Non-WO Purchase Request

Non-work order purchase requests, direct funded.

Order Type*
- Specific order
- Blanket order
Blanket Order Number*
Submitter Information
Submitter Name*
First Last
Submitter Email*
Submitter Phone*
Date Needed
Date Format: MM slash DD slash YYYY
Do Not Ship Before
Date Format: MM slash DD slash YYYY
Contact Submitter before Delivery
- Yes
- No
Comments for the Vendor
Vendor Information
Vendor Number
Vendor Name*
Address Line 1*
Address Line 2*
Email
Vendor Contact*
First Last
Vendor Contact Email*
Vendor Contact Phone*
Shipping Information
Ship To*
Include building name, if applicable.
Address Line 1*
Address Line 2*
Attention*
Shipping*
Order Information
UW Contract No.
DOA Contract No.
Best Judgement: Less than $5,000.00
- Yes
- No
Simplified Bid
- Yes
- No
Requested Items*
Qty Units Unit Cost Description
Total Cost*
Account*
Enter four (4) digits
Fund*
Enter three (3) digits
Department*
Enter six (6) digits
Program*
Please enter a number from 0 to 9.
Enter one (1) digit
Fiscal Year*
Select a fiscal year.
Project
Enter 3 alphanumeric characters and 4 digits.
Building
Enter four (4) digits.
Attachments
Drop files here or
Comments for Approver and/or Purchasing Agent
Approvals
Additional approvals may be required for this purchase request. Enter a total cost to determine whether one or more additional approvals are necessary.
The total cost of this purchase request is less than $5,000.00. No further approvals are required.
Supervisor approval required (all purchases over $5,000.00)
Supervisor Name*
Director approval required (all purchases over $50,000.00)
Director Name*
Deputy AVC or AVC approval required (all purchases over $100,000.00)
Deputy AVC or AVC Name*
For purchase requests that require approval and signatures (purchases $5,000.00 and above), you must do the following:
1. Print the form that is emailed to you when you submit this request.
2. Acquire the required signatures from the required approvers.
3. Scan the signed request form.
4. Do one of the following:
  - For Specific Orders: Email the signed request form and any related documentation to FP&M Business Operations and Purchasing at fpmpurchasing@fpm.wisc.edu.
  - For Blanket Orders: You are responsible for maintaining accurate files of the signed request form and related documents.
  These directions are included in the form that is emailed to you.

Qty	Units	Unit Cost	Description

Submitter Information

Vendor Information

Shipping Information

Order Information

Approvals