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6/16/06
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ACCOUNT NO:
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Address
NAME:
Address
PURCHASE ORDER #:
CHEMISTRY DEPARTMENT PURCHASE REQUISITION FORM
(Person Placing Order)
Vendor Phone
APPROVED:
Vendor Fax
(Director of Project/Course)
Vendor URL
APPROVED:
Catalog #:
(Business Office)
USAGE OF ITEMS REQUESTED:
*ALL ORDERS MUST BE SIGNED AND THE USAGE OF ITEMS BEING REQUESTED LISTED.
PART #
PAGE #
DESCRIPTION OR SPECIFICATIONS
QTY
IF ORDERING CAPITAL EQUIPMENT, WHERE WILL IT BE LOCATED: BLDG.
If purchase exceeds $1,000.00, including freight, please answer 1, 2a, 2b, and 3 below:
1.
Why above vendor recommended as source of supply:
2
a. Why emergency exists:
3.
b. Why requirements not anticipated:
Please list two alternate sources of supply:
a.
b.
Russell Group Purchase Form. Original Form by Guido Verbeck (2003). Form Updated, Improved and Debugged by Jody May, Revision 2006
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