OPRPM Form 136
(Rev. 07/2007)
Memorandum
TO:
President, Vice President, Chancellor, or Designee
VIA:
Name of Fiscal Officer
FROM:
Name of Requesting Official
SUBJECT:
Purchase of Meals, Refreshments, and Protocol Items with Special, Revolving and/or
Endowment Funds
The desires to
(Department or Program)
purchase meals, refreshments, and/or protocol items under with funds
(Purchase Order or Contract No.)
derived from the designated Special, Revolving and/or Endowment Fund (
)
(Account/Campus Code)
for
(Identify Function)
COMPLETE THE FOLLOWING AND ATTACH SUPPORTING DOCUMENTATION
(attach additional pages if
necessary):
Description of the items to be purchased:
Justification for the purchase and explanation of how the purchase benefits the University program:
Names of individuals for whom meals, refreshments and protocol items are being provided, if applicable:
Amount of Purchase:
Vendor Name and Address:
Reviewed By:
Signature of Fiscal Officer Date
Approved By:
Signature of President, Vice President, Chancellor or Designee
Date
PRINT
RESET