Once you have completed the form, you can print the results for faxing. Fax all orders to Lisa Aitken at 448-8478.
Date Order Placed:
UT Contract No.:
UT Blanket P.O. No:
Dept. Account Name:
Dept. Account Number:
Certification: For any item of equipment costing $1,000 or more, purchased
under federal grant: I certify that the appropriate approvals and screening
requirements have been complied with. This requirement is %
Note: This form must be signed by the department head or another
person who is authorized to obligate the account.
VENDORS: Fax confirmation to department contact and Michelle Newman,
Purchasing Services, (901) 448-8028.