SWM-CS101117 imp
North Central Texas Council of Governments
Regional Storm Water Program
FY11 Cooperative Purchase Order Form
Order Deadline: November 19, 2010
To maximize group savings for current program participants, the Regional Storm Water Management Program will
conduct one purchase annually of the items listed below. Our goal is to combine as many orders possible to achieve the
lowest unit cost for program participants. A 20 percent administrative fee will be added to orders of non - participants. To
find out your participation status, please go to http: / /www.nctcog.org /envir /SEEclean /stormwater /participants.asp
The final cost of your order will also include any bulk shipping and handling costs of the total bulk order delivered to
NCTCOG. The estimated costs per unit are based on past purchases and are quoted below for guidance only; NCTCOG
cannot guarantee the final price until all orders have been collected, and the final bulk price and any shipping charges
confirmed with vendors.
Staff will send an email prior to submitting the order notifying you of the final unit price based on all orders received.
Should the unit price greatly exceed the cost estimate, participants will be given the option to purchase at a higher cost or
decline the order. NCTCOG will invoice you after the orders arrive.
Please fill out the table below. A more detailed description of the products offered through this cooperative purchase is
further explained on the pages following the table. Submit page 1, the table (pages 2 and 3), and any supporting pages
per the directions below. Artwork (.eps or other high resolution format) to be placed on items (if applicable) must also be
submitted via email by the order's due date.
Submit Order Form To: Erin Blackman via email (eblackman(cr�.nctcog.orq) or fax (817- 695 - 9191). If you choose to
fax your order, please send a follow up email to Erin Blackman to ensure your order was received.
Name: t Rf2ZA Organization: C' -f a r Coef L t—_
Mailing Address: 2S proev4.-JRy "e'0 /®
City /Zip: (melees tl 15t 1� / Phone: q12.,-3c-I 7oI°1
Shipping Address (if different than mailing address):
City /Zip: Phone:
Email: ME;,ARZAer _of:q-c,(
You will be invoiced after your order arrives (you can then pay by check or credit card). If the invoice needs to
reference a purchase order number, please indicate yes here:
By signing this form you agree to render due payment to NCTCOG upon invoicing.
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Signature: im• Date: t V — V ( o
October 2010 1
How to fill out the table below: (1) Place a check mark by the items you wish to order- column 1. (2) Indicate the total
quantity of those items you would like to order- column 5. (3) Indicate a total maximum price you would like to spend on
the items (optional)- column 6.
Order? Estimated Cost Total Maximum
(place check Item Per Unit Notes Quantity Total Price
mark if yes) Per Item
Pollution Prevention 10 versions. Price reflects order of
Municipal Training -$6.11 128 (various versions) posters at
Posters 18 "x24" size. See page 4 to indicate
quantities.
Texas SmartScape® Assortment of 5 different bookmarks;
Bookmarks $0.09 - $0.22 must be ordered in multiples of 5.
See page 4.
Texas SmartScape® 2" circular stickers. Intended to be
Stickers $0.50 - $2.00 used for the SmartScape initiative.
See page 4.
Plastic Curb Markers $2.03 - $2.67 4 options. See page 5 to indicate J� y 00
quantities.
Plastic Curb Marker $4.95 (5 oz) or Cost of glue depends on desired 5 oz: O
Glue $8.90 (10 oz) application. See page 5. 6-D 10 oz:
Aluminum Curb Markers $2.00 - $2.65 8 options. See page 6 to indicate
quantities.
Aluminum Curb Marker $6.10 - $8.75 (10.1 Amount of glue needed depends on
Glue oz) desired application. Needed for
adhesive installations. See page 5.
Dripless Caulking Gun $7.40 Used to apply tube adhesive. See
_page 5.
1/4" diameter hole predrilled into the
Predrilled Hole $0.30 $0.50 marker to secure the drive rivet
fastener. Needed for fastener
installations. See page 5.
Drive Rivet Fastener Needed for surface and subsurface
(1/4 "x3/4 ") $0.20 - $0.35 installations with fastener. See page
5.
Carbide Drill Bit (4" dia., Complete arbor includes whole saw
complete arbor) $99.65 and center bit. Needed for
subsurface installations. See page 5.
Carbide Bit (1/4 ") $16.50 Needed for surface installation with
fastener. See page 5.
Yard Waste Brochures To educate landscape maintenance English:
for Landscape $0.10 - $0.86 companies about proper yard waste
Maintenance management. See page 6 -7. Spanish:
Companies
Yard Waste Brochure To educate homeowners about English:
for Homeowners $0.10 - $0.86 proper yard waste management. See
page 6 -7. Spanish:
Assortment of 5 different bookmarks;
must be ordered in multiples of 5.
Dog Waste Bookmarks $0.06 - $0.17 Note, we're in the process of
redesigning these bookmarks, but an
image of what they will look like is not
yet available. See page 7.
2 options. Dispenser attaches to a A
leash and holds bags for picking up
Dog Waste Bag $1.74 - $1.98 (a) after your dog. Please send artwork g
Dispensers >$1.97 (b) or indicate if "Doo the Right Thing"
artwork will be used (option a only). Artwork ?:
See page 7.
These go inside the dog waste bag A
Bag Refills (for the dog $0.57 - $0.64 (a &b) dispensers described above. Each
waste bag dispensers) bag refill contains 15 bags. See page g
8.
October 2010 2