Purchase Order Amendment Form

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For Procurement Use Only
ENTRY DATE
ENTERED BY
Purchase Order Amendment Form
Supplier Name:
Purchase Order #:
Date:
    One PO per Form
Requester Name:
Reason for Amendment
Brief Explanation
Adjustment to Existing Purchase Order
Cancel Purchase Order
   Change Budget Information
 Supplier Notified               Yes             No
   Change Existing Item(s)
   Add Additional Item(s)
Change Budget Information
% Changed Comments on Change
Original Budget
Change to Budget
Signature Required for Budget Changes:
NEW COST CENTER MANAGER
Change Item Information
Item #
Description
Quantity Unit Price
Comments on Change
Signature Required for Order Changes:
COST CENTER MANAGER
ORSSP APPROVAL REQUIRED FOR ALL
GRANT RELATED PURCHASES
NOTE: Additional signatures maybe required if revisions to the Purchase Order move the new total into a different expenditure level. 
ORDERS OVER $5,000 REQUIRES ‐ 
ORDERS OVER $100,000 ‐ 
AVP/ASSOC. PROVOST/DEAN/       
CFO/EVP/PROVOST SIGNATURE
HEAD OF ATHLETIC SIGNATURE
ORDERS OVER $50,000 REQUIRES‐ 
ORDERS OVER $1M ‐
    
VP/CIO SIGNATURE   
PRESIDENT SIGNATURE

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