Requisition by XM46j3gN


									    Requisition/Check Request                                                      Union College
              FORM                                           310 College Street, Barbourville, KY 40906               -546-1205

Requisition No. (if applicable) ______________(Dept. Control No.)                Department: _______________________
Vendor Name: ______________________________                                      Budget Account No. _____________________
Address       ______________________________
             ______________________________                                      Date of Requisition: _________________
Telephone # ______________________________
                                                                                 Delivery Required Date:__________________
Contact Name: ______________________________

Check Required (Please check one)     Yes ____ No ____                           Checks are processed each Wednesday.
                                                                                 Please submit your request at least (3) three
When Required ____________ Mail Check Yes ____ No____
                                                                                 business days in advance.
Fuel Card Required Yes ____ No ____

Will credit card be required for purchase? Yes ___ No ____

Item      Quantity         Unit                                Description                                    Unit          Total Price
No.                                                                                                           Price

Justification:                                                                                 Total:

Please forward signed and approved requisition/check request to the Business Office. Attention: Assistant Controller. Allow sufficient time
for processing. This is not an authorization to contact the Vendor for the requested items.
The Business Office will issue a Purchase Order and a P.O. number to formalize the contractual obligations for this purchase

                                  Requested by:________________________________
Business Office Use Only
                                  Approved: __________________________________ ($0-$1,000.00 Limit Only)
                                            (Head of Department or authorized agent)
Received Date:_________
                                            __________________________________ ($1,001.00 - $5,000.00 Limit Only)
                                             (Vice President of Department)
Processed By: ______________
                                            __________________________________ ($5,001.00 - $10,000.00 Limit Only)
PO Number:________________                  (Vice President for Business & Financial Services)

                                            __________________________________ ($10,001.00 +)
PO Date:______________

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