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PL£ASANTONo PURCHASE ORDER AGREEMENT CITY OF PLEASANTON 123 MAIN STREET/ P.O. BOX 520 PLEASANTON, CALIFORNIA 94566-0802 PHONE NUMBER SEND INVOICES TO DELIVER ITEMS TO CITY OF PLEASANTON P.O.B0X520 Name PLEASANTON, CA 94566-0802 Address CARE OF: Name Department City/State/Zip Agreement Number PLEASE SHOW THIS NUMBER ON ALL INVOICES. PACKING SLIPS. PACKAGES AND CORRESPONDENCES This is an order for: D goods D goods & services D services (check one) ITEM NO ITEM OR SERVICE DESCRIPTION QUANTITY UNIT PRICE/ FEES SUBTOTAL •Mail out the Purchase Order to Vendor/Contractor : Yes__ No •Proof of Insurance required prior to start of work: Yes__ No __ TOTAL __. Date _______ _ Terms and Conditions on Reverse are Incorporated into this Agreement Authorized Contractor Signature Taxpayers Identification Number: City Dept Head Signature: Contractor: Address: FY: Vendor ID: New Vendor:If checked, W-9 needs to be attached ACCOUNT CODE Dept #: Estimated Start Date: Estimated Completion Date: PO Type:Project #: DEPARTMENT __________________ _ DATE ______________ _ Date _______ _ City Manager's Office Signature: ___________________________________Finance Signature: ______________________________________ FIN Review_____ 2024227 925-931-5027 4/10/2024 00112100-435133 Advertising Expenses City Clerk 123 Main Street 4 $ 0.00 $ 0.00 1 Original request 1.00 $ 10,000.00 $ 10,000.00 $ 0.00 PO Change Order - Need Additional Funds Added $ 0.00 2 Weekly Advertisement in Pleasanton Weekly 1.00 $ 5,000.00 $ 5,000.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 TAX 0.0000 $ 15,000.00 $ 0.00 $ 15,000.00 4 4 94-2601100 City Clerk 23/24 Embarcadero Media Foundation 3004 450 Cambridge Avenue Palo Alton, CA 94306 12100 07/01/2023 6/30/2024 Not To Exceed City Clerk Jocelyn Kwong Pleasanton, CA 94566 DocuSign Envelope ID: 23291C6F-5A5B-4546-8691-B888202BA522