PURCHASE REQUISITION
PR LOG NO. _______________
MONTANA STATE UNIVERSITY
PD-1 Rev 20141013
Paper Document: Send one signed original or PDF and email all specifications to purchase@montana.edu – Requestor should keep a copy
Electronic Document: Email Requisition, Supporting Documentation and Approvals to purchase@montana.edu
Requestors contact info (name, phone, email):__________________________________________________________
BILL TO:
NOTE: THIS IS NOT AN ORDER
SHIP TO:
ATTN:
1
TEL.#:
ATTN:
New Procurement of
Goods or Services
Please choose one (1) of the
following options:
TEL.#:
Renewal of Purchase Order (PO)
or Contract
PO or Contract Number:
Change in Funding or
Adjustment to Funds
PO or Contract Number:
2 GOODS/SERVICES BEING REQUESTED:
CAPITAL ITEM
Yes/ No
NO.
DESCRIPTION, SIZE AND FULL DETAIL
(Attach additional pages as needed for requirements)
PD-14 Brand and Sole Source Justification
If you have specified a BRAND NAME, complete Brand Name
Justification Form (PD-13). If there is only ONE SUPPLIER for
the product or service, complete Sole Source Justification form
(PD-14).
MFG. &
CAT. NO.
QTY
UNIT OF
MEASURE
UNIT COST
Requisition Date:
Estimated initial purchase price
Required Delivery Date:
Estimated Total Contract Value
(for potential entire term)
TOTAL
3 SUPPORTING DOCUMENTATION: Check all that apply. Please send an electronic version of paperwork to purchase@montana.edu
PD-13 Brand Name Justification
PARR – Trade-In
PD-14 Sole Source Justification
SOURCE: (this information will be used to encumber funds to be used for payment of the Purchase Order or Contract – attach
4 FUNDING
additional sheets as necessary)
Index Number
Org Number
Acct Code
Split % or $
Index Number
Org Number
Acct Code
Split % or $
5 SUGGESTED SUPPLIER(S): (List three if possible.
5
Fiscal Year
ATTN:
STATE:
ZIP CODE:
FAX #:
EMAIL:
2. NAME:
ADDRESS:
CITY:
TELEPHONE #:
3. NAME:
ADDRESS:
CITY:
TELEPHONE #:
Fiscal Year
If Sole Source and PD-14 has been completed list the sole source supplier)
1. NAME:
ADDRESS:
CITY:
TELEPHONE #:
Federal Funds
Yes
No
Federal Funds
Yes
No
ATTN:
STATE
ZIP CODE:
FAX #:
EMAIL:
ATTN:
STATE:
ZIP CODE:
FAX #:
EMAIL:
FUNDING APPROVAL:
I hereby certify that the items specified on this Requisition were absolutely necessary; that there is proper authority of law and sufficient balance in
the index indicated above for this purchase; and this purchase will not result in any request for additional funds.
Required Signatures:
Printed Name:
Signature:
Date:
Requestor/PI
Department Head
College Dean/Director
OSP Administration
(OSP Funded Only)
Vice President
(All Fund Types Except OSP)
These instructions are provided for assistance only and
should not be submitted with purchase requisition.
PURCHASE REQUISITION INSTRUCTIONS
Requestor’s Contact Info: Provide name, phone number, and email of person submitting this requisition.
Bill To: Provide complete information, including name and phone number of billing contact person.
Ship To: Provide complete physical address and any special instructions for where you want your items shipped. Include
name and phone number of contact person who will be receiving your goods.
Type of Requisition: Check the appropriate box to indicate the reason for this requisition.
 If you are adding money or extending a Contract please provide a revised statement of work justifying the cost
increase or the extension.
GOODS/SERVICES BEING REQUESTED:
 Capital Item: An item that costs $5,000 or more and has a life expectancy of greater than 1 year
 Item #: Provide a line number for each item being purchased; if an item consists of a group or package of items, this







would be a single item number.
Description: The name of the commodity and specification details can be provided in the space available on the
Requisition form or attached in a Word document. Include name, size (dimensions); color; physical requirements, as well
as any other specifications required for a vendor to provide a complete quote. If the requisition is being submitted for a
renewal or extension of a Purchase Order or Contract, provide the time period, description of services to be provided
Mfg & Catalog Number; Quantity; Unit of Measure; Unit Cost; Unit Total: For each item specify this information.
Unit of Measure, for example, may be “year”, “month”, “lot”, “system”, “each”, etc.
Estimated Initial Purchase Price: The estimated total is the total for this purchase request.
Total Contract Value: Is the Total Contract Value (TCV) for this product or service. For example if it is a multiple year
contract, the TCV would be a sum of all the Contract Terms.
Requisition Date: Show date Requisition was submitted for approval signatures.
Date Required: Provide a reasonable date you would like the item to be delivered. For services, use the date you would
like service to begin. Please note that purchases are governed by the State Procurement Bureau and proper purchasing
procedures must be followed. The time required for your requisition to be processed will vary.
Additional Requirements: Consider any additional requirements to support a successful selection of the responsible,
responsive, lowest bidder. Things to consider include Warranties, Installation, Training, Maintenance and Support, Special
Delivery Instructions, Documentation (Owner/Operator Manuals), References, Demonstrations, Samples, Parts, etc.
SUPPORTING DOCUMENTATION:
If any of the following apply, the completed signed forms must accompany the Requisition when submitted, check
the appropriate boxes for all that are included:
 Brand Justification (PD-13): Only one brand meets the requirement however this brand may be available from more
than one supplier.

Sole Source Justification (PD-14): Only one supplier is available to provide the supply or service. The goods cannot be
obtained through an alternative source.

Property Asset Removal Request (PARR): Required for Trade-In of MSU Property.
http://www.montana.edu/wwwbu/prop_forms.html
FUNDING SOURCE:
 Index #(s); Org #; Acct Code(s); Split: Specify this information identifying any funding allocations between accounts. If


additional splits are required attach details on an attachment to the Purchase Requisition.
Federal Funds: Are federal funds used to pay for this purchase?
Fiscal Year Allocation: Specify from which fiscal year the funds will be used to pay for this purchase.
SUGGESTED SUPPLIER(S):
Provide complete contact information for at least three vendors or preferred suppliers, if available. If it is a sole source
purchase and you have completed a PD-14 provide the vendor information for the sole source vendor.
FUNDING APPROVAL:
Route for required approval signatures according to schedule in Appendix E of the Purchasing Procedures Manual.
Submission Instructions:
The Requisition form must be completely filled in, including complete description and specifications. If additional space is
needed for the Specifications, please attach a second page. Requisitions may not be used for commodities or services that
have already been received. Call Procurement Services to discuss at x3211.
1. Electronic Submittals
a. Type the names of the individuals who are required to approve the requisition in the printed name box of the funding
approval section.
b. Email all the requisition (PDF with signatures) and all supporting documentation to purchase@montana.edu
c. Attach signed PDF copies of all written quotations, if available. Quotations should only be obtained if it is a sole source
purchase.
2.
Paper Submittals
a.
b.
c.
d.
Submit signed original Requisition to Procurement Services.
Attach original versions of completed and signed Supporting Forms to the Requisition.
Email required specifications to Procurement Services at purchase@montana.edu as a Word attachment.
Attach signed original copies of all written quotations, if available. Quotations should only be obtained if it is a sole
source purchase.