
500.92
00104408200604
P
3
2/29
RM Automation Inc.
Seal Tank Air Regulators
General Repairs
00013492
118.74
00104408200603
P
4
3/01
Cosa Instrument Corp.
Oxygen Analyzer Filters
Operating Supplies
003159
286.67
00104408201103
P
5
3/09
Battery Specialist
Modicon CPU Batteries
Operating Supplies
95687
191.40
00104408201103
1
6
3/09
McMaster Carr
Nylon Flange Bolts — Lime Levels
General Repairs
20006583
22.49
00104408200603
1
7
3/09
McMaster Carr
Air Comp. Heat Exchanger Gauge
General Repairs
20081621
237.15
00104408200603
1
8
3/09
Radwell International
Aer. Unit 3 Vibration Card Repair
Outside Repairs
JOW259:352
450.00
00104408200604
P
9
3/12
3/14
McMaster Carr
Teddscom
22229 Pos. Feedback Coupler
Lab Furnace Fan
General Repairs
General Repairs
20309834
29605658
81.95
82.19
00104408200603
00104408200603
1
P
10
11
3/15
Ga esco Engineering
Furnace Thermocouples-Wells
General Repairs
024452
2345.89
00104408200603
P
12
3/15
Siemens Industry Inc.
Ras Flow Meter Display - Shield
General Repairs
5565785123
220.28
00104408200603
P
13
3/16
Instrument & Valve Svcs.
Hart Communicator Upgrade
Outside Repairs
3335231
703.10
00104408200604
P
14
3/16
Motion Industries
Aeration Unit Solenoids
General Repairs
659403
446.14
00104408200603
P
15
3/16
Caltrol Inc.
22229 Position Transmitter
General Repairs
264211 RI
916.42
00104408200603
P
16
17
18
TOTAL:
7,439.32
(Total must match the total on the monthly
statement, less any disputed items)
ACCOUNT #: 00104408200603
ACCOUNT #: 00104408200604
ACCOUNT* 00104408201103
AMOUNT:
4,471.25
PURCHASE SUMMARY:
General Repairs
AMOUNT:
1,654.02
PURCHASE SUMMARY:
Outside Repairs
AMOUNT:
1,314.05
PURCHASE SUMMARY:
Operating Supplies
ACCOUNT #: 0020000900 1110 7194CC AMOUNT:
TOTAL 7,43932
Charges for the assigned Cardholder have been verified All charge slips, receipts and credit receipts have
been matched and charges properly coded to the correct general ledger account. The billing statement has
been reviewed with the Cardholder and all charges and /or credits are correct as billed Any disputed items are
listed on the attached Statement of Questioned Item form All materials, goods and supplies have been
received, inspected and used for official District business All purchases have been made in compliance with
the District's Purchasing Policies and procedures and competitive sealed bids or proposals or quotations were
not required for any of the listed purchases.
For telephone or Internet orders, check "Phone / Intemet" column and attach Telephonelintemet
Order /Credit Receipt Form in lieu of a receipt.
PURCHASE SUMMARY: 'Miscellaneous
(Total must match the total provided above and the total on monthly statement, less any disputed Items)
CARDHOLDER SIGNATURE
r
APPROVING OFFICIAL SIGNATURE Z� veg��
CENTRAL CONTRA COSTA SANITARY DISTRICT PROCUREMENT CARD TRANSACTION LOG PAGE 1 OF _1
MONTH/YEAR: March/2012
DEPARTMENT /DIVISION: POD APPROVING OFFICIAL: Dave Robbins
CARDHOLDER NAME: Matthew Mahoney PHONE
{Total must match the total on the n
TOTAL: 3924.24 statement, less any disputed items)
ACCOUNT #: 00104408300603 AMOUNT: 3924.24
PURCHASE SUMMARY:
DESCRIPTION OF PURCHASED ITEM
rnw��. • ,...... -•�• •
OR JOB DESCRIPTION
NU MBER
NU
AMOUNT
ACCOUN T NUMOrn
n. cn..�.
