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					                                                                                      GWINNETT COUNTY PUBLIC SCHOOLS
                                                                                                SUPPLY PRODUCT'S SAMPLE REQUEST FORM
              Sample Request Type:    CUSTODIAL SUPPLIES
    GCPS Sample Request Number:                             7013                                                                                                              (*)Date    ___________

                (*)Company Name:      ___________________________________________________                                                                       (*)Representive's Name   _______________________________________

  (*)Representive's Contact Number:   __________________________________                                                                                  (*)Representive's Email Address _______________________________________
                                                           Data Provided by Gwinnett County Public Schools                                                                         Data To Be Provided by Vendor             GCPS Use Only

                                                                                                                                                                 (*)Vendor's Proposed (*)Vendor's Proposed
                                                                                                      Pre-Approved             Pre-Approved                                                                   (*)Vendor's
                                                                                                                                                      Unit of          Sample               Sample
Line Number      GCPS Item ID                         Product Description                           Manufacturer/Brand     Manufacturer/Brand Item                                                             Case Pack     Approval Status
                                                                                                                                                     Measure     Manufacturer/Brand Manufacturer/Brand
                                                                                                          Name                    Number                                                                     (If Required)
                                                                                                                                                                        Name                Number

     1        40820                   DROP CORD MEDIUM DUTY 50 FT-EACH                           MIL-SPEC                16614050 - SJTW             EA
     2        40825                   DROP CORD LIGHT DUTY 25 FT-EACH                            COMMERCIAL ELECTRIC62206                            EA
                                      GUM REMOVER PRODUCT TO REMOVE STUBBORN34
     3        70064                   CTN/12                                                     CLAIRE                  415996                      CTN
                                      GUM REMOVER PRODUCT TO REMOVE STUBBORN34
     4        70064                   CTN/12                                                     CLAIRE                  AP 183                      CTN
                                      GUM REMOVER PRODUCT TO REMOVE STUBBORN34
     5        70064                   CTN/12                                                     UNISOURCE               GUM OFF 4950206             CTN


                                      PURO MINT GRANULAR ABSORBES ODORS
     6        70135                   DEODORIZING BOTTLE                                         AERO                    PA137                       BTL
                                      SPRAY BOTTLE W/SPRAYER 32 OZ PLASTIC POLY
     7        70161                   BOTTLE-EACH                                                CONTINENTAL             5032HG                      EA
                                      SPRAY BOTTLE W/SPRAYER 32 OZ PLASTIC POLY
     8        70161                   BOTTLE-EACH                                                CONTINENTAL             932CG                       EA
                                      SPRAY BOTTLE W/SPRAYER 32 OZ PLASTIC POLY
     9        70161                   BOTTLE-EACH                                                IMPACT                  5032WG/6900                 EA



    10        70162                   TRIGGER SPRAYER-EACH                                       CONTINENTAL             902RW9                      EA
    11        70162                   TRIGGER SPRAYER-EACH                                       IMPACT                  6900                        EA
    12        70162                   TRIGGER SPRAYER-EACH                                       TOLEDO                  110244                      EA
                                      DISINFECTANT SPRAY PLEASANT SMELLING
    13        70164                   ELIMINATES ODORS & REFR                                    CHASE                   433-4104-2                  CTN
                                      DISINFECTANT SPRAY PLEASANT SMELLING
    14        70164                   ELIMINATES ODORS & REFR                                    CLAIRE                  416110                      CTN



    15        70166                   URINAL SCREENS BOX/12                                      HOSP.SPEC.              3901                        BOX
                                      FORCE PUMP PLUNGER RUBBER CUP 5 3/4" DIAMETER.
    16        70170                   21" HANDLE EA                                              IMPACT                  9200                        EA
    17        70180                   WET WIPE TOWELS WHITE IN COLOR. BOX/100                    CHICOPEE                8481                        BOX

