Purchase Requisition
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1State of West Virginia
WV-35 (Rev. 05/15/06)
Purchasing Division
PURCHASE REQUISITION
Buyer
Requisition Date
Requisition No.
WVFIMS Document #
Agency/Invoice To:
TEAM Code _______
Suggested Vendors:
1.
2.
TEAM Code _______
Agency/Ship To:
3.
Additional Vendors on Reverse Side
PURCHASING DIVISION'S USE ONLY
This Section Only For: Releases, Direct Purchases, Emergency Purchases and Agreements
Commodity Code: ________________________________
Vendor Name and Address:
Instructions:
WVFIMS Vendor #
TEAM Vendor #
Terms
F.O.B.
Item No.
Quantity
Description
Unit Price
Amount
Type of Purchase
Total Estimated Value
Authorized
of this Requisition: _____________________________________________
Signature ___________________________________________________
Title _______________________________________________________
Maximum Budgeted Amount: ____________________________________
Telephone __________________________________________________
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Parent category: Business