PP Form 20

MAKERERE UNIVERSITY BUSINESS SCHOOL

PROCUREMENT REQUISITION

R 104 (1)

Page ___ of ___

Procurement Reference Number (Refer to the Procurement Guidelines)PD Entity Code Wrks/Srvcs/Supplies? Budget Year Sequence Number ITB Number Contract Number

Subject of Procurement:

Location for Delivery: Date Required:

Item No.

Description(A detailed list, Statement of Requirements or Stock Management Information may be attached)

Quantity Unit of Measure

EstimatedUnit Cost

Estimated Total Cost

Funds Availability: Vote/Head No.

Programme Sub-programme Item Balance Remaining

Currency: __________ Estimated Total Cost:

(1) Confirmation of Need(Originating Officer)

(2) Approval to Procure(Authorising Officer)

(3) Confirmation of Funding(Accounting Officer unless delegated)

Signature:_____________________________________ _____________________________________ _____________________________________

Name: _____________________________________ _____________________________________ _____________________________________

Position: _____________________________________ _____________________________________ _____________________________________

Date: _____________________________________ _____________________________________ _____________________________________

PP Form issued May 2003 Continue on additional pages if necessary. Any attachments must be signed in the same way as this form.