Desktop Schools Popup

Series - 704.2.3.2P - Procurement Card Application and Change Form

Each Procurement Card application or change requires approval from the Principal/Department Supervisor.  The Procurement Card Program Administrator will review the application and/or change to ensure the applicant’s intended usage meets district criteria and will issue a Procurement Card or change authorization when appropriate.

Cardholder Name:

 

Employee ID#:

 

Site/Location:

 

District E-mail Address:

 

 

@district196.org

 

FOR NEW CARD APPLICATION USE ONLY:

 

Monthly Dollar Limit:

 

One Time Purchase Limit:

 

Default Accounting Code

 

Cardholder Signature:

 

Date:

 

When applying for a new account, the Procurement Card Agreement must be read, signed and dated by the applicant and submitted to the Procurement Card Program Administrator before a card will be issued.

         

 

FOR CHANGE TO AN EXISTING CARD USE ONLY:

Cardholder’s Name Change:

 

Change single purchase limit to:

 

 

Change monthly limit to:

 

Deactivate card (include date of deactivation):

 

 

Cardholder Site Change:

 

Other:

 

 

Default Accounting Code Change to:

 

 

 

As Principal/Department Supervisor, I hereby grant this applicant authorization to apply for or change, and use, the Independent School District 196 Procurement Card.  I will review our site budget limitations and Policy 704 Expenditures with the applicant.  I agree to review and approve the monthly Procurement Card statements issued to this applicant.  If the applicant’s employment with the district is terminated, I agree to immediately request return of the Procurement Card and notify the Procurement Card Program Administrator.

Principal/Dept. Supervisor Signature

 

Date:

 

 

********** The following is to be completed by the District Finance Department **********

Program Administrator Approval & Date:

 

Agreement Received:

 

Card Ordered:

 

 

Procedure 704.2.3.2P/4-1-19