CENTRAL STORES REQUISITION
Complete form, print secure signature and fax to 4-2644
(Use “Tab” and/or “Shift-Tab” to move from field to field)
Materiel Management – Central Stores: 4-2478 Req. No.___________________
Department: _______________________________ Budget No: _______________________
Bldg/Room: ________________________________ Authorized: _______________________
Contact: _____________________________ Extension: __________ Date: ______________
TU LOGO ENVELOPES: Order all envelopes from Printing Center.
INTEROFFICE ENVELOPES: Custom printed in format required by University Mail Services.
QTY
U/M
CC#
DESCRIPTION
QTY DEL
UNIT
PRICE*
EXT.
PRICE
BX/100
31024-0065
LARGE, 10 X 13
15.92
BX/500
31024-0068
SMALL, 4 ½ X 10 1/4
25.71
MISCELLANEOUS:
QTY
U/M
CC#
DESCRIPTION
QTY DEL
UNIT
PRICE*
EXT.
PRICE
EA
61515-0190
CLASS RECORD BOOK
3.85
Special Instructions: ___________________________________________________________
FILLED BY:
DATE
DATE
*PRICES SUBJECT TO CHANGE WITHOUT PRIOR NOTICE
8/12/16