                                      CORN BROOM SMALL LIGHTWEIGHT WITH HANGER
    18        71005                   EACH                                                       DAISEY BROOM            13-01-DAISY                 EA
                                      CORN BROOM SMALL LIGHTWEIGHT WITH HANGER
    19        71005                   EACH                                                       LIBERTY BROOM           5178508                     EA
    20        71015                   DUO SWEEP ANGLE BROOM -EA                                  FLO PAC                 863                         EA
    21        71025                   LOBBY DUST PAN WITH "L" GRIP HANDLE -EACH                  IMPACT                  2602                        EA
    22        71026                   LOBBY BROOM -EACH                                          FLO PAC                 859                         EA




                                                                                                                          Page 1 of 4
              Sample Request Type:    CUSTODIAL SUPPLIES
    GCPS Sample Request Number:                              7013                                                                                                              (*)Date    ___________

                (*)Company Name:      ___________________________________________________                                                                        (*)Representive's Name   _______________________________________

  (*)Representive's Contact Number:   __________________________________                                                                                   (*)Representive's Email Address _______________________________________
                                                            Data Provided by Gwinnett County Public Schools                                                                         Data To Be Provided by Vendor             GCPS Use Only

                                                                                                                                                                  (*)Vendor's Proposed (*)Vendor's Proposed
                                                                                                       Pre-Approved             Pre-Approved                                                                   (*)Vendor's
                                                                                                                                                       Unit of          Sample               Sample
Line Number      GCPS Item ID                           Product Description                          Manufacturer/Brand     Manufacturer/Brand Item                                                             Case Pack     Approval Status
                                                                                                                                                      Measure     Manufacturer/Brand Manufacturer/Brand
                                                                                                           Name                    Number                                                                     (If Required)
                                                                                                                                                                         Name                Number

                                      WET MOP HANDLE 60" LARGE PLASTIC HEAD, VINYL-
    23        71030                   COVERED -EACH                                               RUBBERMAID              H 136                       EA
                                      WET MOP REFILL 24 OZ LOOPED ENDS & DOUBLE SEWN
    24        71040                   FAN TAIL-EAC                                                ODELL                   400 L WHITE                 EA
                                      WET MOP REFILL 24 OZ LOOPED ENDS & DOUBLE SEWN
    25        71040                   FAN TAIL-EAC                                                WILEN                   A02003                      EA
    26        71045                   LARGE FLOOR FINISH MOP -EACH                                ETC                     6618213                     EA
                                      MOP BUCKET 35 QT FIBERGLASS WITH 3" CASTERS.
    27        71050                   EACH                                                        WHITE                   WH2635-3G                   EA
    28        71060                   MOP PRESS FITS 12-32 OZ MOPS -EACH                          WHITE                   WH6000G                     EA
                                      SAFETY SIGN WET FLOOR CAUTION YELLOW & RED
    29        71070                   SELF FOLDING-EA                                             CARLISLE                36900                       EA
                                      SAFETY SIGN WET FLOOR CAUTION YELLOW & RED
    30        71070                   SELF FOLDING-EA                                             CONTINENTAL             119(215005607)              EA
                                      DUST MOP REFILL NEW 36" ON TREATED FINE QUALITY -
    31        71111                   EACH                                                        SECO                    L25500                      EA
                                      DUST MOP COMPLETE 60" 5"X60" FRAME 5' HANDLE AND
    32        71113                   MOP HEAD-E                                                  WILEN                   SEE SPECIFICATIONS          EA
                                      DUST MOP REFILL NEW 60" NON TREATED. FINE
    33        71115                   QUALITY -EACH                                               WILEN                   C041060                     EA
    34        71136                   PRO ALUMINUM ACME 3.0 HANDLE                                UNGER                   AL14T                       EA

