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
Purchases for goods or services made in the name of the University without delegated authority or use of an
authorized purchase/service order/contract may be considered a personal obligation of the person making the
purchase and not an obligation of the University. Submission of this request does not guarantee approval of
payment. Until notication that approval is granted, the purchase is considered the obligation of the individual.
Unauthorized
Purchase Approval
Request
SIGNATURE PRINT NAME DATE
SIGNATURE PRINT NAME DATE
AUTHORIZATION
Requestor:
Dean/Chair/Administrator:
Title:
P&CS: Unauthorized Purchase Approval Request Updated June 2014
DEPARTMENT AND VENDOR INFORMATION
Date: Department:
Requested Vendor:
Requested Item(s)/Service:
Contact: Ext.: Total Amount:
JUSTIFICATION
The following justication information is required before payment will be considered. Attach proof of
delivery or services performed which may be in the form of a packing slip, freight bill or invoice and enter a
purchase requisition into PeopleSoft.
1. The reason why the standard purchasing procedures were not followed:
2. Explain the detailed facts regarding the situation:
3. What steps have been taken to avoid another unauthorized purchase in the same or similar situation?
SIGNATURE PRINT NAME DATE
PROCUREMENT & OTHER CAMPUS APPROVALS
Procurement & Contract Services Approval:
(required on all)
