Purchase Order Requisition

     Requisition: #R03-12345        PO #                    Status: Submitted

                                                           Req. Date: 10/22/07

     Requisitioner:                                       Req. Cost:

        Order Site:

     Ship to Site:                                             Room:

     Vender Code: 001325, GST

         Req. Info:

                     Account Number                    Amount      Year

Extended Qty

Ln# Item # Qty Unit Purchase Order Line Item Amount Rcvd

1 1 each Basic PC System as per minimum 1233.75

specifications in current bid #9900-20

2 1 each 5 year warranty 150.00

3 1 each Installation 15.00

Sample

4 1 each Upgrade the monitor to a Viewsonic 160.00

Model VE175 17” FLAT-PANEL DISPLAY

5 1 each Add an internal IDE Iomega 250 MB Zip Drive 88.00

MODEL 11113

6 1 each Add Creative Labs SBS 250 or newer-model 22.00

amplified office speakers

7 1 each Add a Tripp Lite Isobar 6 Ultra Surge 53.00

Suppressor MODEL ISOBAR6ULTRA

PLEASE DELIVER THE ABOVE COMPUTER TO THE

FOLLOWING:

Linda VLAD – Room SS-109

Note: If ordering both a Desktop and Laptop computer, please use separate requisitions.

Taxable Amount:     $1556.75

     Sales Tax:      $128.43

Nontaxable Amount:      $165.00

           Shipping:

                      ____________

   Requisition Total:     $1850.18

Approved by: Date:

Requisition #R03-12345 Page 1 10/22/07