Purchase Order Change Request

PO Number (*)

Vendor Name (*)

Blanket Order? YES NO

Cancel the PO? YES NO

Make the following changes:

Enter new total dollar amount of purchase order: (*)

Accounting Changes, only if applicable:

Do you want Purchasing Services to fax a copy of the Change Order
to the vendor? YES NO

Changes approved by: (*) (Must be Authorized Signer)

Comments? Other changes? (Ex. timeframes, performance issues, etc.)

Your Name : (*) Phone: (*)

Your Email Address: (*)

Your Department: (*)

Please have grant fund changes approved by the Office of Sponsored Programs prior to processing