Procurement Request


STOP

Please check the Chemstores catalog before placing your order.


View the catalogue

This form will be emailed to the Chemistry Requisitioning Office upon submission. Inquiries regarding order modifications or placement should be directed to chemreq@indiana.edu.


Requestor Information


Required by
Name
Phone Number
Email
Email CC
Add Another
Account(s)
Add More

Identify account distribution here, if applicable.

Activity/Project Number
Supervisor Approval

Vendor Information


Name
Address
City
State
Zip
Phone
Fax
Contact
*One preferred vendor per request, please

Purpose


Will items be used to construct equipment?

 
Fabrication Number

Will items be used to replace, repair, or upgrade existing equipment?

 
IU Tag Number

Order Details


Shipping Instructions

   
Overnight shipping will incur an additional expense, likely $30-$60.

Shipping charge variations depend upon shipping point and method.


Quantity Catalogue or Item Number Description/Specs Unit Price Unit Total Price
ORDER TOTAL
Add Item

Comments/Instructions


Attachments


Hold Ctrl (Windows) or Cmd (Mac) to select multiple files.
Submit Order

If there are any problems with this form, please contact ITG.