Procurement and ContractServices
P.O.Box425439/BralleyAnnex
Denton,TX762045439
P
:
(940)8983812
F
:
(940) 8983519 Rev:10/16
1. Form to be used along with Departmental Purchase Requisition. It is used for the purchase of
products/services that need to be processed on an emergency basis.
2. Indicate the reason for the emergency purchase, explai
n what the emergency is and/or what caused
the emergency situation.
3. Indicate the type of emergency the financial or operational damage/risk that will occur if needs are
not satisfied immediately.
4. Indicate why the needs were not or could not be anticipated so that products/services could not have
been purchased following standard procedures.
5. Indicate the reason and process used for selecting the vendor (provide supporting documentation)
6. Obtain appropriate authorized signatures.
7. Submit the form and supporting documentation to the Purchasing Office.
NOTE:PriortocommittingaPurchaseOrderfortheproductorservice,thejustificationmustbereviewedand
approvedbytheAVP for Procurementand Contract Servicesor his/her designee.
EmergencyJustification
INSTRUCTIONSFORJUSTIFICATIONFORM
Procurementand Contract Services
P.O.Box425439/BralleyAnnex
Denton,TX762045439
P
:
(940)8983812
F
:
(940) 8983519 Rev:10/16
JustificationforEmergencyPurchase
Req#:______________
PO#: ______________
Thisformhasbeendesignedtoassistfacultyandstaffinprovidinginformationnecessaryintheprocessingof
emergencyrequisitionsfortheprocurementofproducts orservices.Pleasecompleteandforwardtothe
PurchasingOffice.Ifmorespac eisneeded , pleaseattachadditionalpage(s).
PURCHASEINFORMATION
1. Stateth
ereasonfortheemergency purchasebyexplainingwhattheemergencyisandwh atcausedthe
emergencysituation:
2. Statethefactsthatle
adtotheconclusionthatf inancialoroperationaldamageorriskofdamagewilloccur
ifneeds arenotsatisfiedimmed iately (dono tsimplysaythatth ere willbedamageorriskofdamage):
3. Statewh
ytheneedswerenotorcouldnotbeanticipatedsothatgoodsorservicescouldnothavebeen
purchasedfoll owing standardprocedures:
4. Stateth
ereasonandprocessusedforselectingthevendor (Attachallquotes/proposals received
fromothersources,ifapplicable:
Icertifytha t theabove statemen ts aretrueandcorrect, andthatno othermater i a lfactor considerationofferedor
givenhasinfluencedth is recommendationforaneme rgenc yprocurement.
Print/TypeName Print/TypeTitle Department
DepartmentAuthorizedSignature Date TelephoneNumber
PURCHASINGUSEONLY
Reviewedby: Date:
Appro
vedby: Date:
AVP for Procurementand Contract Services(or designee)