    35        71151                   FLOOR SQUEEGEE 18" FOR RESTROOMS ONLY. -EACH                UNGER                   MW18A                       EA
                                      FLOOR SQUEEGEE 22" HEAVY DUTY HM22A UNGER
    36        71162                   ONLY-EACH                                                   UNGER                   HM22A                       EA
                                      FLOOR SQUEEGEE 30" HEAVY DUTY HM30 UNGER ONLY-
    37        71163                   EACH                                                        UNGER                   HM30A                       EA
    38        71164                   THREADED INSERT FOR FLOOR SQUEEGEE EACH                     UNGER                   FWA10 ACME                  EA
                                      WINDOW SQUEEGEE REFILL 18" UNGER RR45 RUBBER
    39        71175                   BLADE ONLY-EACH                                             UNGER                   RR450                       EA
    40        71177                   WINDOW SCRAPER 4"-EACH                                      UNGER                   SHO4                        EA
                                      REPLACEMENT BLADE FOR SCRAPER UNGER SB04 -
    41        71178                   EACH                                                        UNGER                   RB10C                       EA
                                      18" STRIP PAD BLACK ,FLOOR STRIPPER/STRIP OLD
    42        71182                   FINISH-BOX/5                                                3M                      61-5000-4441-9              BOX
                                      18" SCRUB PAD GREEN, DEEP SCRUB/RECOAT TILE,
    43        71183                   TERRAZZO-BOX/5                                              ETC                     20180                       BOX
                                      18" BUFF PAD RED, AUTO SCRUBBER DAILY FLOOR
    44        71184                   MAINT-BOX/5                                                 3M                      61-5000-4495-5083938        BOX
    45        71185                   20" STRIP PAD BLACK THIN, FLOOR STRIPPER-BOX/5              3M                      61-5000-1489-1082788        BOX
                                      20" STRIP PAD BLACK THICK,GENERAL PURPOSE
    46        71187                   STRIPPING-BOX/5                                             3M                      61-5000-3592-0              BOX
                                      20" SAND SCREEN DISK, FOR WOOD GYM FLOORS. 80
    47        71189                   GRIT-BOX/10                                                 GLIT                    42145                       BOX




                                                                                                                           Page 2 of 4
              Sample Request Type:    CUSTODIAL SUPPLIES
    GCPS Sample Request Number:                               7013                                                                                                              (*)Date    ___________

                (*)Company Name:      ___________________________________________________                                                                         (*)Representive's Name   _______________________________________

  (*)Representive's Contact Number:   __________________________________                                                                                    (*)Representive's Email Address _______________________________________
                                                             Data Provided by Gwinnett County Public Schools                                                                         Data To Be Provided by Vendor             GCPS Use Only

                                                                                                                                                                   (*)Vendor's Proposed (*)Vendor's Proposed
                                                                                                        Pre-Approved             Pre-Approved                                                                   (*)Vendor's
                                                                                                                                                        Unit of          Sample               Sample
Line Number      GCPS Item ID                          Product Description                            Manufacturer/Brand     Manufacturer/Brand Item                                                             Case Pack     Approval Status
                                                                                                                                                       Measure     Manufacturer/Brand Manufacturer/Brand
                                                                                                            Name                    Number                                                                     (If Required)
                                                                                                                                                                          Name                Number

                                      20" BURNISHING HAIR PAD, SPEEDS TO 2500 RPM-
    48        71190                   BOX/5                                                        3M                      61-5001-1448-5              BOX
                                      20" SCRUB PAD GREEN, DEEP SCRUB/RECOATING-
    49        71200                   BOX/5                                                        ETC                     20200                       BOX


