HomeMy WebLinkAboutCo-op Survey SheetCO-OP SURVEY SUET
SURVEY RESPONSE DUE DAY & DATE.
1. Product
Friday. March 14. 2005
CO-OP GASOLINE SURVEY
LOW SULFUR
DIESEL
TANKWAGON
#2
TRANSPORT
HIGH SULFUR.
DIESEL #2
RED DYE
RED DYE
LOW
SULFUR
DIESEL
FUEL #2
LOW SULFUR
DIESEL FUEL
#2
TANKWAGON
TANKWAGON
TRANSPORT
550,000
Gallons/Year
125,000
GallonslYear
Note: Please indicate your annual usage in gallons.
2. Do you have a current contract for this item? Yes _ No
If yes, please complete: Miami -Dade County Contract. Weekly spot market pricing.
Weekly pricing attached.
Vendor Name:
Address/City/State:
Contract Expiration Date: Nat _ a1crv_ t e,we.jolltybackina".
Please attach tabulation sheet or price sheet. Attached.
3. Anticipated usage per delivery location,
(Attach additional sheets, if needed)
Dinner Kev Marina, 3400 Pan American Drive. Miami, FL - 125.000 Gallons/Year
Fleet Management. 1390 N.W, 20th St. Miami . FL — 550.000 Gallons/Year
Total Anticipated Volume: 675.000 Gallons/Year . (All locations)
4. Specifications are attached to this Survey Sheet.
Are these specifications approved? X Yes — No
Ink, state objection below:
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5. Special Requirements:
6. Recommended Vendors: (Please attach your suggested bidder's list)
Bidder List attached? Yes No
7. I understand that a signature on this survey form is a commitment by my entity to
participate in any resulting en -operative bid for this product.
Authorized Signature:.
Title:
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Date Submitted:
PLEASE COMPLETE THE FOLLOWING:
City/Organization Name: Citv_pf Miami. Purchasing Department
Address: 444 SW 2nd Ave. Miami. FL 33130
Principal Contact: Michael Rath. Assistant Purchasing Director
(Name & title of respondent)
Telephone No.: (305) 416-1921
SURVEY SHEET MAY BE RETURNED BY MAIL OR FAX NUMBER INDICATED
BELOW.
RETURN SURVEY SHEET NO LATER THAN: Friday, March 18. 2005
BY MAIL:
RETURN SURVEY TO:
Angelo Salomone, Purchasing Administrator_
City of Coral Springs
9551 West Sample Road
Coral Springs, FL 33065
Phone: 954 344.1100
Fax: 954 344-1186
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BROWARD GOVERNMENTAL CO-OPERATIVE PURCHASING GROUP