PROCUREMENT CARD

PROCUREMENT CARD

PURCHASE JUSTIFICATION

PURCHASE JUSTIFICATION

CARDHOLDER:

DATE:

CARDHOLDER:

DATE:

VENDOR:

VENDOR:

ADDRESS:

ADDRESS:

CITY/STATE:

ZIP CODE:

CITY/STATE:

ZIP CODE:

ITEM

DESCRIPTION

PRICE

TOTAL

ITEM

DESCRIPTION

PRICE

TOTAL

1

1

2

2

3

3

4

4

5

5

6

6

ITEM

ACCOUNT TO BE CHARGED

BAL. OF ACCOUNT

ITEM

ACCOUNT TO BE CHARGED

BAL. OF ACCOUNT

1

1

2

2

3

3

4

4

5

5

6

6

REASON FOR PURCHASE

REASON FOR PURCHASE

ACCOUNT APPROVAL

DATE:

ACCOUNT APPROVAL

DATE:

Accounts Payable Copy (attach receipts and approved statement)

Originator Copy