College Of Pharmacy Purchase Order Form
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College of Pharmacy
PURCHASE ORDER FORM
Account Number: _________________________
Quote:__________________
Account Name: ___________________________
Date: ____________
Date Needed: ____________
VENDOR INFORMATION
Vendor Name: _______________________________
ROUTINE
Generally delivered within two weeks.
Address: ____________________________________
EMERGENCY
City: _________________________
If needed before two weeks.
State/Province: ________________
Zip/Postal Code: ______________
Deliver To
Phone Number: ______________________
Bldg # _____ Room # _____ Lab #_____
Fax Number: _________________________
Person placing the order _________________________________
Item #
Description
Quantity
Unit Price
Amount
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
TOTAL
$0.00
Purpose of Purchase: ____________________________________________________________
______________________________________________________________________________
Requested By: ________________________________________
Authorized By: ________________________________________
The items requested above are for official University business.
Note: Department/Unit Administrative Staff will make a determination about the mode of purchase
(E‐purchase or P‐card).
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Parent category: Business