East Stroudsburg University of Pennsylvania Procurement and Contracting

East Stroudsburg University of Pennsylvania

Procurement and Contracting

Individual Record of Use for Purchasing Dept Credit Card Purchases

CARD #_______________

Vendor Name: ____American Future Systems_________
Total Amount: $_____400.00_______________________________
Cost Center : _____3011405100___________________________
Fund: ____________3011000000_____________________________
GL #: _____________616000________________________________

Vendor Address: 384 Technology Drive, Malvern, PA 19355______

Vendor Phone and Fax:_____610-695-8600 ext. 364_____________

Vendor URL: ___________________________

Description: (Item, Part #, Qty, Size, Etc.)

_______IRS Compliance: Vital Year 1099 & Independent Contractor Updates Course #301________________________________________

___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

End User Name, Dept & Location:EXACT LOCATION * PHONE

Person filling this out:_Jane Togher_______________ Phone#___ext.3513______________

Approvers Signature________________________________________________

Deans Signature (if required)_________________________________________

Once the order is placed it will be shipped to the end user or person filling this out –Please send any packing slips, receipts you may receive with your order to Purchasing.