Purchase Order Funding by ner17598

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									                                                                                             This is for internal use and is not a valid Purchase Order
                                                                                                                   Banner Requisition
                                                                                                                           701460

  X_______________________________________________________________________
 AUTHORIZED SIGNATURE(S): I hereby certify that articles or services are budgeted and are necessary to properly conduct
 the activities of this department. NOTE: Official signature will be authority for payment.
 Department Name:              [Dept. Name]                                     DATE:       July 16, 2010
 Contact Name:                 [Contact]                                       INDEX:       [Index]
 Campus Phone:                 [Phone - use 7 digits XXX-XXXX]                  FUND:       [Fund]
 E-Mail                        [E-Mail]                                          ORG:       [Org]
 Funding Type:               ___GTAIDS          ___Grants        ___Aux   ___Concession             ___Foundation          Other ______________
 Receiving Deliver to:
 [Name/Building/Extension]                                                 Date Delivery Desired By               [Date]

 Vendor Name:                [Vendor Name]                                 City/State/Zip              [City/State/Zip]
 Attn To:                    [Attn]                                        Phone:                      [Phone]
                                                                                                       [Note: Providing vendor’s email address will reduce
 Vendor Address:             [Vendor Address]                              Vendor’s Email:
                                                                                                       order time by several days]
ITEM                                                                        ACCOUNT                                    UNIT                 EXTENSION
                                      DESCRIPTION                                            QTY         UNIT                     DISC %
  #                                                                          CODE                                     PRICE                   TOTAL




       Total                                                                                                                                        $0.00

For Purchasing's Use Only
For
Buyer Assignment __________________________




                                                                                                                                7/16/20102:53 PM

								
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