For Office Use Only Associated Students Inc P O No by ugd11381

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									                                                                                   For Office Use Only
                          Associated Students Inc.                                      P.O. No:
                                     Cal Poly Pomona

                                    Purchase Order Request

   Date:        July 13, 2010

   From:                                                   Ship to:


                       (Telephone/Extension #)
                                                           Please Check One Below:
   Vendor:                                                               Mail to Vendor
                                                                         Return to Originator
                                                                         Hold for Pick-Up
   Phone #:
                                                                         Account No. (All Groups)
   Date of Event: (if applicable)

   Justification for Purchase:

    Quantity                                 Description                        Unit Price           Total Amount
                                                                                    Subtotal        $         -
                                                                                    Shipping        $
                                                                                        Tax         $
                                                                                       Total        $         -

         We authorize the ASI Business Office to pay the vendor's invoice, not to exceed the
                     amount of the purchase order, unless otherwise directed.

   By:                                                                                                Signature(s)
                President/Chair/Business Manager                                                      Verified By:


ASI Net Server/Forms-Templates

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