SERVICE CONTRACT ADDITION
SAIC - Frederick, Inc.
Purchasing Department, Bldg. 1050
Equipment Maintenance - Phone: x5040/5642 - Fax: x6154

THE FOLLOWING INFORMATION IS REQUIRED. IF ANY INFORMATION IS NOT PROVIDED, YOUR REQUEST WILL BE RETURNED WITHOUT ACTION. INDIVIDUAL SIGNING THIS REQUEST SHOULD HAVE SIGNATURE AUTHORITY FOR THE CENTER NUMBER THAT WILL PAY FOR THE SERVICE CONTRACT. IF ITEM IS PART OF AN EQUIPMENT SYSTEM, ALL ACCESSORIES SHOULD BE LISTED. WHEN ADDING A COPIER, INCLUDE THE ESTIMATED NUMBER OF COPIES PER MONTH. ATTACH ANY PAPERWORK/QUOTES PROVIDED BY A VENDOR.

Date: Center #: Email:
Contact: Phone Ext.: Fax Ext.:


Equipment Information

Property Decal # Description Manufacturer Model Serial # Location(Bldg/Rm) Requested Start Date Vendor

ALS Form SC01, dtd 02/01/04