Philadelphia Mural Arts Program
FY2017 Supply, Paint and Sundry Order and Delivery Form as of November 2016 Fund
DATE SUBMITTED: DATE/TIME DELIVERY REQUESTED FOR:
Dept
PROJECT MANAGER'S NAME & PHONE:
Project
REQUESTING ARTIST'S NAME:
Grant
Project manager signature:
Sundries
6360
Amount
$0.00
Paint
6370
Amount
$0.00
DELIVERY ADDRESS - BE SPECIFIC - BUILDING NAME - ORGANIZATION NAME - HOURS - ETC.
Site Name:
PICK UP FROM:
DROP OFF TO: Site Name:
Address:
Address:
Contact Person/Phone:
Contact Person/Phone:
More Info:
More Info:
PAINT (6370)
5 Gallon Buckets -- Gel, Prep, and Sealing Materials
(colors below are 1 gallon in size, Novacolor Acrylic Mural Paint unless noted)
COLOR NAME Carbon Black TITANIUM WHITE Payne's Gray Pyrrole Red Aliz. Crimson (Nova) Venetian Red (Nova) Quin. Red (Nova) Napthol Red Crimson (Nova) Cad. Orange (Nova) Cad. Yellow Med. (Golden) Cad. Yellow Light (Golden) Indian Yellow (Nova) Yellow Oxide (Golden) CHROM OX. GREEN (Nova) Perm. Light Green (Nova) Medium Green (Nova) Deep Green (Nova) Pthalo Blue (Golden) Ultra Blue (Nova) Cerulean Blue (Nova) Cobalt Blue (Nova) Quin. Purple (Nova) Medium Violet (Nova) Quinacridone Magenta (Nova) Raw Sienna (Golden) Raw Umber (Nova) Raw Umber Dark (Nova) Burnt Umber (Golden) Burnt Sienna (Golden) Matte Medium Gel (Nova)
PRICE
QTY
TOTAL
$41.00 $55.50 $66.05 $65.00 $88.06 $63.06 $84.06 $58.06 $101.06 $100.00 $100.00 $59.75 $39.00 $77.06 $81.75 $55.05
$0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
$77.06 $49.00 $51.11 $57.75 $170.05 $70.77 $58.77 $90.70 $39.00 $51.00 $47.05 $39.00 $39.00 $31.72
$0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
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ITEM
PRICE
Crew: Please record quantity of undelivered items and notify project manager Finance: Please deduct the cost of these items from the grand total Project mgr: Please submit a new order form for these items
REVIEWED BY FINANCE: Signature, Date and Time: Print Name:
ü
$0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0
$0.00
SUNDRIES (6360) ITEM Brushes - 1" (36 in a box) Brushes - 2" (24 in a box) Brushes - 3" (12 in a box) Roller Covers - 9" x 3/4" 9" Roller Frame Roller Extension Poles - 4' Parachute Cloth (1 roll = 3,750 sq. ft.) 9" Metal Tray Plastic Tray Liner Butyl Drop Cloths (12' x 15') Plastic Drop Cloths (9' x 12') 5 Qt Plastic Bucket Dust Mask Rags 8lb Long handle scraper w/ wire brush 3" Metal Scraper (wall) Bucket Grids Blue Masking Tape - 2" Plastic Container w/Lid - 16oz (cs - 250) Plastic Container w/Lid - 32oz (cs - 250)
GRAND TOTAL
If any of the requested items did not get delivered, please note here.
TOTAL $0.00 $0.00
TOTAL PAINT 6370
TOTAL SUNDRIES 6360
UNDELIVERED ITEMS
QTY
$179.00 $189.00 $192.00 $84.10 $209.15 $83.15 Sher. Williams Seal Krete Sealer $101.95 Benjamin Moore Corotech Acrylic Sealer $74.99 1 Gallon Buckets Metal Primer - Kem bond $57.00 Primer (Sherwin Williams) $39.50 ProCryl (Sherwin Williams) $39.50 Regular Golden Gel -5 gallon Heavy Golden Gel -5 gallon Matte Medium (Nova) Sher. Williams PrepRite ProBlock Primer Sher. Williams Pro-Cryl Bonding Primer Sher. Williams PrepRite Block Filler
PRICE
QTY
TOTAL
$0.44 $0.52 $1.15 $4.19 $1.56 $3.96 $290.00 $2.33 $2.50 $33.04 $2.57 $3.05 $0.78 $24.75 $4.48 $4.48 $2.00 $6.71 $0.25 $0.40 0
$0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
$0.00
ü
DELIVERY RECEIVED BY: Signature, Date and Time: RECIPIENT MUST SIGN Print name: