purchase order template word

Purchase Order Template Date Needed (Note: no “ASAP”): _______________ Program Name: _________________________________________ Index #: ____________ Requested by: ____________________________ Low Value ( < $2,500) ? _______ High Value ( > $2,500) ? _______ Suggested Vendor: _____________________ Vendor Phone: (____)____-_______ Vendor Fax: (____)_____-_______ Vendor Contact: ____________________ Comments, Notes, Special conditions: _______________________________________________________ ______________________________________________________________________________________ Catalog # Mfg. Item Name Model # Description (size, color, etc) Quantity Unit Cost Total Cost $ $ Catalog # Mfg. Item Name Model # Description (size, color, etc) Quantity Unit Cost Total Cost $ $ Deliver to whom: __________________________________ Deliver to where: University of California, San Diego 9500 Gilman Drive, 0117 La Jolla, CA 92093-0529