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Document No.: OPD-F-01
                                                 Purchase Order                                 Issue.Revision: 1.2
                                                  Request Form                                  Issue Date:            01/02/2004
                                                                                                Rev. Date:             12/12/2007

                                                                 OPD                            Page:                  1 of 1


PROJECT / CONTRACT INFORMATION
 P.O. NUMBER                                       CUSTOMER NAME




REQUESTER INFORMATION
 BUSINESS UNIT / DEPARTMENT NAME                             BU / DEPT. NO.                          ACCOUNT NO.




                           REQUESTED BY                         1ST LEVEL APPROVED BY                   2ND LEVEL APPROVED BY

 NAME

 POSITION

 DATE


 SIGNATURE




REQUESTED ITEM(S) INFORMATION
   SUPPLIER NAME :




   SUPPLIER ADDRESS :                                     CONTACT NAME :                        PHONE NUMBER :         FAX NUMBER :




   REQUESTED SHIP-TO NAME :                                REQUESTED SHIP-TO ADDRESS



   PRICE REFERENCE (PRICE LIST ,QUOTATION) :   (PLEASE SPECIFY IN DETAILS)


   REQUESTED ITEMS ARE BUDGETED ON GREAT PLAINS SYSTEM AND REMAINING BUDGET WILL COVER THEM:         Y/N ?




REQUESTED ITEM(S) DETAILS
SER     PART NUMBER /                  DESCRIPTION                   QTY      UNIT PRICE /   TOTAL     COST CATEGORY        COMMENTS
        ITEM NUMBER                                                           CURRENCY                    NUMBER




Notes / Special Requirements :



                                       Confidential – Copyright © 2007, Giza Systems

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Opd F 01 (Purchase Order Request Form V 1.2)

  • 1. Document No.: OPD-F-01 Purchase Order Issue.Revision: 1.2 Request Form Issue Date: 01/02/2004 Rev. Date: 12/12/2007 OPD Page: 1 of 1 PROJECT / CONTRACT INFORMATION P.O. NUMBER CUSTOMER NAME REQUESTER INFORMATION BUSINESS UNIT / DEPARTMENT NAME BU / DEPT. NO. ACCOUNT NO. REQUESTED BY 1ST LEVEL APPROVED BY 2ND LEVEL APPROVED BY NAME POSITION DATE SIGNATURE REQUESTED ITEM(S) INFORMATION SUPPLIER NAME : SUPPLIER ADDRESS : CONTACT NAME : PHONE NUMBER : FAX NUMBER : REQUESTED SHIP-TO NAME : REQUESTED SHIP-TO ADDRESS PRICE REFERENCE (PRICE LIST ,QUOTATION) : (PLEASE SPECIFY IN DETAILS) REQUESTED ITEMS ARE BUDGETED ON GREAT PLAINS SYSTEM AND REMAINING BUDGET WILL COVER THEM: Y/N ? REQUESTED ITEM(S) DETAILS SER PART NUMBER / DESCRIPTION QTY UNIT PRICE / TOTAL COST CATEGORY COMMENTS ITEM NUMBER CURRENCY NUMBER Notes / Special Requirements : Confidential – Copyright © 2007, Giza Systems