HomeMy WebLinkAboutRequest FormECONOMIC DEVELOPMENT
REQUISITION REQUEST FORM
Date: July 26,2006
Requested by: Glendon Hall Supervisor's signatur(_%
Vendor Name: US Laboratories/(PEICO)
Vendor Address: 10125 NW 116th Wav, Suite 18
City, State, Zip: Miami, Florida 33178
Contact Name: Thomas E. Mesk
Telephone: 305 651 8483
Fax: 305 651 4460
FEI or SS# ': 061889244
Email address: torn.meska.us.bureauveritas.com
Amount: $99,977.70
Account/Project # (if applicable): 500101-240
B # (it applicable): N/A
Description: Site preparation, soil excavation and disposal, application of engineering control and
preparation of. Source Removal Report,
Director's signature or designee:
Administration Use only
Entered in GEMS: Vendor #:
Commodity Code