PURCHASE REQUISITION
INSTRUCTIONS FOR USE OF THIS FORM: Send completed forms with an Electronic Signature to
purchasing@cnr.edu. Be sure to fill in each section or Print out completed forms without an Electronic
Signature. Send completed form with authorized signature to the Purchasing Department. Be sure to
include any relevant quotes, links, and forms along with the requisition.
_______________
DATE
REQUESTED BY:
DELIVERY DATE:
FUND –
ORG
-
ACCT CODE -
ACCT DESCRIPTION
AMOUNT
________
________
___________
_________________
$_______________
APPROVED BY: ____________________________
FUND –
ORG
-
ACCT CODE -
ACCT DESCRIPTION
AMOUNT
________
________
___________
_________________
$_______________
APPROVED BY: ____________________________
UNIT
TOTAL
COMMODITY
QUANTITY COMMODITY DESCRIPTION
CODE
COST
COST
SHIPPING
TOTAL
VENDOR:
DELIVERY DESTINATION:
____________________________________
CHECK ONE:
CENTRAL RECEIVING
DIRECT SHIP
_____________________________________________
_________________________________________________
_____________________________________________
_________________________________________________
_____________________________________________
_________________________________________________
PO#
_________________________________
__________________________________________________
Provide address where order is ultimately to be delivered