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California State Tax Extension - Excel

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					            California State University, Chico                                                          Date:
            PURCHASE/SERVICE REQUISITION                                                                Requestor Name/Ext.:
                                (THIS IS NOT AN ORDER)
V
E                                                                                                       Dept/Zip:
N
D                                                                                                       Campus Delivery Location (Building/Room):
O Phone:                                     Fax:
R SS# or Tax ID # (if applicable):                                                                      Dept. Budget Contact/Ext./Zip:

  Pmt Terms:                    %           days, Net                          days                     Notes to Procurement & Contract Services
    (fill in one)            Prepay (check to accompany order)
  Frt Terms:           DS        prices include shipping costs
    (fill in one)      SP        separate shipping costs - note cost below1)
                       PU        department will pick up
                       NA        not applicable (no shipping required)
  Vendor Delivery Time:                days after receipt of order                       CMAS or other contract # (if applicable):

                                                                                                                                No
   LINE #   CATEGORY          QUANTITY UNIT                                       DESCRIPTION                                   Tax
                                                                                                                                      UNIT PRICE     EXTENSION




                                                                                         1)
                    96286          1            frt                                       FREIGHT COST (if applicable) *
   Warranty: (if applicable)                                                                                                             TAX
   Quote To/From and Date:
                                                                                                                                        TOTAL

   Line #       Account          Fund          Dept ID           Program              Class               Proj/Grant                  Quantity        $ Amount




       REQUIRED ONLY FOR NON-SUPPORTED IT PURCHASES >$2500:                                                   REQUIRED FOR ALL REQUISITIONS:
  I understand campus support for IT items (computing, networking, or                     I certify that the goods & services requested are necessary for the
  communications equipment/software) is limited to those items on the                     operation of the department, that there are sufficient funds to cover the
  University-supported list available at the web site below. Maint/repair costs           expense, and that I am authorized to approve such expenses. In addition, I
  for non-supported IT items will be the responsibility of my unit.                       understand that maint/repair costs for non-supported IT items will be the
               http://www.csuchico.edu/usrv/supported/purchasing.html                     responsibility of my department.
   X                                                                                      X
                       Dean or Administrative Head Signature                                                 Authorized Dept/Unit Head Signature
   FMS/EMHS/INF OR OTHER APPROVAL (if necessary):                                         X
                                                                                                                                                   11/14/2010

				
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Description: California State Tax Extension document sample