Pre-Approval Form - Army Contracting Command
PURCHASE REQUEST
1. Order Number:
5.Describe Government Requirement:
2. Requester:
3. Phone Number
4. Date:
6. Description of Supplies or Services
7. Part Number 8.Quantity 9. Unit Price 10. Total Price
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
11. Recommended Source
SAMS Check. YesNo Approver Position CH:
Shipping/Handling $
Total $
Procurement (Source Filled in by Cardholder)
I. FAR Mandatory Sources. (UNICOR, AbilityOne)
II. DoD Mandatory Sources. (FSSI BPAs, GSA, DoD EMALL)
III. Other Federal Sources. (CHESS, NextGen Wireless, Local BPAs)
IV. Commercial Sources
Pre-Purchase Approvals
Signature
Approver Position
Signature
BO: RM Budget Approval 12. Name of Receiver
Funds Available
WBS:
Signature
Independent Receipt and Acceptance
13. Section/Directorate 14. Date Received
15. Signature
16. Name of Supply Officer
Property Book Office Screening
17. PBO Accountability: YesNo
18. Signature
Receipt provided to PBO. YesNo
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