Invoice Voucher 2page - SIU Foundation | Southern Illinois ... · Check Number Voucher Preparer...

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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. , SIU Foundation Date Additional Approval (When Appropriate) Date , SIU Foundation Date DISB. EDIT Date Clerk Approval (When Appropriate) Date Invoice Voucher FEIN or SIU AIS:

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