SUNY FARMINGDALE
PURCHASE REQUISITION
VENDOR:
REQUISITION / P.O.#
DATE:
ADDRESS:
STATE CONTR. NO.
GROUP
ATTENTION:
FEDERAL I.D.#
FAX#
TELEPHONE#
AMOUNT
PRICE
UNIT
DESCRIPTION
QUANTITY
ITEM
Person Responsible for Checking Delivery:
Requisitioned By:
TOTAL $
Are Shipping Charges included in Total?
YES
Date Delivery Required:
NO
Dept. Name:
Dept.#
Telephone Extension:
APPROVED BY V.P./OR DESIGNEEAPPROVED BY DEPT. HEAD
Var.
Cost Center
Yr.
Dept.
SUNY ACCOUNT
SUB
OBJECT
(SEE REVERSE SIDE FOR INSTRUCTIONS)
I attest that the above item(s) were purchased at the best possible price for the College and documentation of such is available in the
department.
NAME
TITLE
DATE
1