DEPARTMENT OF MATERIALS REQUISITION FORM
SUPPLIER
Req number
ADDRESS
PO number
ADDRESS
Authorised
ADDRESS
Input by
POSTCODE COUNTRY
Checked/sent
1
2
3
4
5
6
7
8
9
10
11
12
DELIVER TO (check one box ) Delivery.
Hume-Rothery Begbroke No delivery Sub-total
IMPORTANT PRICING INFORMATION
Unit
cost
TotalSupplier ref or cat no. Description (If Equipment please complete location & installation details below)Qty
IMPORTANT PRICING INFORMATION
Have you confirmed up-to-date cost of the items and the delivery charge? (delete as appropriate) TOTAL
University policy requires at least two quotations for individual items costing > £1,000. See departmental website for further information.
Indicate the cost centre number (not description) in the Source of funds box. Requisitions without a number will be returned.
Building
If Yes provide details
Special instructions
Originator Signature Date Originator email address
Authorisation Date Originator phone number
STD, INTERNAL OR OX LTD? EIC CODE (NON-INVENTORY ITEMS ONLY)
GENERAL LEDGER
PROJECTS
If you are purchasing equipment please complete the followingSource of funds
Room No
ORGPROJECT TASK AWARD EXPENDITURE TYPE
NATURAL CODE ACT
NET AMOUNT VAT AMOUNT CODE
ORGNET AMOUNT VAT AMOUNT CODE COST CENTRE
Will additional installation costs be involved?
SOURCE OF FUNDS
Location
Y / N
Y / N
Printed on 15/03/2012