Southern Connecticut State University

Purchase Requisition

Department Charged:		Requested by:
Telephone #:		Date Required:
Deliver to - (Dept Name/Building/Room No./End user):		Contract Award Number:

Does price include delivery? YES NO

To ensure that SCSU meets the standards established by the State of Connecticut’s Software Inventory Control Policy and Procedures (Chapter 7 of the State’s Property Control Manual), the requester of this requisition must answer the following question:

Does this requisition contain any software products, licenses, and/or applications? YES NO

Are you trading in any tagged equipment? If so, please list:

Requisition total:

*CGS Chapter 10,Sec 1-84(i) ''Immediate family'' means any spouse, children or dependent relatives who reside in the individual's household.