Blanket Independent Contractor Agreement by gah17860

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									    CALS PURCHASE ORDER REQUEST FORM                                                                     SUBMISSION INSTRUCTIONS:
CALS FINANCIAL BUSINESS SERVICES CENTER                                            Campus mail/hand deliver:          CALS BSC 409 College Ave. 3rd floor
Attachments included (if required):                                               Fax:                                               254-2790
                                          Sole Source (over $10K if not preferred Email:                             calsbsc-procuregeneral@cornell.edu
            Quote                         vendor)
                                                                                  If there are any questions concerning this form please contact customer service
            Contract/Agreement            Independent Contractor                  via email calsbsc-custsrvc@cornell.edu or by phone at 254-4BSC


Order may be purchased from:                                Charge to following account:
Vendor:
                                                                    dept#             acct.           obj.          prj.        duo
Address:
                                                            Ordered by:
City:             State:         Zip Code:                  Account owner signature (PI, dept. rep., etc.)
Vendor Phone#                    Fax#:                      DBA/FRS approval, if required
Date:    January 6, 2011                                    All equipment: (signature of chair or administrator required)


          CATALOG NO., ARTICLES AND DESCRIPTION                                      QTY.           UOM             UNIT PRICE            TOTAL PRICE
                                                                                                                                                0
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                                                                                                                                                0
                                                                                                                                                0
                                                                                                                                                0
                                                                                                                                                0
Describe business purpose for payment in detail below:                                                                                          0
                                                                                                                                                0
                                                                                                                                                0
                                                                                                                                                0
                                                                     Total:                                                                     0
Ship to:                                  Special ordering instructions or notes to BSC:                                              BSC USE ONLY
ADDRESS:                                                                                                                    Req#:
                                                                                                                            PO#:
ATTN:                                                                                                                       Notes:

								
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