    50        71203                   13" STRIP PAD BLACK ,STRIPPING OLD FINISH -BOX/5             3M                      61-5000-4437-7              BOX
                                      13" BUFF PAD RED, AUTO SCRUBBER DAILY FLOOR
    51        71205                   MAINT-BOX/5                                                  3M                      61-5000-4491-4              BOX
                                      13" SCRUB PAD GREEN, DEEP SCRUB/RECOAT TILE,
    52        71206                   TERRAZZO-BOX/5                                               3M                      61-50000-4471-6             BOX
                                      13" SCRUB PAD GREEN, DEEP SCRUB/RECOAT TILE,
    53        71206                   TERRAZZO-BOX/5                                               ETC                     20130                       BOX
    54        71210                   20" BUFF PAD RED,-SPRAY BUFF SOLUTION- BOX/5                 3M                      61-5000-3594-0              BOX
                                      14" STRIP PAD BLACK , AUTO SCRUBBER STRIPPING-
    55        71212                   BOX/5                                                        3M                      61-5000-4438-5              BOX
                                      14" BUFF PAD RED, AUTO SCRUBBER DAILY FLOOR
    56        71213                   MAINT-BOX/5                                                  3M                      61-5000-4492-2083891        BOX


                                      14" SCRUB PAD GREEN, DEEP SCRUB/RECOAT
    57        71214                   TILE,TERRAZZO -BOX/5                                         ETC                     20140                       BOX
    58        71215                   13"CARPET CLEANING PAD CLEAN CARPETS BOX/5                   3M                      70-0711-6314-4              BOX

    59        71215                   13"CARPET CLEANING PAD CLEAN CARPETS BOX/6                   NORTON                  69957353401                 BOX
                                      20"CARPET CLEANING PAD FOR CLEANING CARPETS
    60        71216                   BOX/5                                                        NORTON                  66261017118                 BOX
                                      20"CARPET CLEANING PAD FOR CLEANING CARPETS
    61        71216                   BOX/5                                                        3M                      70-0711-6312-8              BOX
    62        71218                   SMART SWIVEL BRUSH-EACH                                      UNGER                   SB20G                       EA
    63        71221                   BOWL MOP WITH WRINGER-EACH                                   MAGNOLIA                150WC                       EA
                                      ERGO TOILET BOWL BRUSH W/HOLDER (INCLUDES 2
    64        71245                   HEAD) UNGER ONLY                                             UNGER                   BBWHR                       SET
                                      ERGO TOILET BOWL BRUSH REPLACEMENT HEADS
    65        71246                   UNGER ONLY                                                   UNGER                   BBRHR                       PK


    66        71250                   PROTEAM VAC MVP-43 PAPER FILTER BAGS PACK/10                 PRO-TEAM                1000331                     PK
                                      PRO TEAM CARPET TOOL FOR BACK PACK VAC 1 1/2" X
    67        71350                   14" -EACH                                                    PRO-TEAM                100147                      EA
    68        71351                   20'"JET SWEEP HARD FLOOR TOOL - EACH                         PRO-TEAM                101613                      EA
                                      PRO TEAM FLOOR BRUSH FOR BACK PACK VAC 1 1/2" X
    69        71355                   14" -EACH                                                    PRO-TEAM                100623                      EA
                                      UTILITY GLOVES LATEX MEDIUM COTTON LINED
    70        71400                   FLEXIBLE FIRM HOL                                            SAFETY ZONE             GRFY-M                      PR
                                      UTILITY GLOVES LATEX LARGE COTTON LINED
    71        71405                   FLEXIBLE FIRM HOLD                                           SAFETY ZONE             GRFY-L                      PR
                                      SAFETY GLASSES ONE PIECE CLEAR PLASTIC LENS
    72        71410                   MOLDED NOSE PA                                               PYRAMEX                 G204                        EA


                                                                                                                            Page 3 of 4
              Sample Request Type:    CUSTODIAL SUPPLIES
    GCPS Sample Request Number:                               7013                                                                                                              (*)Date    ___________

                (*)Company Name:      ___________________________________________________                                                                         (*)Representive's Name   _______________________________________

  (*)Representive's Contact Number:   __________________________________                                                                                    (*)Representive's Email Address _______________________________________
                                                             Data Provided by Gwinnett County Public Schools                                                                         Data To Be Provided by Vendor             GCPS Use Only

