Request For Equipment

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REQUEST FOR EQUIPMENT
Date
Requested by:
Department Requisition #
Name:
Deliver to:
Department:
APPROVING ACTION
(Initials)
(Date)
Building and Room #:
Department Chair
THRU:
Appropriate Dean
Associate Vice President
VP
Instructions for Preparations
:
Forward all four copies thru Department Chair to Appropriate Dean to
the Associate Vice President to the Appropriate VP and to the Office of
Business and Finance.
Print or type all information. Use fill-in form or ball point pen.
Hand Carry
Order From:
State Contract
Name of Company:
Address:
Only Vendor
Address:
Request Bids
Quantity
Commodity
Stock
PLEASE SUPPLY ITEMS LISTED BELOW
Unit
Total
Ordered
Number
Number
Price
Description
1
2
3
4
5
6
7
8
9
10
11
12
13
I certify that the items requested on this requisition dated
are required, to continue the normal operation of this office/department during the
current fiscal year and are not being purchased for the purpose of stockpiling for use after the present fiscal year.
Signature
OFFICE OF BUSINESS AND FINANCE USE ONLY
Funds Available:
Yes
No
Purchase Order Issued
Budget Code:
No:
Dated:
FTCC Form E-28
Revised 03/07/2013

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