CALIFORNIA STATE UNIVERSITY CHICO
FINANCIAL SERVICES
PROCUREMENT AND
CONTRACT SERVICES
KENDALL HALL ROOM 206
CHICO, CA 95929-0244
530-898-5134
www.csuchico.edu/purc
Invoice
PAYEE INFORMATION
Requisition/PO#: Payment Amount:
Date:
Payee: Name:
Address:
City: State: ZIP:
P&CS: Invoice Updated November 2014
AUTHORIZATION
Purchases: I certify that I have personally paid for the items identied above and that upon reimbursement
they become University property. If any items are returned, I will refund the appropriate amount to
the University. Further, if any items are for use at a non-University location, I will complete and obtain
departmental approval on the “Off-Campus Use of State Property” form located at www.csuchico.edu/pm/
forms.shtml
Services: I certify that I have personally provided the services described above on the dates noted and that
prior payment has not been received.
Payee:
I certify the items identied above have been received and are for University related use. Please proceed
with payment to the named individual.
Authorizing Individual:
(must be a higher authority as applicable)
SIGNATURE PRINT NAME DATE
SIGNATURE PRINT NAME DATE
DESCRIPTION OF PURCHASE
Payment is requested for the following items purchased:
DESCRIPTION OF SERVICES
Payment is requested for the following services provided:
Dates of service:
Processing Procedure: Submit completed form to above ofce along with the original itemized receipt(s)
conrming items were paid. Add a comment to the CFS requisition to advise Procurement that this invoice
and receipt(s) are en route.
Reimbursements for purchases may not exceed $1,000. Payment will normally
be made within 30 days of the date the invoice is approved and received.
if campus
payee, please
note campus
ZIP only.
