Invoice Voucher 2page - SIU Foundation | Southern Illinois ... · Check Number Voucher Preparer...
Transcript of Invoice Voucher 2page - SIU Foundation | Southern Illinois ... · Check Number Voucher Preparer...
Check Number
Voucher Preparer Phone
Check Date
Department Mail Code
Vendor Invoice Number
Vendor Invoice Date
Payee: Last Name, First Name, Middle or Company Name
Voucher ID
Address Home Business new address
Vender ID W9
City State Zip Code
I hereby certify that the Goods, Merchandise, Wares, or Services shipped or performed in accordance with this invoice have met the required standards set forth in the Purchasing Contract or employment agreement and are proper charges against Southern Illinois University Foundation and that payment has not been received.
PO Number
SELLER'S CERTIFICATION-SIGN ORIGINAL ONLY IN INK.
FY
Is the payment to or on behalf of an U.S. Citizen or Permanent Resident? Yes No (If no, submit expenses on a Contractual Service Voucher.)
Form 1099 Yes No
Purpose and Description
Price Object Code
Foundation GL Account Title Foundation GL Account Number Amount
Foundation GL Account Title Foundation GL Account Number Amount
Authorization and Approvals I certify that the goods or services specified on this voucher were for the use of this agency and that the expenditure for such goods or services was authorized and lawfully incurred; that such goods or services meet all the required standards set forth in the purchase agreement or contract to which this voucher relates; and that the amount shown on this voucher is correct and approved for payment.
Date
Budget Officer I certify that the above goods have been received or services rendered and this bill is payable from the Unit indicated above. All the information on this form is true and correct to the best of my knowledge.
CFO, SIU Foundation Date
Additional Approval (When Appropriate) Date Controller, SIU Foundation Date
DISB. EDIT
Date Clerk Propriety / Other Approval (When Appropriate) Date
Invoice Voucher
FEIN or SIU AIS:
Vendor or Payee
Last Name First Name Middle
Address
City State Zip Code
Vendor Invoice Number
Vendor Invoice Date
Purpose and Description
Amount
SIU PO Number (if applicable):
Foundation GL Account Title Foundation GL Account Number Amount
If you have questions concerning this payment, you may call Name (Phone: ) in the Department.
Or
The SIU Foundation Accounts Payable Office
Carbondale 618/453-4900
Springfield 217/545-2955
Invoice Voucher - Vendor Copy
Invoice Voucher – Vendor Copy