Purchase Verification (PV) Form

Submitter Information
Please login (top right) with your UCB IdentiKey via SSO if you have one.
Primary Affiliation
One file only.
32 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.
If you’re a student you must first connect with the faculty or staff member who is providing funding for the transaction to receive permission from them to submit a purchase, reimbursement or travel request.  Once you've received permission, you may submit a request through the appropriate CS finance form.  You must include the email of the faculty who has authorized/approved the transaction in the email section of the form so that they receive a copy of your request.
Request Details
Type of Request
Request a reimbursement, the transaction is already complete
Request the department to place an order on your behalf
Is this a software or subscription purchase, or any other type of purchase that includes terms and conditions?

Please attach the completed ICT review.
The Email subject must contain "Compliance Review Completed".
 
Unlimited number of files can be uploaded to this field.
32 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods, eml.
A quote or screenshot from the company website that shows the cost of the service.
Unlimited number of files can be uploaded to this field.
32 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods, eml.
Enter a URL leading to the company’s terms and conditions (this can be a link to the company’s T&C from their website).
Reimbursement Details
Select an Option
F-1, J-1, etc...
Information for Non-Employees' on International Visas is requested to determine immigration documents that will be required for reimbursement as per the international tax office.
Home Address
Unlimited number of files can be uploaded to this field.
32 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.
Is this being filled on behalf of someone?
I will provide their contact information
Reimburse To
Purchase Description
Unlimited number of files can be uploaded to this field.
32 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.
Agreement
Sign above
For the purchases listed above, I certify that the transactions were all purchases for University of Colorado business and that no personal purchases were made. For sponsored project purchases, I also verify that the cost is reasonable, allocable to the project, and that the item(s) will be used only for the project listed.
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