8H007 Request to Purchase

For Business Officer's Use Only:

Link to Document Journal

Date:

Enter Form Preparer's Name*

Grad Student/Other Form Preparer's Name

Enter Form Preparer's Email*

Please Verify Email

PI Information:

Note: This purchase will be charged to is used in the approval process in a conditional branch and so MUST be required.

This purchase will be charged to:*

Other account (grant, startup, salary savings, etc...)Department AccountStudent Group Account

Student Group Account*

BMES (Biomedical Engineering Society)EMBS (Engineering in Medicine & Biology Society)SFB (Society for Biomaterials)Other

Other Student Group Account*

Are you charging against faculty salary savings, reimbursement funds or start up funds?

YesNo

Are you the PI/responsible person for approving the charges on this account?

YesNo

This purchase is on a department account. Is the purchase for you?

YesNo

Who is the PI/Faculty approver?

Current Approval Flow

PI Email*

Please Verify Email

Chair Approval

Purchases on Dept Account

Business Office Email

example@example.com

Is this a request for an urgent purchase or reimbursement (purchase already been made)?*

Reason why this order is urgent/preapproval wasn't obtained.

Please provide the business justification for this order that defines how this purchase will benefit your research, the department and/or UK.*

Vendor/Reimbursee*

Would you like to enter the Vendor Contact Information?

YesNo

Vendor/Reimbursee Contact Info (optional)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Customer Rep Contact Info:

Delivery Type

The following vendors are SRM vendors and should be considered first before using other vendors: Grainger, Sigma, Dell, CDW, Fisher, Thermo-Fisher, VWR, and Office Depot.

Account #*

Account #

Grant #*

Request to Purchase

	Description of Item	Part #	Qty	Unit	Individual Item Amount	Total Item Cost	Expense Type
Item #1
Item #2
Item #3
Item #4
Item #5
Item #6
Item #7
Item #8
Item #9
Item #10

Total

Is the Total amount above equal to the amount which you are requesting? If not, please make appropriate adjustments.*

The amount above is equal to the amount I am requesting.

Enter web link, cart, etc....

Attach Documents, if needed. Note: If requesting a reimbursement, please attach the Employee Expense Reimbursement Form (link below).

Browse Files

Employee Expense Reimbursement Form

UPS Shipment Request Form BME

Software & Subscription Licensing

JV #

Check Transmittal

Business Office approval is to ensure that all transactions are:

• authorized in accordance with the established approval authority,
• in compliance with University policies and procedures,
• allowable within the grant/contract budgets and/or the account being charged,
• recorded in the correct account, g/l, and cost object,
• recorded in a timely manner to the correct accounting period

Expiration Policy

All approved Request to Purchase JotForms will have an expiration date 30 days from the time of Business Office approval.

Failure to purchase items described in form may result in a request from Business Office for resubmission of a new JotForm.

8H007 Biomedical Engr- Request to Purchase