PSV Helpdesk

PSV Purchase Request Form

Modified on: Wed, 14 Jun, 2017 7:14 AM

PSV PURCHASE REQUEST FORM

Requestor:Complete Purchase Request Form and attach all supporting documentation. Email completed Purchase Request Form and attachments to Yan Huang([email protected]) for processing.

Requestor's Name:

Phone No:

PSV Cost Center for Purchase:

Item(s)/Service to be Purchased:

Provide detailed description(s)

Justification for Request:

Method of Payment:

Are there enclosures to be attached to payment?

All checks will be mailed directly to Payee

Vendor/Payee Information

(name)

(website or address)

Tax ID# (if applicable):

Custumer ID or Order # (if applicable):

ORDER DETAILS

Item #

Description

Quantity

Cost per Unit

Cost Center

Estimated Cost

$0.00

$0.00

$0.00

$0.00

Shipping and Handling (If applicable)

$0.00

Total Estimated Cost of Purchase:

$0.00

SHIPPING/DELIVERY DETAILS

Method of Shipping:

Point of Contact for Delivery:

Phone Number:

Delivery Address:

NOTE: Attach all supporting documentation to the Purchase Request Form when submitting for review/approval (ie/ invoices, price quotes, printout from website, etc).All approvals must be obtained prior to items being purchased or payment being completed. Incomplete requests will not be processed.

APPROVAL SIGNATURES

Administrator

Date

Director of Finance

Date

Chief Operating Officer

Date

(required for purchase requests exceeding $1,000.00)

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