Fillable Information-tech-purchase-request-form IT Request Approval Form

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Information-tech-purchase-request-form IT Request Approval Form

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PURFR093 – Version 6 – 04/10/2019
INFORMATION TECHNOLOGY
REQUEST / APPROVAL FORM
Purchases of information technology hardware and software must be reviewed and approved by the
Information Technology Services Division, Department Chair/Director and ELT member or designee of the
requesting organization. Completed forms must be returned to Purchasing, MC 7130.
The Lansing Community College Technology Replacement Fund is intended to be used solely to replace
existing information technology.
Approval does not alter or replace the existing Lansing Community College Purchasing Policy.
If you are requesting any of the following hardware items, you do not need to submit this request: Keyboards,
Mice, External hard drives, External DVD/Blu-Ray Drives, Flash Drives, Head Sets, Label Makers.
1. Please provide a brief non-technical description of the goods/services to be acquired. List any special
equipment involved. Please indicate if this is for students/academics or employee use (circle one).
2. Please provide the source of funds (FOAPAL) for the purchase.
3. Please provide the name(s) and contact information of any vendor(s) who can provide the goods/services
and estimated cost of the items to be purchased. Please state if you have communicated with a vendor and
obtained any pricing or if they have assisted in the development of this purchase request in any way.
4. How will you procure the goods and/or services requested:
□ Procurement Card □Requisition □BPO
5. Requesting Department:
6. Vendor Name:
_____________________________________________ ________________
_____________________________________________ ________________
_____________________________________________ ________________
_____________________________________________ ________________
_____________________________________________ ________________
PURFR093 – Version 6 – 04/10/2019
7. For software requests only: You must provide accessibility compliant information per LCC’s Accessibility
Initiative (https://internal.lcc.edu/accessibility/initiative/index.aspx).
Is the software you are requesting accessible? If yes, please provide Voluntary Product Accessibility
Template (VPAT™)* information with this request. If the software is not accessible or you were unable to
determine accessibility, please provide the reason(s) why and provide all information you collected
regarding your accessibility research.
* A Voluntary Product Accessibility Template (VPAT™) is a document that explains how
Information and Communication Technology (ICT) products such as software, hardware,
electronic content, and support documentation meet (conform to) the Revised 508 Standards for
IT accessibility. The following sites have additional information about VPATs:
• https://www.section508.gov/sell/vpat
• https://www.itic.org/policy/accessibility/vpat
Approvals:
Printed Name of Requesting Department Chair/Director Date
Signature of Requesting Department Chair/Director Date
ELT Member or Designee of Requesting Organization Date
ITS Division CIO or Director Date
ITS Information Security Director (not needed for HW requests) Date
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Information-tech-purchase-request-form IT Request Approval Form

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Completed 14 February 2020

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