Purchase Request Form
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1PURCHASE REQUEST FORM
TODAY'S DATE:
REQ. DELIVERY DATE:
PO#______________
DELIVER TO NAME:
ACCOUNT(S) TO CHARGE:
DELIVER TO ADDRESS:
(Room No.)
(Building)
Equipment:
Research:
Date______________
Supplies:
Teaching:
DO NOT WRITE IN THIS BOX
VENDOR NAME:
VENDOR ADDRESS:
(Complete mailing address and division of your vendor)
(City)
(State)
(Zip Code)
VENDOR TELEPHONE:
VENDOR FACSIMILE:
Description and Specifications
Item
Catalog
Quantity
Unit
Extended
Number
(Include quantity per case, pkg., unit size, etc…)
Price
Price
Number
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Order Total
0.00
SPECIAL NOTES:
(instructions pertaining to this purchase, return bids before acceptance, etc.)
Note: All purchase requests with requested delivery dates less than 2 weeks must have emergency letter attached.
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Parent category: Business