PSCS Requisition

VENDOR INFORMATION

Provide detailed information
Vendor Name, Address, Phone, Fax or URL Address*
Upload any information you cannot include in this form or other related information

Upload a File

Cancelof
ITEM #1
Item #1 Product/Item #, and/or Description*
Item #1 PER ITEM Cost*
Item #1 Quantity*
Item #1 SHIPPING Cost (If more items are added from same vendor, include TOTAL Shipping charge HERE)*
TOTAL OF Item #1 (Including ALL Shipping)
Do you have a second item FROM THE SAME VENDOR to request?*

YESNO

ITEM #6 or more (Same Vendor)
For the sixth or more item(s), list the specific information here, including product #/description, per item cost, quantity, and total cost for each item*
Total cost of above items (Items #6 or more)*

To receive a copy of the submitted form, include your email address (The emailed copy is NOT an approval)
Today's Date*

MonthDayYear
Calculator for YOUR use only - will not change numbers.
TOTAL COST OF ALL ITEMS REQUESTED (Including Shipping)
CONFIRM the above TOTAL COST listed above is ACCURATE and TYPE INITIALS HERE*
Should be Empty:

VENDOR INFORMATION