Revised 07/2015
Multi-User Log Exception
Procurement Card Program
Cardholder Information
Cardholder Name:
Date Requested:
Department:
Last 4 Digits of Card:
Reason for Exception
Terms and Conditions of Exception
In order to be granted the ability to share your Procurement Card a log must be retained detailing the use of the
Procurement Card.
Required Information in Log
Name of person checking out card
Date and time the card was checked out
Detailed purchase information
Checked verification that the required documentation was turned in with the card
Date and time the card was checked back in
Cardholder Acknowledgment & Certification of Signature
I hereby acknowledge that an exception has been made for my Procurement Card so that others may use it on
certain occasions. I agree to keep a detailed log of all the transactions of my pcard when used by others. I
understand that I am liable and responsible for all charges made on my pcard. I am also responsible for making sure
that all transactions are reallocated to the appropriate Indexes. I understand that not following these rules will result
in a Violation Notification against myself.
Cardholder Signature
Date
Approving Officials' Signature
Date
Controller
Date