American Express- Monthly Certification by zgCNc9

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									Christopher Newport University         242                                                                               Page _____of_____


                                                SPCC - Monthly Certification

Department:_______________________________________________________________________________
Cardholder:_______________________________________________________________________________

Card Number (last four digits only):____________________________________________________________
Statement Closing Date:___________________________ Total Amount:_____________________________
“I hereby certify that information provided on the log and its attachments are correct, purchases are valid state expenses and comply
with SPCC policies and procedures, and the monthly statement has been reconciled to the purchasing log and supporting
documentation.”


(Cardholder Signature)                                                                          Date


(Cardholder’s Supervisor Signature)                                                             Date


 ORGANIZATION                 EXPENSE                                                      AUTHORIZED SIGNATURE
                                                        AMOUNT                                (see line 3 at the bottom of page)
    CODE                       CODE




                  Total      (Must agree to Statement Total)               $_______________________________________

1)   ORIGINAL CERTIFICATION LOG, ORIGINAL PURCHASE LOG, ORIGINAL ITEMIZED INVOICES/RECEIPTS, AND DELIVERY
     TICKETS MUST BE SUBMITTED TO THE BUSINESS OFFICE BY THE 1ST WORKDAY OF EACH MONTH.
2)   The only object codes that may be used are the detail object codes per the new policy – see webpage http://businessoffice.cnu.edu/ap.htm
3)   Authorized Signature required when the cardholder’s supervisor is not authorized to approve expenses on the accounts listed.


         C:\Docstoc\Working\pdf\16df3923-60a5-4478-a592-a4e3c5153bdb.doc
Christopher Newport University         242                                                                                Page _____of_____



                                                SPCC - Monthly Certification
                                                    Continuation Sheet
     ACCOUNT                   OBJECT                   AMOUNT                              AUTHORIZED SIGNATURE
                                                                                              (see line 3 at the bottom of the page)




                  Total      (Must agree to Statement Total)               $_______________________________________
1) ORIGINAL CERTIFICATION LOG, ORIGINAL PURCHASE LOG, ORIGINAL ITEMIZED INVOICES/RECEIPTS, AND DELIVERY
   TICKETS MUST BE SUBMITTED TO THE BUSINESS OFFICE BY THE 1ST WORKDAY OF EACH MONTH.
2) The only object codes that may be used are the detail object codes per the new policy – see webpage http://businessoffice.cnu.edu/ap.htm
3) Authorized Signature required when the cardholder’s supervisor is not authorized to approve expenses on the accounts listed.


         C:\Docstoc\Working\pdf\16df3923-60a5-4478-a592-a4e3c5153bdb.doc
Christopher Newport University       242                                  Page _____of_____




        C:\Docstoc\Working\pdf\16df3923-60a5-4478-a592-a4e3c5153bdb.doc

								
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