Request!for!Purchase!Order!
Description!and!Justification!of!Purchase:!_______________________________________________!
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________!
Were competitive quotes obtained!(recommended for purchases up to $5,000)?! ❑ Yes!!!!! ❑ No!
Was a!bid!completed!by!Purchasing!(required!if!over!$5,000)?! ❑ Yes!!!!!!!❑ No!
Vendors!Participating!in!Bid!(minimum!of!3!required if over $5,000.!Please!attach!
information!!received!from!each!vendor):!_________________________________________________!
_________________________________________________________________________________________________!
Project!Name!and!Number!(if!applicable):!________________________________________________
Standing Purchase Order (more than one payment)?! ❑ Yes!!!!!!!❑ No!
Special Instructions:!________________________________________________________________________
________________________________________________________________________________________________
How would you like the purchase order sent to the vendor?
Email To: ________________________________________________
Send Via Mail
Do Not Send
Purchase!Order Requestor:!________________________________________________________________
Vendor:! ______________________________________________________________________________________!
Amount:!___________________________________!!Request Date: _________________________________!
Funding!Source!(Account!or!Index):!______________________________________________________!
Location/Building: _________________________________________________________________________
Updated: 11/13/2017