Fillable Sample Form 56 printable pdf download

Sample Form 56

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OPRPM Form 56

(Rev. 01/2004)

Memorandum

TO:

Cindy Yamamoto

Name of Fiscal Officer

Francine Ching

FROM:

Name of Principal Investigator, Department Head, Administrator

SUBJECT:

Purchase of Meals and Refreshments (APM, Section A8.265)

Student Life

The

(Department or Program)

Requisition #10000

desires to purchase meals and/or refreshments under

(Purchase Order or Contract No.)

3326553

with funds derived from

(Grant, Contract, Fees, and Title)

Name of Event: WELCOME BACK WEEK EVENTS (HELD ON 01/13/14 & 01/14/14

for

(Identify Function)

Check appropriate block and attach supporting documentation:

Tuition or fees collected specifically include the cost of meals and/or

refreshments.

Legislative appropriations, resolutions or expression (e.g. Committee

reports) specifically allow expenditures for meals and/or refreshments.

The terms and conditions of a grant or contract specifically provide for

payment of meals and/or refreshments.

The President, Vice Presidents or Chancellors sponsor and present an

employee retirement recognition ceremony, for which such cost shall be no

less than $6.00 and no more than $15.00 per person.

Reviewed and Approved by:

Signature of Department Head

Date

Signature of Fiscal Officer

Date

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Sample Form 56

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