Procurement Request

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. If you have any questions regarding website submissions, please reference our compiled documentation of standard operating procedures, CSOP101- General Purchasing Guidelines..

Requestor Information

Name:*

Phone Number:

Email:*

Email CC:

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Affiliation:*

Office/Group, not just department.

Accounts must be 7 digit numbers, with no hyphens. (ex. 1122233)

Account(s):*

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Identify account distribution here, if applicable. Please use either dollar amounts or percentages.

Vendor Information

Name:*

Address:

City:

State:

Zip:

Phone:

Fax:

Contact Email/Phone:*

*One preferred vendor per request, please

Purpose

Will items be used to construct equipment?*

Yes No

Fabrication Number:*

Are item(s) in this request a new equipment purchase?*

Yes No

Will items be used to repair existing equipment?*

Yes No

IU Tag Number:*

Will items be used to upgrade existing equipment?*

Yes No

IU Tag Number:*

Order Details

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.

If your purchasing request is complete and correct, select "Submit Order" to email this form to the Chemistry Requisitioning Office for processing.

Submit Order

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