Maintenance and Supply Request

Maintenance and Supply Request

Repairs, Supplies, Lost and/or Damaged
Date

MonthDayYear
Date
Assigned Station
Name*

First NameLast Name
Email*
example@example.com
Phone Number
Please enter a valid phone number.
Maintenance Request Type

Apparatus MaintenanceFacility MaintenanceEquipment MaintenanceOther
Supply/Procurement Request Type

Commissary SuppliesEMS Equipment/SuppliesOffice/IT Equipment/SuppliesCleaning SuppliesAutomotive Equipment/SuppliesFacility Equipment/SuppliesCommunication Equipment/SuppliesPersonal Protective Equipment/SuppliesCapital Purchase ItemsTraining Equipment/SuppliesOperations Equipment/Supplies (Hose, Nozzles, etc.)Other

Reminder (Competitive Procurement Requirements):

$10K - $40K

Quotes Required for Purchases

$40K - $75K

MRSC Roster Required for Purchases

Apparatus ID Number
Facility ID Number
Equipment Description
Description of Maintenance or Supply/Procurement Needed
Please be very detailed and specific. Add model #'s, dimensions, etc. or take a picture and add to request.
Quantity Needed
Please be very detailed and specific.
Attach Descriptive Information

Webpage with item numbers, photos, equipment model #'s, serial #'s, etc.
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