County of San Diego

*PURCHASE ORDER CHANGE

Department of Purchasing & Contracting
5560 Overland Ave, Ste 270
San Diego, CA 92123-1204
PH: (858) 505-6367 FAX: (858) 715-6452

(Do Not Duplicate Order)
P.O.Number-Rev:
546972- 16
P.O.Type:
STANDARD
Date:
05-JUN-17

Page : 1 of 1

I SUPPLIER:

MAUREEN SCHLENTZ
(858) 505-6446

Authorized By:
Phone No:

FILE COPY

I TERMS:

PRIZM JANITORIAL SERVICES INC
555 COUNTRY CLUB LANE# C196
ESCONDIDO, CA 92026

NET 30 DAYS
DESTINATION
PREPAID
BEST METHOD

Payments:

F.O.B.:
Freight:
Carrier:

I SEND ORIGINAL INVOICE TO:

I SHIP TO:

DEPARTMENT OF PUBLIC WORKS
FIELD OPS-- DIV 1 HEADQUARTERS. MS: S153
11970 SINGER LN
SPRING VALLEY. CA 91978

PUBLIC WORKS
ROADS
5510 OVERLAND AVE STE 410
SAN DIEGO. CA 92123

The P.O. Number mus1 eppeeron ell invoices end shipping documents. For out-of-State Invoices, the county
wfll pay Celifomls Use Tax directly to the Stale of CAper Parmi/ no. SR FH 25-632384. Prior to first
psyment, new supplittrs must submil a complet!Jd IRS Form W-9and a FTB Form 590. Feluro to submit e
completed FTB Form 590 trill rusult In back up withholding on pJJyments per CA Revenve and Texetion
Code section 18662. Submit both forms to Auditor & Controler vfa folf ot (858) 694·'1060 and ms/1 orlglrntls
to: Coun of San 01
, 55300VerlendAv& S/e 410. SanD
. CA 92123

I REQUIRED DELIVERY DATE:

IJ"

*

(See Order Items Below)

NOTE TO THE SUPPLIER:
REVISION 16, ADDED LINES 14 AND 15. DEPT CONTACT: ERIC JONES (858) 694-3880

I ORDER ITEMS:
* I Line: 14
Quantity: 4938.36
UOM: DOLLAR
Unit Price:
1.00
UNSPSC: 721000.0000 Item#:
Taxable: NO TAX
Description:
FY17-18 JANITORITAL SERVICES FOR DIVISION I HEADQUARTERS.

Total Line Price:

4,938.36

4938.36
01-JUL-17

Ship Quantity:
Delivery Date:

*I

$

(including Ta:t)

Line: 15
Quantity: 4938.36
UOM: DOLLAR
Unit Price:
1.00
Taxable: NO TAX
UNSPSC: 721000.0000 Item#:
Description:
FY17-18 JANITORIAL SERVICES AT LAKESIDE ROAD STATION# 33.

Total Line Price:

I TOTAL P.O. PRICE (Including Tax):
END OF ORDER

4,938.36

4938.36
01-JUL-17

Ship Quantity:
Delivery Date:

I ADDITIONAL INFORMATION :

$

(including Tax)

$

28,807.10