Marymount Manhattan College
Requisition Form
Purchasing Department
Suggested Supplier (Vendor) Information
Please Issue:
You must provide complete Name and Address
Is this a new vendor?
Phone:
Please submit with this requisition any pertinent
information to be mailed with the check. Label this
documentation: “To be mailed with check”
Purchase Order:
Blanket Purchase Order:
Change Order: (PO# Required)
E-check
Mail check
Fax:
Email:
Purpose for requested materials/services and additional requests:
Budget Code
xx xxxxx xxxxx
Description and Specifications Quantity
Unit
Cost
Total
Date:
Initiated by (sign and type)
Grand Total:
Division/Dept Chair (sign and type)
Vice President’s Approval
President’s Approval (over 25,000)
------------Do Not Write Below this Line – Purchasing Department Use Only-----------------
Comments:
Revised 2/11/10
Date:
Date:
Date:
Estimated Shipping and Handling Costs:
