PURCHASING CARD and OUT-OF-POCKET (OOP) EXPENSE ACCOUNT APPLICATION
I AM APPLYING FOR: _____ P-CARD _____ OUT-OF-POCKET (OOP) ACCOUNT ONLY _____ CHANGE TO AN EXISTING P-CARD OR OOP ACCOUNT
SECTION 1 – APPLICANT INFORMATION (TO BE COMPLETED BY THE APPLICANT)
NAME AS IT WILL APPEAR ON THE
C
ARD OR OOP ACCOUNT
(A MAXIMUM OF 24 CHARACTERS & SPACES) __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
EMPLOYEE IDENTIFICATION NUMBER __________________________________
DEPARTMENT, SCHOOL, TEACHING SITE ________________________________________________________________________
BUSINESS MAILING ADDRESS ________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
EMAIL ADDRESS __________________________________
BUSINESS TELEPHONE NUMBER __________________________________
SUPERVISORS NAME ________________________________________________________________________
SUPERVISORS EMAIL ADDRESS __________________________________
BUDGET AUTHORITYS NAME ________________________________________________________________________
BUDGET AUTHORITYS EMAIL ADDRESS __________________________________
SECTION 2 – SPENDING INFORMATION (TO BE COMPLETED BY THE BUDGET AUTHORITY)
CARD TYPE - SELECT ONLY ONE GGU 1 ____ GGU 2 ____ GGU3 ____ GGU4 ____ GGU5 ____ GGU6 ____
GGU1 USED FOR ROUTINE PURCHASES SUCH AS … OFFICE SUPPLIES, COPY JOBS, AND CATERING.
GGU2 INCLUDES GGU1 TRANSACTIONS … PLUS TRAVEL, HOTEL AND AIRFARE.
GGU3 INCLUDES GGU1 TRANSACTIONS … PLUS UTILITIES, FACILITY REPAIR, CLEANING AND MAINTENANCE.
GGU4 INCLUDES GGU3 TRANSACTIONS … PLUS ENTERTAINMENT, STAFFING, TRAVEL, HOTEL AND AIRFARE.
GGU5 NO MERCHANT RESTRICTIONS.
GGU6 PROJECT CARD
MONTHLY CARD LIMIT ( DOLLAR AMOUNT) $ 500.00 OR _______________
DAILY LIMIT (DOLLAR AMOUNT) $ 500.00 OR _______________
TRANSACTION LIMIT (DOLLAR AMOUNT) $ 500.00 OR _______________
LIST THE GGU ACCOUNT CODES (ORG KEY NUMBERS ONLY) THE CARDHOLDER MAY CHARGE TO:
___________________, ___________________, ___________________, ___________________, ______________________
NOTE: THE ANNUAL CREDIT LIMIT (THE MONTHLY CARD LIMIT X 12 FOR ALL ISSUED CARDS) CANNOT EXCEED THE TOTAL ANNUAL BUDGET FOR THE
ACCOUNTS LISTED.
SECTION 3 – CARD HOLDER BANKING INFORMATION – OPTIONAL (TO BE COMPLETED BY THE APPLICANT ON-LINE)
U
PON RECEIPT OF YOUR CARD, YOU WILL BE REQUIRED TO ACTIVATE YOUR CARD AND COMMERCIAL ELECTRONIC OFFICE (CEO) ACCOUNT. AS PART OF THIS
PROCESS YOU WILL BE ABLE TO MODIFY YOUR PERSONAL PROFILE INFORMATION
. THIS PROCESS WILL ALLOW YOU TO LINK YOUR P-CARD TO YOUR PERSONAL
CHECKING (DDA) ACCOUNT OR SAVINGS (SAV) ACCOUNT. THIS IS REQURIED FOR REIMBURSEMENT OF OUT-OF-POCKET EXPENSES; AND IF YOU MAKE ANY
PERSONAL CHARGES ON THE CARD
, GGU WILL AUTOMATICALLY DEBIT YOUR PERSONAL ACCOUNT FOR ANY FUNDS OWED TO GGU.
SECTION 4 – TERMS-AND-CONDITIONS FOR USING THE P-CARD (READ AND SIGN)
The Purchasing Card (P-Card) is issued directly by Wells Fargo Bank (WFB) in accordance with their commercial credit requirements.
The Business Services & Facilities Department (BSF) serves as the P-Card Office for the university. BSF will issue the P-Card, and will
notify you in writing if a card cannot be issued to you.
The P-Card is provided for your use when performing official university business. It should not be used for personal transactions.
If you need to be reimbursed for any out-of-pocket expense, or if you use the P-Card for any non-business transaction, then you must
link your P-Card and/or OOP Account to your personal bank account (checking or savings).
This information will be used to electronically credit your account for any funds owed to you by GGU, or to electronically debit
any funds from your account that you may owe the university.
Your personal account information will be safeguarded, and it will not be shared with any other GGU organization or external
agency except for WFB.
If you do not want to provide your personal bank account information, then you cannot be reimbursed for any out-of-pocket
expense, nor can you use the P-Card for any non-business transaction.
You will receive an electronic statement from Wells Fargo Bank on/or about the 20
th
of each month.
An email message will be sent notifying you that your statement is available. You will have three days to reconcile the
statement and submit all required receipts to Accounts Payable (AP).
If you have not completed the reconciliation within this timeframe, you will receive a reminder message and you then have a
three-day “grace” period to completion the reconciliation process. Failure to comply within the allowable timeframe will result
in your charge privileges being temporarily suspended until the reconciliation has been completed and approved.
Repeated failure to reconcile your monthly statement on time will result in your P-Card being permanently revoked and
possibly other disciplinary action.
The P-Card Administrators will routinely review the status of all card accounts to include the transaction details, payment history and
other related information.
Please route all P-Card Applications and requests for changes to previously issued cards to your Budget Authority. S/he must approve
all applications and change requests
The P-Card must be returned to BSF for failure to comply with the program terms-and-conditions, or at the discretion of your Budget
Authority, or when you change positions/departments, or when you leave the employ of the university. The P-Card must be
safeguarded at all times. Lost or stolen cards must be reported immediately to BSF and WFB.
I AUTHORIZE THE GGU P-CARD OFFICE TO PROCESS THIS APPLICATION AND TO ISSUE THE ABOVE NAMED EMPLOYEE
A P-CARD OR OOP ACCOUNT IN ACCORDANCE WITH THE GGU-WFB PROGRAM GUIDELINES.
______________________________________________________ __________________________________________________
SUPERVISORS NAME (PLEASE PRINT) TITLE
______________________________________________________ __________________________________________________
SIGNATURE DATE
______________________________________________________ __________________________________________________
BUDGET AUTHORITYS NAME (PLEASE PRINT) TITLE
______________________________________________________ __________________________________________________
SIGNATURE DATE
BY SIGNING THIS APPLICATION, I AM APPLYING FOR A GGU-WFB PURCHASING CARD OR AN OOP ACCOUNT. I
UNDERSTAND THE TERMS-AND-CONDITIONS AS STATED ABOVE, AND WILL COMPLY WITH THESE REQUIREMENTS. I
ALSO AUTHORIZE THE GGU P-CARD PROGRAM OFFICE TO PROVIDE MY NAME, HOME ADDRESS, HOME AND WORK
TELEPHONE NUMBERS, EMPLOYEE NUMBER, AND PERSONAL BANKING INFORMATION TO WFB AS REQUIRED.
______________________________________________________ __________________________________________________
APPLICANTS NAME (PLEASE PRINT) TITLE
_____________________________________________________ __________________________________________________
SIGNATURE DATE
SEND THE COMPLETED APPLICATION TO BSF, ATTN: P-CARD PROGRAM OFFICE.
Revised: June 20, 2003