Fillable Hardwaresoftwarepurchaseapplication

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Hardwaresoftwarepurchaseapplication

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Country of origin: US
File type: PDF

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For use by Office of Information Systems
Approved: Yes No
Arkansas Tech University Hardware/Software Purchase Application
This application must accompany all software or hardware purchase requests with the intent to be used
and/or distributed to university owned devices for the purposes of administrating or educating the
student population. Its purpose is to insure that the requested software or hardware meet all
requirements necessary to be used successfully within our infrastructure and service capabilities and is
within our legal and financial constraints. By completing this form you are acknowledging that you have
done sufficient research to be assured that this software or hardware meets your functional needs.
Requestor Information
Name:
Bldg./Room:
Phone:
Email:
Department:
Complete this section for Software Purchases
Upgrade/Renewal:
Vendor Name:
Software Version:
Software Title:
Purpose:
How many computers (not including student
labs) will use this software?
Which (if any) lab(s)
will use this software?
Is there a contract or agreement required to purchase this software?
Yes No Uncertain
Complete this section for Hardware Purchases
Type of Hardware (any equipment that may require networking or web services, installation or other
technical assistance ex. Kiosk, desktop computer, copier, card swipes, projectors and smartboards)
Will this equipment be used to process credit card transactions?
Yes No Uncertain
Vendor Contact Information
Vendor Name:
Contact Name:
Phone:
Email:
Website:
Price:
Yearly Maintenance or Subscription Fee:
Desired method of payment:
Requisition/Purchase Order
Requisition Number:
Requisition Number is required.
PCard
A copy of this approved form must
accompany your PCard log.
This portion to be used by Office of Information Systems and Purchasing Department only
Comments:
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Hardwaresoftwarepurchaseapplication

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Completed 22 March 2020

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