                                                                                                                                                                   (*)Vendor's Proposed (*)Vendor's Proposed
                                                                                                        Pre-Approved             Pre-Approved                                                                   (*)Vendor's
                                                                                                                                                        Unit of          Sample               Sample
Line Number      GCPS Item ID                            Product Description                          Manufacturer/Brand     Manufacturer/Brand Item                                                             Case Pack     Approval Status
                                                                                                                                                       Measure     Manufacturer/Brand Manufacturer/Brand
                                                                                                            Name                    Number                                                                     (If Required)
                                                                                                                                                                          Name                Number

                                      VINYL SURGICALTYPE GLOVE EXTRA LARGE POWDER
    73        71418                   FREE BOX/100                                                 AMERICARE               500-4                       BOX
                                      VINYL SURGICAL GLOVE LARGE TYPE DISPOSABLE
    74        71420                   GLOVES -PFBOX/100                                            AMERICARE               500-3                       BOX
                                      VINYL SURGICAL GLOVE MEDIUM TYPE DISPOSABLE
    75        71425                   GLOVES-PFBOX/100                                             AMERICARE               500-2                       BOX
                                      VINYL SURGICAL GLOVE SMALL TYPE DISPOSABLE
    76        71426                   GLOVES-PF BOX/100                                            AMERICARE               500-1                       BOX
    77        71450                   5/8"X50'RUBBER HOSE L IGHT WEIGHT -EACH                      IMPACT                  7650                        EA
                                      TOILET TISSUE 96 ROLLS/CASE 2 PLY 500 SHEETS/ROLL-
    78        72000                   CTN                                                          FORT JAMES              19800                       CTN
                                      TOILET TISSUE 96 ROLLS/CASE 2 PLY 500 SHEETS/ROLL-
    79        72000                   CTN                                                          GEORGIA PACIFIC         19880                       CTN
                                      TOILET TISSUE 96 ROLLS/CASE 2 PLY 500 SHEETS/ROLL-
    80        72000                   CTN                                                          SCA                     TM1616                      CTN
                                      TOILET TISSUE 96 ROLLS/CASE 2 PLY 500 SHEETS/ROLL-
    81        72000                   CTN                                                          UNISOURCE               4933738                     CTN
    82        72020                   TOILET TISSUE HOLDER -CHROME -EACH                           CONTINENTAL             RT22                        EA
                                      ROLL PAPER TOWEL CABINET 8 1/2" DIAMETER 8" WIDE -
    83        72031                   EACH                                                         SAN JAMAR               T1290TBK                    EA
                                      TWINSAVR JUMBO TISSUE DISPENSER HI IMPACT
    84        72033                   PLASTIC HINGED-EA                                            SAN JAMAR               R4000TBK                    EA
                                      DRIVE MODULE FOR ROLL CABINET T1000 TBK XT12A -
    85        72034                   EACH                                                         SAN JAMAR               XT12A                       EA
                                      DRIVE MODULE FOR OCEANS ROLL CABINET XT14A -
    86        72035                   EACH                                                         SAN JAMAR               XT14                        EA
                                      REPLACEMENT FINGER FOR TISSUE AND TOWEL
    87        72036                   DISPENSERS                                                   SAN JAMAR               T1438                       EA
                                      HAND SOAP CARTRIDGE SANI FRESHC TO FIT SANI
    88        72041                   FRESH SOAP DISP.                                             HOSP.SPEC.              80801                       EA
                                      HAND SOAP CARTRIDGE SANI FRESHC TO FIT SANI
    89        72041                   FRESH SOAP DISP.                                             RELIABLE                444006                      EA
                                      SANITARY NAPKIN DISPOSAL BAGS 9 3/4 X 9 7/8 WAXED
    90        72070                   BOX                                                          HOSP.SPEC.              6141                        BOX




                                                                                                                            Page 4 of 4

				
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posted:7/27/2011
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