Blanket Purchase Order Requisition

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BLANKET PURCHASE ORDER REQUISITION (BPOR)
DATE TODAY
INITIATING DEPARTMENT
SUGGESTED SUPPLIER
CURRENCY:
CANADIAN
US $
Other - specify __________
SHIP GOODS TO:
Default - Central Receiving, 10 King St, Sackville
If Alternate Location, Identify Bldg:________________________
Goods to be Picked up at Supplier’s Address
SERVICES PERFORMED AT:
S
The
upplier’s Address
On Campus, Identify Building:____________________________
TEL
FAX
MEANS OF SHIPMENT TO BE SELECTED BY
COST OF SHIPMENT
PURCHASING
SUPPLIER
NOT INCLUDED IN PRICES
INCLUDED IN PRICES
PO TYPE: (PLEASE COMPLETE)
G
L
J
A
R
OODS ONLY
ABOUR ONLY
ANITORIAL SERVICE
GOODS
ND LABOUR
ENTED EQPMT WITH OPERATO
TO REQUEST STANDING PURCHASE ORDER or TO CONFIRM AGREEMENT for SERVICES,
MAINTENANCE OR SOFTWARE CONTRACTS
To supply or release of goods or services, maintenance agreements, or software licensing under University Terms and
Conditions.
Description of Goods or Services to be Supplied:
The Department Head or Grantee confirms that the following Person(s) listed below are approved to request supply directly from
the supplier under this agreement:
Show names or attach list: __________________________________________________________________________
_________________________________________________________________________________________________
Related information: Previous BPO #
______________
Supplier Maintenance Agreement or Contract attached
YES
NO
MtA Professional Services Agreement attached
YES
NO
Agreement Begins:
_____ / _________ / 200__
Agreement Ends: _____ / April / 200__
(Day)
(Month)
(Year)
(Day)
(Year)
0.00
0.00
Net $ _____________ plus HST @ 15% $ ____________
=
$ ___________________
( Net $ = Net $ x # of months)
13
DEPARTMENT HEAD/GRANTEE
BUDGET ACCOUNT NUMBER
AMOUNT
DEAN OR VP
-
-
-
PURCHASING
-
-
-
FINANCIAL SERVICES
TAX CODE
PO #
YES
NO
Not Required
WHSCC CERTIFICATE:
S
G
L
J
A
R
PO TYPE
WHSCC EXP DATE:

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