Purchasing Card Requisition Form
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1
2PURCHASING CARD REQUISITION FORM
(Recommended Format)
Please see the back of this form for instructions.
Vendor Name: _______________________________
Date:
_____________________
Address:
_______________________________
FEID #: _____________________
_______________________________
Phone #: (_____)______________
Vendor Contact: _______________________________
Org. #
____________________
When calling to get quotes, be sure to verify the address and FEID # (Federal ID Number).
Item
Description *
Qty
Unit
Extended
Price
Total
$
$
$
$
$
$
$
$
$
$
$
$
$
$
Subtotal:
$
Shipping & Handling:
$
TOTAL:
$
* Please note: The description should contain model, part, or catalog number(s) to identify the item(s). When
ordering software, please include the version number, media type and size, and operating system.
Additional Comments: ___________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Initiated by: __________________________ Approved by: ____________________________
Generated: March 12, 2003
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