—•—
EM
DATE
VENDOR NAME
6" 300# Gate Valve
R.O. Unit cleaners
2" Keckl Valve
Freight for item #3
Wo#46240
Mech Sho
Wo#46479
Wo#46479
3537JC
WA
048403-00
048403 -00
1540.65
358.74
2008.61
16.24
00104408300603
00104408300603
00104408300603
00104408300603
Phone
Phone
Phone
Phone
No
o
No
o
1
02/23
Bay Valve Service Inc
ECOLAB Center
2
02/29
3
03/12
Pittsbur Winnelson
A
03/14
Pittsburg Winnelson
{Total must match the total on the n
TOTAL: 3924.24 statement, less any disputed items)
ACCOUNT #: 00104408300603 AMOUNT: 3924.24
PURCHASE SUMMARY:
PURCHASE SUMMARY:
AMOUNT:
ACCOUNT #:
PURCHASE SUMMARY:
AMOUNT:
ACCOUNT #:
PURCHASE SUMMARY:
AMOUNT:
ACCOUNT #:
the total provided above and the total on monthly statement, less any disputed items
TOTAL 3924.24
(Total must match
Charges for the assigned Cardholder have been verified. All charge slips, receipts and credit receipts have
coded to the correct general ledger account. The billing statement has
been matched and charges properly
been reviewed with the Cardholder and all charges and/or credits are correct as billed. Any disputed items are
supplies have been
Date 3 28 Z
listed on the attached Statement of Questioned Item form. All materials, goods and
for official District business. All purchases have been made in compliance with
CARDHOLDER SIGNATURE
received, inspected and used
the District's Purchasing Policies and procedures and competitive sealed bids or proposals or quotations were
not required for any of the listed purchases.
L
For telephone or Internet orders, check "PhoneAnternet" column and attach Telephonellnternet
APPROVING Date
OFFICIAL SIGNATURE 2e2zl�
Order /Credit Receipt Form in lieu of a receipt.
CENTRAL CONTRA COSTA SANITARY DISTRICT PROCUREMENT CARD TRANSACTION LOG
MONTH /YEAR: MARCH, 2012
CARDHOLDER NAME: ROY MANES DEPARTMENT /DIVISION: POD / Buildings and Grounds APPROVING OFFICIAL:
PAGE _1 OF _1
DAVID ROBBINS
ITEM
DATE
VENDOR NAME
DESCRIPTION OF PURCHASED ITEM
PROJECT NUMBER
OR JOB DESCRIPTION
RECEIPT
NUMBER
PURCHASE
AMOUNT
ACCOUNT NUMBER
PHONE
INTERNET
DISPUTED
1
2/23/12
Grainger
Tool Retractor
UV Facility Repairs
9763010502
$ 283.19
001 - 04400- 850.06 -03
Internet
2
3108/12
Grainger
Inflator Gauge
Shop Repairs
9774255450
$ 91.19
001 - 0440 - 850.06 -03
Internet
3
3/12/12
Lowe's
Muriatic Acid
Repairs to Pond
P 835214
$ 162.80
001 - 0440 - 850.06 -03
4
3/12/12
The Home Depot
Roofing repairs, Patch
Repairs to roof
C 46619
$ 127.45
001 - 0440 - 850.06 -03
5
3/15/12
The Home Depot
Roofing repairs, parts
Repairs to roof
C 46619
$ 139.03
001 - 0440 - 850.06 -03
6
3/15/12
Grain er
Repair tools and supplies
Shop Repairs
9780152634
$ 431.78
001 -0440- 850.06 -03
Internet
7
3/19/12
Omega Industrial Supply
Emergency repair, parts and supplies
Shop Repairs
SO021891
$ 2456.04
001 - 0440 - 850.06 -03
8
3/19/12
Grainger
Repair and maintenance tools, vac
MRC maintenance
9782155692
$ 525.49
001 -0440- 850.06 -03
Internet
9
10
11
12
13
14
15
16
17
18
19
20
ACCOUNT #: 001 -0440- 850.06 -03
ACCOUNT #:
ACCOUNT #:
ACCOUNT #:
TOTAL: $ 4,216.97 statement, less any disputed items)
AMOUNT: $ 4,216.97 ✓ PURCHASE SUMMARY: Buildings and Grounds, General Repairs and Maintenance
AMOUNT:
AMOUNT:
AMOUNT:
PURCHASE SUMMARY:
PURCHASE SUMMARY:
PURCHASE SUMMARY:
TOTAL $ 4,216.97 (Total must match the total provided above and the total on monthly statement, less any disputed iterr
Charges for the assigned Cardholder have been verified. All charge slips, receipts and credit receipts have
been matched and charges properly coded to the correct general ledger account The billing statement has
been reviewed with the Cardholder and all charges and /or credits are correct as billed. Any disputed items are
listed on the attached Statement of Questioned Item form All materials, goods and supplies have been
received, inspected and used for official District business All purchases have been made in compliance with CARDHOLDER SIGNATURE Date.
the District's Purchasing Policies and procedures and competitive sealed bids or proposals or quotations were oe
not required for any of the listed purchases n
For telephone or Internet orders, check "Phone /Internet" column and attach Telephone /Internet APPROVING
Order /Credit Receipt Form in lieu of a receipt OFFICIAL SIGNATURE