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*
Date Format: MM slash DD slash YYYY
Estimated Delivery Date*
Date Format: MM slash DD slash YYYY
Cardholder Information
Name*
Phone*
Individual Responsible for Equipment
Name*
Email*
Phone*
Funding Information
Note: Dept must enter edits in PVS Net to reflect the correct 4000 series capital equipment code(s) referenced below!
*
FY Fund Project/Grant Dept. Program Account Amount
Capital Equipment Project Information
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:*
Item Description Information
Vendor name*
Manufacturer*
Serial number*
Model Number*
Description
Campus Location*
Street Address Address Line 2

FY	Fund	Project/Grant	Dept.	Program	Account	Amount

Cardholder Information