Procedure No. 902.2 - Supplement 1
Area: Facilities Management

Adopted: 04/23/96
Revisions Approved:

Description: Purchase Requisition Backcharge

---

                                                   Purchase Order No.__________
                      PURCHASE REQUISITION          
Date____________ Budget Code__________   Vendor________________________________
Department____________________________   Address_______________________________
Originator____________________________   City__________________________________
Dept. Head____________________________   Deliver to____________________________
Division Head_________________________    Services    _____
                                          Supplies    _____   Check one
President_____________________________    Equipment   _____   
Dean__________________________________

Qty.	Catalog Number	_______Description_______	Unit Price	Amount
.	.	.	$	$
.	.	.	$	$
.	.	.	$	$
.	.	.	$	$
.	.	.	$	$
.	.	.	$	$
.	.	.	$	$
.	.	.	$	$

Budget Restrictions___________________ ________________________________________
                                               DIRECTOR OF BUSINESS SERVICES
For Purchasing Department Use Only     
___Confirmation     Quotation________________  _____Phone Order
___Purchase Order   Bid No.__________________ _________________________________
                                                      Purchasing Department
   WHITE-Purchasing Department    YELLOW-Department Head  PINK-Originator

Procedures:

Authorization of Backcharge Supplement 2, No. 902.2
Prior Approvals No. 902.3
Real Property Records No. 902.4
New Construction (New Facilities, Additions or Major Alterations) No. 902.5
New Construction (New Facilities, Additions or Major Alterations)Supplement 1, No. 902.5
Safety and Emergency Rules No. 902.6
Community Use of College Facilities No. 902.7

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