Purchasing Card Capital Equipment Documentation Form

A Purchasing Card can be used to purchase capital equipment items given the transactions meet the following criteria:

The purchase is a single transaction for a stand alone capital equipment item individually costing $5000 or more and not to exceed your delegated limit.
The purchase is for component parts of a larger capital equipment assembly or fabrication project that has an established UW Capital Equipment Inventory Number, or was established by a requisition that can be referenced by number.
The purchase is within the card holders current authorization limits.

Transaction Date*

Estimated Delivery Date*

Name*

Phone*

Name*

Email*

Phone*

Note: Dept must enter edits in PVS Net to reflect the correct 4000 series capital equipment code(s) referenced below!

Fund

Project/Grant

Dept.

Program

Account

Amount

Choose one option*

This is a one time purchase of a stand alone capital equipment item costing $5000 or more.

This is a component item that will be added to an existing capital equipment project.

UW Capital Equipment Inventory Number:*

Original Purchase Order/Requisition Number:*

Vendor name*

Manufacturer*

Serial number*

Model Number*

Description

Campus Location*

Street Address Address Line 2