CLAIM #:
LA JOYA INDEPENDENT SCHOOL DISTRICT
201 EAST EXPRESSWAY 83
LA JOYA, TEXAS 78560
PAYMENT REQUEST
DATE:
VENDOR #
PAYABLE TO:
FOR:
I certify that this is an allowable expenditure from the funding source(s) being utilized. If these are federal/state
funds, this purchase is educationally supplemental to the basic program. Information supporting this expenditure is
contained in the Comprehensive Needs Assessment and the District/Campus Improvement Plan. This purchase meets
goal
and task .
INVOICE NUMBER:
INVOICE DATE:
INVOICE TOTAL:
APPROPRIATION CODE AMOUNT
$
$
$
TOTAL $
All purchases must be made in accordance with State Laws, Federal Laws, School Board Policy and current
administrative procedures. As per local School Board Policy, “all purchase commitments must be made on a properly
drawn and issued purchase order” (CH Local). Furthermore, policy states that “persons making unauthorized
purchases shall assume full responsibility for all such debts” (CH Local).
REQUESTED BY:
PRINCIPAL/DEPARTMENT HEAD
APPROVED BY:
PROGRAM DIRECTOR (IF APPLICABLE)
ASSISTANT SUPERINTENDENT
APPROVED FOR PAYMENT:
EXECUTIVE DIRECTOR FOR FINANCE
FOR ACCOUNTS PAYABLE USE ONLY
DATE CHECK ISSUED:
CHECK NUMBER:
APPROVED BY:
APPROVED BY:
SUPERINTENDENT (IF APPLICABLE)
(FOR AREA)
