Fillable UW-Whitewater For Procurement Use Only Purchase Requisition OVER (University of Wisconsin - Whitewater)

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UW-Whitewater For Procurement Use Only Purchase Requisition OVER (University of Wisconsin - Whitewater)

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UW-Whitewater
Purchase Requisition OVER $5,000.00
Tax Exempt No. ES40706
Date:
Vendor:
Name:
Attn:
Address:
City, State, Zip:
Phone:
Fax:
E-mail:
Requestor:
Name:
Phone:
Deliver to:
Dept:
Building, Room:
Delivery Contact:
Name:
Phone:
Bill to:
Accounting Information:
Fund Program Organization Project Account Amount Authorized Signature
Total:
Invoice Terms
Shipping Charges:
Items to Order:
Qty Unit Catalog Number & Item Description Unit Price Ext Total
Total:
Comments / Instructions:
For Procurement Use Only
Purchase Order #
Category
Reference
Print, sign, and send completed form with attachments to procurement. Save a copy for your records!
11/12/2010
UW-Whitewater
800 W. Main St
Whitewater, WI 53190
UW-Whitewater
P.O. Box 296
Whitewater, WI 53190
Total:
$0.00
Net 30
Pre-Pay & Add
Included in Price
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
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UW-Whitewater For Procurement Use Only Purchase Requisition OVER (University of Wisconsin - Whitewater)

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Completed 31 August 2020

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