| A | B | C | D | E | F | G | H | I | |
|---|---|---|---|---|---|---|---|---|---|
1 | PO Change Request Form | ||||||||
2 | Sonoma County Office of Education | ||||||||
3 | |||||||||
4 | Contact Name: | Division/Dept: | |||||||
5 | Contact Ext #: | Request Date: | |||||||
6 | |||||||||
7 | |||||||||
8 | Vendor Name: | Req -or- PO #: | |||||||
9 | |||||||||
10 | Justification of Change: | ||||||||
11 | |||||||||
12 | Type of PO Change Request: | ||||||||
13 | INCREASE OR DECREASE | ||||||||
14 | Use for: -Change in cost of item of existing line item -Addition of extra fee related to existing line items (such as shipping & handling) that was not originally included | ||||||||
15 | Existing Budget Code Account Description (Name of Budget) | Existing Budget Code | Existing Budget Code Current Encumbrance ("Encumbered" Column in Req/PO Accounts Section) | Increase or Decrease Requested Use - for decreases Use + for increases | Encumbrance + Change = Available Amount for Original Budget (CANNOT BE NEGATIVE) | ||||
16 | $ - | $0.00 | 0.00 | ||||||
17 | $ - | $0.00 | 0.00 | ||||||
18 | $ - | $0.00 | 0.00 | ||||||
19 | $ - | $0.00 | 0.00 | ||||||
20 | $ - | $0.00 | 0.00 | ||||||
21 | $ - | $0.00 | 0.00 | ||||||
22 | TOTAL CHANGE: | $0.00 | |||||||
23 | |||||||||
24 | BUDGET CODE CORRECTION | ||||||||
25 | Use for: -correcting digits within the existing account code(s), such as the year code. Note: Budget code corrections do NOT include adding a new budget code or a new cost. For those changes, a new PO must be openend and processed through the normal Escape approval path. | ||||||||
26 | Existing Budget Code to Eliminate or Edit | Existing Budget Code Current Encumbrance ("Encumbered" Column in Req/PO Accounts Section) | Correct Budget Code To Use --> Leave blank if eliminating budget code | Requested AMOUNT TO MOVE to Correct Budget Code *OR* Amount to Eliminate | Encumbrance + Change = Available Amount for Original Budget (CANNOT BE NEGATIVE) | ||||
27 | $0.00 | $ - | 0.00 | ||||||
28 | $0.00 | $ - | 0.00 | ||||||
29 | $0.00 | $ - | 0.00 | ||||||
30 | $0.00 | $ - | 0.00 | ||||||
31 | $0.00 | $ - | 0.00 | ||||||
32 | $0.00 | $ - | 0.00 | ||||||
33 | |||||||||
34 | |||||||||
35 | |||||||||
36 | Department / Division Approvals | ||||||||
37 | Note: Approval is required by each individual in the approval path in Escape of the original PO. | ||||||||
38 | Role | Name | Signature | Date | |||||
39 | Dept Contact | ______________________________________________________ | |||||||
40 | Budget Manager | ______________________________________________________ | |||||||
41 | Dept Lead | ______________________________________________________ | |||||||
42 | Division Lead | ______________________________________________________ | |||||||
43 | |||||||||
44 | Business Services Use Only: | Posted By: | |||||||
45 | |||||||||
46 | Date Posted: | ||||||||
47 | |||||||||
48 | |||||||||