Purchasing Card Capital Equipment Documentation Form

A Purchasing Card can be used to purchase capital equipment items given the transactions meet the following criteria:

The purchase is a single transaction for a stand alone capital equipment item individually costing $5000 or more and not to exceed your delegated limit.
The purchase is for component parts of a larger capital equipment assembly or fabrication project that has an established UW Capital Equipment Inventory Number, or was established by a requisition that can be referenced by number.
The purchase is within the card holders current authorization limits.

Transaction Date:

Estimated Delivery Date:

Name:

Phone:

Name:

Email:

Phone:

Note: Dept must enter edits in PVS Net to reflect the correct 4000 series capital equipment code(s) referenced below!

	This is a one time purchase of a stand alone capital equipment item costing $5000 or more.
	-----or-----
	This is a component item that will be added to an existing capital equipment project.

Please complete one or both of the boxes below
UW Capital Equipment Inventory Number:
Original Purchase Order/Requisition Number:

Vendor Name:

Manufacturer:

Serial #:

Model#:

Description:

Campus Equipment Location:

University of Wisconsin-Madison