LOS ANGELES MISSION COLLEGE
REVOLVING FUND REIMBURSEMENT REQUEST
NOT TO EXCEED $250
*** I. PRIOR TO PURCHASE APPROVAL
Requested by
Ext.
Activity Supervisor
Date
Supervising Administrator
Date
Date
Destination Office
Account Number
II. INSTRUCTIONS
1. Itemize purchase, unless it is itemized on receipt. Attach separate sheet for additional items if needed.
2. Attach receipt (signed by you), paid invoice(s), or copy of advertisement for payment.
3. Obtain signature of Supervising Administrator on this form.
4. Take items purchased to Receiving Department for certification of receipt.
5. Forward completed form (with attachments) to: BUSINESS OFFICE
QUANTITY
*ITEM
UNIT PRICE
Make Check Payable to:
TOTAL
Subtotal
Sales Tax
Total
Supervising Administrator:
III. CERTIFICATION
Certification that items listed were received at Los Angeles Mission College:
Stock Control Supervisor
I hereby CERTIFY that the item(s) listed above is/are for the use of the
Los Angeles Mission College.
Office of
Print Name
Signature
*For electrical devices only. It is the responsibility of the Purchaser to make sure that the electrical
equipment meets L. A. City code and has approval stamp. See Facilities Manager for details.
Items passed inspection:
Facilities Manager
FOR OFFICE USE ONLY
IV. REIMBURSEMENT APPROVAL
Vice President, Administrative Services:
Check #
College Financial Administrator:
Amount
Date
(LAMC 09/03)
*** REIMBURSEMENT IS NOT GUARANTEED UNLESS PRIOR TO PURCHASE APPROVAL IS OBTAINED!!!
Purpose of Form
The Revolving Cash Fund, authorized by the Board of Trustees under provisions of the Education Code
Section 85410, is used to reimburse college employees who have made cash purchases for the college.
Expenditures are direct charges against the appropriated departmental budget.
THE BOARD OF TRUSTEES RULES FOR THE REVOLVING CASH FUND

The College Financial Administrator shall be custodian for the Fund, and responsible for adherence to
applicable rules and regulations regarding disbursements from the Fund at the college.

The Vice President of Administrative Services or his/her designee shall approve all disbursements.

Disbursement from revolving funds shall be limited to a maximum expenditure of $250; including taxes,
for any one transaction, for small quantities of urgently needed supplies or materials. Multiple common
transactions are not authorized.

The Fund may not be used for salary payments, equipment replacement, or capital outlay
expenditures.

The fund may not be used to pay for credit purchases made in the name of the college. No employee
has the authority to commit the credit of the college in this manner.
UNAUTHORIZED EXPENDITURES
Freight bills, postage, memberships, mileage, convention or travel expenses, hospitality expenses, awards
of any kind, or insurance premiums of any type.
Equipment items, film rental in excess of $10, subscriptions, unless payment is required in advance and
postage unless an emergency.
PURCHASE DOCUMENTATION REQUIREMENTS
Revolving Fund Reimbursement Request document with signature approval from the department head and
college and Vice President of Administration designating authority to make a purchase for the college.
Electrical devices must be inspected and approved by the Facilities Manager. All items purchased must be
inspected and signed as received by the Stock Control Supervisor.
Paid invoices showing detail of the purchase, specifically item description, quantity, price by item, total per
invoice, and the vendor name. Cash register receipts must be supported by an itemized list of the items
included in the purchase. Cash register receipts must have the vendor’s name imprinted on it. The
individual receiving the reimbursement must sign all receipts and invoices.
Purchaser need to certify on the Revolving Fund Reimbursement Request that the purchases were for the
college by completing Section III—Certification.
O:\Bus_Admin\districtFORM\Revolving Fund Reimb Form.doc