Administrative Request Form

THINGS TO REMEMBER:

• For ANY transaction involving the Procurement Card (including over the phone and internet purchases)
  

1. The Procurement Card log must be signed by the individual using the card.
2. The Cultural Center Procurement Card Request form must be completed.
3. All receipts must be submitted when returning the procurement card.
4. A sign-in sheet must be submitted for any event that has food within 24 hours of the event.
5. By submitting this form, you are acknowledging that you have read and understand everything on this page.
   
6. The University of Louisville is TAX-EXEMPT; no transaction can include tax. Receipts with tax included must be returned to the vendor by the person who checked out the card for a refund or re-processing within 3 business days of the original transaction
   

• The administrative request form must be completed for ALL requests

REQUESTOR NAME (Required)

ORGANIZATION/DEPARTMENT (Required)

CONTACT PHONE NUMBER (Required)

Example: 5028526656

EMAIL ADDRESS (Required)

Example:ccul01@cardmail.louisville.edu

REQUESTING (Required)

Please indicate the service or items that you are submitting an administrative request for. PLEASE NOTE REQUESTS SHOULD BE MADE DURING THE FOLLOWING TIME FRAMES BEFORE: Catering for event (6 weeks), Catering for regular meeting (1 week), Event/Meeting Supplies (2 weeks), Office Supplies (1-2 weeks) & Special Event/Guest Speakers (1-2 months)

Procurement card: Catering for event

Procurement card: Catering for regular meeting

Procurement card: Event/Meeting Supplies

Event/Meeting Supplies (including paper products)- University Stockroom

Intra-university Transfer(IUT)

Office Supplies- Corporate Express

Office Supplies- University Stockroom

Special Event Guest Speaker

Other

DESCRIPTION (Required)

Please explain WHAT, WHEN, & WHERE the request applies to (including estimated cost if applicable)

PROGRAM, EVENT, MEETING NAME:

If your request is for a specific event please tell us the event name

REQUESTING: OTHER

If "Other" was selected above please describe here

EVENT DATE & TIME

If your request is for a specific event, please select the date and time of your event

-- 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 / -- January February March April May June July August September October November December / -- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 -- 12 01 02 03 04 05 06 07 08 09 10 11 : -- 00 05 10 15 20 25 30 35 40 45 50 55 -- AM PM

PROCUREMENT CARD PICK-UP REQUEST DATE/TIME

Procurement card pick-up times: 9:00am-12:00pm & 1:00pm-4:30pm. Please note that requests are processed in the order received therefore the requested pick up time may or may not be available. Pick-up time will confirmed upon request approval.

-- 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 / -- January February March April May June July August September October November December / -- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 -- 12 01 02 03 04 05 06 07 08 09 10 11 : -- 00 05 10 15 20 25 30 35 40 45 50 55 -- AM PM

VENDOR(S) FROM WHOM YOU PLAN TO MAKE PURCHASE

PROCUREMENT CARD & EVENT/MEETING SUPPLIES REQUEST ONLY

DID YOU CHECK YOUR BUDGET?

PURCHASES ONLY

YES

NO

ESTIMATED COST

If you are planning to purchase anything please include the estimated cost of the purchase.

BUDGET VERIFICATION

Please input the name of the person that checked your budget

PROCUREMENT CARD AGREEMENT

 This card is the University of Louisville property and should be used in accordance with the University Louisville Procurement Card Policies & Procedures. Your signature verifies that you understand and agree to comply with the following: The card is for University of Louisville business-related purchases only; personal charges are not to be made to the card. Students or employees who violate purchasing policies or otherwise act outside their authority do so at their own personal risk. Misuse of the procurement card will result in forfeiture of card privileges for the individual, residence hall, and/or entire organization for the remainder of the academic year and disciplinary action will be taken and/or criminal charges filed against the student or employee.

The individual who signs for card responsibility will be held account for all purchases made while the card is signed out under their name. Do not give the card to anyone else. If the card is given to another person to use, you are still liable for any misuse. If procurement card is lost or stolen, the responsible person must report this to PNC Bank, Cultural Center staff and University Public Safety. The lost/stolen card notification form must be completed and faxed to Purchasing at 852-7160 ASAP. This can found on the Purchasing Dept. Procurement card website.

The procurement card must be returned with original receipts within 24 hours of checking out the card unless checked out over a weekend or other special arrangement are made in advance. The card must be turned in to Darla Frazier or Leondra Gully. If neither person is available, the procurement card can be left with a Cultural Center professional staff member. If the card is checked out on Friday, return the card and receipts before 10:00 a.m. on the following Monday morning. Receipts with tax on them must be returned to the vendor, by the person who checked out the card (the responsible person) for a refund or reprocessing within 3 business days of the original transaction. If purchasing food, a sign in sheet and ALL itemized receipts MUST be returned with form. REMEMBER, UofL is TAX-EXEMPT (C-102)!

Infraction Notice: Failure to adhere to the Cultural Center policies could result in the following: Verbal warning for first infraction, written warning for second infraction and loss of procurement card privileges for a period of time to be determined by Cultural Center staff.

Additional information is available on the University of Louisville Purchasing website. I certify that I have read and understand the foregoing agreement. I have read the list of restricted card purchases. I will abide by all of the University policies and procedures regarding card usage. I understand the consequences for misuse and/or abuse of card privileges. I accept full responsibility for any card usage while the procurement card is in my possession and until it is properly returned to professional staff at the Cultural Center.