Purchase, Invoice, and Reimbursement – Request Form Purchase, Invoice, and Reimbursement Step 1 of 2 50% Preparer Information Preparer / Submitter(Required) I am submitting on my own behalf I am submitting on another's behalf Preparer Name(Required) Your name First Last Preparer UW Email(Required) Your email Name(Required) Name of individual you are preparing on behalf of. First Last Email(Required) Email of individual you are preparing on behalf of. Alternate Contact In the event of your absence, who should be contacted? First Last Alternate Contact UW Email Alternate contact's UW email address Unit(Required) -CHOOSE ONE-Academic Personnel & Faculty (APF)Academic Strategy & Affairs (ASA)Division of Campus Community Safety (DCCS)Faculty SenatePresident (PRES)Provost (PROV)Attorney General's Office (AGO) APF Sub-Unit(Required) -CHOOSE ONE-APF: CoreAPF: Faculty AffairsAPF: Faculty DevelopmentAP: Faculty Inclusive Excellence ASA Sub-Unit(Required) -CHOOSE ONE-ASA: Academic Technologies (AT)ASA: EM: AdmissionsASA: AdvancementASA: Center for Teaching & Learning (CTL)ASA: CoreASA: Enrollment Management (EM)ASA: EM: Financial AidASA: Information Services (ASA-IS)ASA: EM: International Student Services (ISS)ASA: EM: Registrar (OUR)ASA: Strategic Initiatives DCCS Sub-Unit(Required) -CHOOSE ONE-DCCS: CoreDCCS: SafeCampusDCCS: Emergency ManagementDCCS: UWPD This field is hidden when viewing the form HSS Sub-Unit -CHOOSE ONE-HSS: Academic Services & Facilities (AS&F)HSS: CoreHSS: Interprofessional Education (IPE) PRES Sub-Unit(Required) -CHOOSE ONE-PRES: Board of Regents (BOR)PRES: CorePRES: Environmental Health & Safety (EH&S)PRES: Internal Audit (IA)PRES: OmbudPRES: Population HealthPRES: University Rules & PolicyPRES: UWINCO PROV Sub-Unit(Required) -CHOOSE ONE-PROV: CorePROV: Health Sciences ServicesPROV: Scientific Instruments Action Request EO Assistance(Required) Did you consult with or receive assistance from an Executive Office Finance team member prior to filling out this form? No Yes Team Member Name Who assisted you? I need assistance with...(Required) Is this for invoicing or purchasing non-travel items or services? Purchasing goods or services Paying a vendor invoice Processing a non-travel reimbursement Item(s) Needed(Required) Office Supplies Food Conference Registration Other Items for Reimbursement(Required) Office Supplies Food Conference Registration Other Items - Other(Required) Office Supply Vendor & Purchase Details Provide vendors and links for desired items. For example: Supplies: Office supply store name | stapler, tape, reams of paper | link to order/website | $236.19 Vendor Item(s) Link Amount Add Remove Mailing/Shipping Address(Required) Deliver office supplies to this address. Street Address UW Box Number City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Food Vendor & Purchase Details Provide vendors and links for desired items. For example: Food: Sandwich Deli | 75 sandwich boxes | link to sandwich place menu | $149.67 Vendor Item(s) Link Amount Add Remove Number of Invitees(Required) How may individuals are expected to attend the event where food will be provided? Attendee List - Invoice(Required) Would you like to upload a document with the list of names or enter each name individually? Upload List of Attendees Provide Attendee Names Attendee List - Reimbursement(Required) Would you like to upload a document with the list of names or enter each name individually? Upload List of Attendees Provide Attendee Names Upload List of Attendees(Required) Upload a document or image that includes a list of all attendees at the food event. Drop files here or Select files Accepted file types: pdf, doc, docx, jpg, jpeg, png, Max. file size: 15 MB. Attendee Names(Required) Provide the names of all attendees to event where food service was provided. (Add as many rows as needed.) Add Remove Conference Attendance Method(Required) In-Person Online Conference Title(Required) Estimated Total Amount(Required) Total amount including taxes and fees in USD. Justification(Required) Provide a brief justification for purchase, payment of invoice, or non-travel reimbursement. Receipts and Documentation(Required) Upload receipts any additional background documentation that would be helpful to the EO Finance Team when reviewing this request. Drop files here or Select files Accepted file types: pdf, doc, docx, jpg, jpeg, png, Max. file size: 15 MB. Receipts and Documentation(Required) Upload receipts any additional background documentation that would be helpful to the EO Finance Team when reviewing this request. Drop files here or Select files Accepted file types: pdf, doc, docx, jpg, jpeg, png, Max. file size: 15 MB. Documentation Upload Upload receipts any additional background documentation that would be helpful to the EO Finance Team when reviewing this request. Drop files here or Select files Accepted file types: pdf, doc, docx, xls, xlsx, jpg, jpeg, png, Max. file size: 15 MB. Additional Information Provide any additional, relevant information on needed action.