12-027.00 Spokane County Sheriff JAG Grant: Equipment PurchaseSUBGRANTOR: CITY OF SPOKANE VALLEY
SUBGRANTEE: SPOKANE COUNTY SHERIFF'S DEPARTMENT
I hereby acknowledge receipt of the following equipment from Subgrantor as part of the 2009
ARRA JAG funds (CFDA # 16.804). These are Federal grant funds. This equipment was
purchased with such funds, and my agency is responsible for reporting the receipt of such
equipment purchased with these funds.
Item Description Part # Quantity Unit Cost Total
1. Leaflet Display 146221 1 $232.20 $232.20
2. Magazine Display 146151 1 $243.00 $243.00
Sales Tax $ 41.34
Total cost of all items — $516.54
I understand that my agency is responsible for licensing, maintenance, training, inventorying and
proper storage and use of the equipment. Subgrantee further acknowledges that the above - listed
equipment will be used for its original intended purpose. Equipment lost, stolen, or deemed
unusable will not be replaced. Each piece of equipment valued at $5,000 or more cannot be
disposed of without permission from the grantor pursuant to OMB Circular A -87.
Subgrantee holds Subgrantor harmless for any and all damages that may result from the
acceptance of this equipment. I also understand that our agency may receive an audit in
accordance with OMB Circular A -133 and the conditions of JAG grant placed on Subgrantor,
including maintenance procedures, current utilization and justification for continued need for the
item(s).
Signed by ( Subgrantor)
Signed by (Subgrantee): �
Date: 2/i4b —
Date: Z —,1 IZ—
Office
Office Depot, Ins
PAGE NUMBER
PO BOX 630813
DEPOT
CINCINNATI OH
45263 -0813
FEDERAL ID:59- 2663954
BILL TO:
o ATTN: ACCTS PAYABLE
CITY OF SPOKANE VALLEY
° g STE 106
N 11707 E AVE
N SPOKANE VALLEY WA 99206 -6124
0
ORIGINAL INVO'gE 10000
THANKS FOR YOUR ORDER
IF YOU HAVE ANY QUESTIONS
OR PROBLEMS. JUST CALL US
FOR CUSTOMER SERVICE ORDER: (888) 263 -3423
FOR ACCOUNT: (800) 721 -6592
INVOICE NUMBER
AMOUNT DUE
PAGE NUMBER
5956868820
516.54
Pagel oft
INVOICE DATE
TERMS
PAYMENT DUE
30- JAN -12
Net 30
29- FEB -12
SHIP TO:
CITY OF SPOKANE VALLEY
STE 106
11707 E SPRAGUE AVE
° o= SPOKANE VALLEY WA 99206 -6124
o
ACCOUNT NUMBER PURCHASE ORDER
ISHIP TO ID
I ORDER NUMBER
ORDER DATE
SHIPPED
DATE
39244163
1 42848
JCITYHALL
1 595686882001
25- JAN -12
30- JAN -12
BILLING ID
ACCOUNT MANAGER
RELEASE
JORDERED BY
I DESKTOP
IC OST CENTER
84044
IGREG BINGAMAN
CATALOG ITEM /t/
DESCRIPTION/
U/M
QTY
QTY
QTY
UNIT
EXTENDED
MANUF CODE
CUSTOMER ITEM #
ORD
SHP
B/O
PRICE
PRICE
146221
DISPLAY, LEAFLET,24PCKT,CR EA 1
1
0
232.200
232.20
SAF5601 C L
146221
146151
DISPLAY, MAG, 1 2PCKT,CR EA 1
1
0
243.000
243.00
SAF5602CL
146151
APP OU D FOR PAYMENT
C_
SIGNATURE DATE
Po # y as yl�
GARS CODE
SUB-TOTAL
475.20
DELIVERY
0.00
SALES TAX
41.34
All amounts are based on USD currency TOTAL
516.54
10 :turn supplies, please rMcK in original box ana insert our pacKing n st or copy OT tnis invoice. riease note proaiem so we may issue creak or
replacement, whichever you prefer. Please do not ship collect. Please do not return furniture or machines until you call us first for instructions. Shortage
or damage must be reported within 5 days after delivery.
A DETACH HERE AL
CUSTOMER NAME BILLING ID INVOICE NUMBER INVOICE INVOICE
CITY OF SPOKANE VALLEY 84044
FLO
Please OFFICE DEPOT
Send Your PO Box 70025
Check to: Los Angeles CA 90074 -0025
DATE AMOUNT AMOUNT ENCLOSED
595686882001 30- JAN -12 516.54
000840447 5956868820018 00000051654 1 3
Please return this stub with your payment to
ensure prompt credit to your account.
Please DO NOT staple or fold. Thank You.
a
r.
0
0
002823 - 000470 00002/00006