Purchase Requisition / Check Request by 3yLAz82

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									                                  TOMPKINS CORTLAND COMMUNITY COLLEGE
                                    PURCHASE REQUISITION/CHECK REQUEST


PAY TO: (Name,Address,Contact Information of Vendor)                           DATE:
                                                                               DATE:

                                                                                DEPT./BUDGET CODE EXPENSE REQUIRED:

                                                                                           (Use this format: 000-0000-0000)
 QUANTITY                         DESCRIPTION                                               UNIT PRICE                         LINE TOTAL
                                                                                                                              $        -
                                                                                                                              $        -
                                                                                                                              $        -
                                                                                                                              $        -
                                                                                                                              $        -
                                                                                                                              $        -
                                                                                                                              $        -
                                                                                                                              $        -
                                                                                                                              $        -
                                                                                                                              $        -
                                                                                                                              $        -
                                                                                                                              $        -
                                                                                                                              $        -
                                                                                                                              $        -
                                                                                                                              $        -
                                                                                                                              $        -
                                                                                                                              $        -
                                                                                                                              $        -
                                                                                                                              $        -
                                                                                                                              $        -
                                                                                                                              $        -
                                                                                                                              $        -
                                                                               EST. SHIPPING/HANDLING                         $        -

                                                                               TOTAL                                          $        -

                                                       REQUESTED BY:
                                                       (Signature Required)
                                                       BUDGET MANAGER:
                                                       (Signature/Date required)
                                                       PURCHASING AGENT:
                                                       DIR. OF BUDGET & FINANCE:
                                                       DEAN:
                                                       (Signature required if over $500)
Revised 4/2010
Budget & Finance                Form can be found at www.tc3.edu/faculty/forms

								
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