Purchase Request Form
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PURCHASE REQUEST FORM
Date
Req#_________
PO# __________
Organization Information
Vendor/FSU Dept Information
Organization’s Name
Vendor’s Name
Organization’s Budget Number
Address
Individual Initiating Request
Telephone/Fax
Telephone Number
Federal Employee Identification No/SS#
The type of funds being used: A&S
Self-Generated
Budget Category: Food
Clothing/Awards
Expense
OCO
Type of Purchase: Blanket
Line Item
OCO
Interdepartmental
If this is a blanket purchase, complete the following:
Type of items being purchased:
Purchase dates: From
to
Who will be picking up items from the store?
TOTAL BLANKET AMOUNT $
(Purchases Cannot Exceed this amount)
Line Item, Interdepartmental, or OCO:
Line #
Quantity
Description
Unit Price
Total item
price
Attach any vendor quotes and/or additional sheet(s) if necessary
TOTAL COST OF PURCHASE
$
Will items be picked-up from local store or delivered?
(If delivered, items will be shipped to Oglesby Union A205; exception of COGS, LAW, Music, and WVFS
If purchasing item(s) are for recurring use, where will they be stored?
Signature of staff person responsible for OCO item: __________________________________
EVENT INFORMATION:
Are items being purchased for an event?
Anticipated Attendance
If yes, what event? (Please attach event flyer) If no, what purpose?
Date/Time of Event, (if applicable)
Location of Event
Will information regarding this event be circulated:
yes
No
How?
Is this event open and free to all FSU students?
Yes
No
ATTACH EVENT FLYER
Will there be a charge for Non-FSU students to attend? Yes
no
How Much? $_______________
I
certify that the second authorized signature
has reviewed and approves this
purchase request. I, also, realize that any falsification of this form constitutes a violation of
the Student Conduct Code as well as a possible violation of law.
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Parent category: Business