PURCHASE
REQUISITION
PROCARD:
Scorsolini
DATE:
/
/
PO#:
REQ.#:
TOTAL: $
Masciocchi
Graziola
Mileski
Pallanti
Vanberg
Slogoff
ACCT #:
REQUESTED BY:
PROJECT TO BE CHARGED:
Name
AUTHORIZATION:
Phone
VENDOR: Name & Address
SHIP TO:
CATALOG/MODEL #
NEED-BY DATE:
DRL- Math
Fed X Delivery
DRL- P&A
DRL- SAS Computing
LRSM
DRL- Business Office
EES/IES
SASFOS
Supplies
OTHER
Red Lodge
Service
COMPLETE ITEM
/
/
Default is 1 week
TYPE OF REQUEST:
QTY
Equipment
UNIT
UNIT PRICE
TOTAL PRICE
1
2
3
4
5
6
7
8
9
10
FOR EQUIPMENT ORDERS (all fields MUST be completed):
CUSTODIAN:
LOCATION of EQUIPMENT:
Name
Phone
Name
Phone
TAG CONTACT:
or
Room/Bldg/Mail Code
Off-Campus Location
ITEM on APPROVED LIST:
Form must be filled out COMPLETELY. Please remember: IF WE CAN’T READ IT, WE CAN’T PROCESS IT!!
Updated: April 8, 2003