Corporate Purchasing Card Application
US Bank
Procurement
Procurement Towson University - 8000 York Rd, Towson MD 21252 - 410-704-2171 - towson.edu/procurement
CARDHOLDER NAME:
PHONE:
CARDHOLDER TU ID: EMAIL:
DEPT. NAME:
DEPT. NO.:
EXPENSE ACCOUNT:
DEPT. ADDRESS: CITY: STATE: ZIP:
REQUESTED SINGLE TRANSACTION LIMIT:
$1,000 $2,500 $5,000
REQUESTED MONTHLY SPEND LIMIT:
$1,000 $2,500 $5,000 Other:
PHONE:
EMAIL:
I,__________________________, hereby request a Corporate Purchasing Card. As a Cardholder, I agree to comply with the following terms and conditions
related to use of the card:
1.
I understand that I am being delegated the authority to purchase supplies and services on behalf of Towson University, using the State of Maryland
Corporate Purchasing Card.
2.
I agree that this card will be used for approved purchases only and, further, that I will not charge any personal purchases to this card. All purchases must
be made in accordance with applicable laws, Code of Maryland Regulations (COMAR) or USM Policies and Procedures, and the State of Maryland
Corporate Purchasing Card Program Policy and Procedures Manual.
3.
I agree to return the card immediately upon suspension and/or termination (including retirement) or upon reassignment to another Towson University
Department or Cost Center. Also, I agr
ee to return the card immediately upon request of my supervisor and that disciplinary actions referred to below
would also apply for failure to do so.
4. If the card is lost or stolen, I agree to immediately notify US Bank and the Purchasing Card Program Administrator (PCPA).
5.
I certify that I shall purchase supplies or services in accordance with applicable COMAR or USM Policies and Procedures, State laws, State of Maryland
Corporate Procurement Card Policy and Procedures, and Towson Universi
ty Corporate Procurement Card Policies and Procedures. I certify that, to the
best of my knowledge and belief, all of my statements are true, correct, complete, and made in good faith, and subject to app
licable COMAR or USM
Policies and Procedures, State l
aws, State of Maryland Corporate Purchasing Card Program Policy and Procedures Manual, and Towson University
Corporate Procurement Card Policies and Procedures.
6.
I understand that my failure to follow established procedures may result in disciplinary actions against me, including reimbursement of unauthorized
purchases, loss of leave time, suspension and/or termination of employment, fine, and/or criminal prosecution.
7.
I further acknowledge and certify that I shall be personally responsible for any unauthorized Corporate Purchasing Card purchase. I hereby authorize the
State to deduct from my payroll check and from any other payments to me the amount of such unauthorized purchases made on the
Corporate Purchasing
Card issued to me.
CARDHOLDER SIGNATURE
PRINT
DATE
REVIEWER SIGNATURE
PRINT
DATE
DEPARTMENT HEAD OR CHAIR SIGNATURE
PRINT
DATE
Academic Cardholders Only
DEAN SIGNATURE
PRINT
DATE
DIVISIONAL BUDGET OFFICER SIGNATURE
PRINT
DATE
Do Not Complete This Area
TU FISCAL OFFICER SIGNATURE
PRINT
DATE
TU PCPA SIGNATURE
PRINT
DATE
8000 York Road
Baltimore
MD
21252