Purchase
Order
Form
West Virginia Northern Community Purchase Order No.
College
1704 Market Street
PO Date:
Wheeling WV 26003 - 3643
Ship to: WV Northern Community College
Vendor
Name,
Address
and Contact
Information:
Attn:
Vendors FEIN:
PO Date
Purchaser
Item No.
Quantity
Ship Via
F. O. B.
Terms
Net 45
Item Description
Unit Price
THIS ORDER IS
SUBJECT TO THE
GENERAL TERMS
AND CONDITIONS
AS PRESENTED ON
THE NEXT PAGE.
Contract No.
Extended Price
1
2
3
4
5
6
7
8
9
10
11
FY2015 GRANT
FOPAL
Line
1
Fiscal
Year
Department
2016
Fund
Line Item
3100
For Non-Payment Cardholders ONLY
Fixed Asset - Date ________________
Attn: Accounts Payable Office
West Virginia Northern Community College
1704 Market Street
Wheeling, WV 26003-3699
SHIPPING
TOTAL
THIS ORDER IS TAX EXEMPT:
ID Number: 550530182
Business Office please place order
Submit an original invoice with this Purchase Order
Number referenced to:
Encumbered
Amount
Purchaser Authorization
Date
Grant Manager REQUIRED
Date
CPO Approval