Revised: March 5,
2020
PROCUREMENT DEPARTMENT
procurement@floridapoly.edu
EXPENSE CARD PROGRAM
Cardholder Profile/Temporary limit increase
Department:
Phone Number:
Fax Number:
CARDHODER'S INFO
Cardholder's First Name:
Cardholder's Last Name:
Cardholder's Mother's Maiden
Name
Employee Id Number:
REQUESTED ACTION
Permanent Increase
Increase Monthly Limit Increase:
Single transaction limit:
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APPROVAL
Cardholder's Signature
Supervisor's Signature
Procurement Official
Signature
E-mail:
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Request date:
Commodities Only
Commodities & Travel*
*Requires travel addendum
Temporary Increase
Increase short-term credit
Start date:
End date:
Request new card
Close Account-complete termination form
Change existing profile
Other:
Justification
(For new requests only):
click to sign
signature
click to edit
click to sign
signature
click to edit
click to sign
signature
click to edit