PURCHASE ORDER REQUISITION
(For purchases over $2,000)
Today’s Date:_________________________ Date needed:_________________________
Check One:
__ STANDARD __ BLANKET __ CONFIRMING (for emergencies)
From: to:
Requesting Department: Suggested Vendor:
Ship to: (if different from above)
Account and line item#:
Quotations Received:
Vendor Contact Phone Service Date Price
1.____________________________________________________________________________
2. ________________________________________________________________________
3. ________________________________________________________________________
(Attach any additional information stating items, source, quantity, price discounts, shipping, delivery
time and contact information).
If less than three quotes were obtained, or if this is a confirming service order, please explain:
Department Head or Designee
Quantity
Weight/
Measure
Item Number & Description
Unit Price
Total
Price