Center for Advanced Microstructures & Devices
6980 Jefferson Highway
Baton Rouge, Louisiana 70806
225-578-8887/ 225-578-6954 (Fax)
Form for Campus Machine Shops and Labs
Purchaser Name__________________________
Phone # _______________________________
PI / Supervisor Initials __________
Shop Name ____________________________________
Contact @ Shop Name________________________________
CAMD Account # to be Charged ________________________
Brief Description of Work to be Done:
# of Items:
_______________________
Estimate of Amount _________________
PO # _______________________
Date Order Placed _________________________
Est. Receiving Date _________________________
For Office Use Only:
Order placed by initials: ___________
Account # (to be charged): _______________________________ Date
Received: __________________________________________ Invoice #
______________________________________________ Credit Card
Used Initials: _________
Authorized By: _________________________________
Caryl Boyet (CAMD Purchasing / Accounting Coordinator)