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Request Document #

Request Document

Date:

07/19/2016

Name & Address of Suggested Vendor

Contact Name and Telephone No.

Sigma-Aldrich

Requestor Sela Woldesenbet

Department CARC
Acct. Desc.
Account No.
DESCRIPTION

AMOUNT

Item #

QUANTITY

UNIT COST

13

Palmitoleic acid analytical standard, # 76169

134.50

134.50

14

Methyl Palmitoleate analytical standard, # 76176

103.00

103.00

15

Stearic acid analytical standard, # 85679

24.20

24.20

16

Methyl Stearate analytical standard, # 85769

40.20

40.20

17

Methyl Heptadecanoate analytical standard, # 51633

66.50

66.50

0.00

0.00

0.00

0.00

0.00

0.00

0.00

TOTAL

Check box if NEW vendor. If so, W-9 form required, please attach to this document.

$ 368.40

JUSTIFICATION: (MUST answer the who, what, where, when, and why inclusive of the NIFA Goals and how this meets the goals and
objectives of the POW for the Cooperative Extension Program.)

Signature (Requestor):

Date:

Approved
Immediate Supervisor Signature

Date

Approved ___________________________________________________________________________________________________
Director/Associate Director

Date

Fiscal Office and/or Administrator Signature

Date

Dean /Administrator Signature

Date

Approved
Approved
Revised 08/26/2013