Purchase Request Form
Note:  Please fill out, print and return this form to the Purchasing Office.  Should additional pages be required, attach to this form.
This form must be received in the Procurement and Contracting Office on or before April 25, 2008.
 

Date of Request:    School/Department: 

Contact (Name/Phone):

Approval Required (Note:  E-mail approval may be provided)
(e.g. Principal, Division Head, Instruction, Facilities, Consultant Review Panel):

Date of Approval:  

Fund String to be used for purchase (enter complete number and attach e-mail confirmation
if signature not provided above:

Delivery Date Required: 

Description of Purchase: 

What are the most important aspects of the product or service you are looking for?  (Be sure to
identify any constraints such as the need to operate with an existing product or piece of
equipment, certification or other aspects that would limit which products will meet your needs.)

Supporting Needs such as Equipment, Maintenance, Training, etc. (should these items be
 purchased as well):

Suggested Sources of Purchase (if known):

_______________________________________________________________________________
Contracting Officer (To be entered by Procurement and Contracting)

Acquisition Strategy Recommended (Competitive, Blanket, Existing Contract, Sole Source, etc.
 (To be entered by Procurement and Contracting):