Date: Ship to:
Vendor:
Contact: Deliver to:
Phone: Attention:
Ship Via: Extension:
Special instructions:
Qty
Units
Item #
Description
Unit
Price
Total
Account Code
Subtotal
Sales/Comp Tax
Shipping
Misc. Charge
Total Cost
Ordered by: Date:
Staff Signature
Approved by: Date:
Principal Signature
General Fund Procurement-Card - Transaction Form
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signature
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signature
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