UNIVERSITY OF VIRGINIA
LPO Number Date Ordered
Limited Purchase Order
valid if less than $5,000.00 VENDOR NAME/ ADDRESS/ WEB SITE DELIVERY LOCATION CODE
RESTRICTED ITEMS: Web Site: Phone: Attn: DELIVER TO: Charles L. Brown Department of Electrical and Computer Engineering Thornton Hall, Rm. C222 351 McCormick Road P.O. Box 400743 Charlottesville, VA 22904-4743 Attn: SEND INVOICE TO: University of Virginia Procurement Services Accounts Payable P.O. Box 400197 Charlottesville, VA 22904-4197 SHIPPING CHARGES (pick one) PICK-UP BY UVA X ITEM UVA PAYS SHIPPING* VENDOR PAYS SHIPPING DETAILED DESCRIPTION # UNIT UNIT PRICE AMOUNT DELIVERY DATE
These items may NOT be purchased using this authorization:
Payment Terms: Net 30 days
Alcoholic beverages, ammunition, firearms, prescription
Upon Receipt of Invoice DEPT REF (OPTIONAL)
drugs, carpet & window treatments, flowers, food, framing, furniture, (any kind), gifts, radioactive materials, renovation/ construction services, security systems or purchases from an employee of the Commonwealth of Virginia.
SUMMARY DESCRIPTION / ITEM CATEGORY:
Vendor Info:
eVA: YES or NO Contract: YES or NO
eVA Info Provided: YES / NO Minority / Women Owned: YES / NO
PTAO - ACCOUNT CODES PROJECT# TASK#
AWARD#
ORG#
AMOUNT
1
/
ORDERED BY SIGNATURE
/
@Virginia.EDU E-Mail
/ 434TELEPHONE 434-924-7544
TOTAL AMOUNT
Gloria R. Walker
APPROVED BY (mandatory) SIGNATURE
TELEPHONE PURCHASING COPY revised September 15, 2006
THIS ORDER VALID ONLY IF AMOUNT IS LESS THAN $5,000.00 excluding transportation costs
*NOTE: FOR SMALL TO MEDIUM SIZED PACKAGES, DEPARTMENT PREFERS SHIPMENT WITH UPS or FedEx.