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VILLAGE OF GOWANDA PURCHASE AUTHORIZATION FORM PURCHASE VENDOR: PURCHASING DEPARTMENT (multiple if split): REASON/DESCRIPTION OF PURCHASE: O Split c Fire O Administration O Recteation o Highway 3 Sewer ; oO Water O Code Enforcement / SPLIT (Why) O Police O Other Line Item: Budget Code: Anticipated Amount; _Funds Available 0 Yes 0 No Line Item: Budget Code: Anticipated Amount: Funds Available c Yes a No Line Item: Budget Code: Anticipated Amount: Funds Available Q YesONo | Ifmatked “No” above- please document budget allocation plan Purchasing Employee: - Date: understand that ALL. purchases need prior written approval by my department head before a purchase can be mate. Department Head Approval: Date: Department Head Approval (if split): Date: Department Head Approval (if split): Date: understand that all purchases from my department budget require prior written approval before a purchase can be made by any employee designee. Administration Approval (above $500 only): Date: _ This form must be attached to receipt and ot invoicc to be included with cach voucher for payment VILLAGE OF GOWANDA PURCHASE AUTHORIZATION FORM PURCHASE VENDOR: PURCHASING DEPARTMENT (multiple if split): REASON/DESCRIPTION OF PURCHASE: a Split OD Fire O Administration O Recteation a Highway O Sewer ; o Water 0 Code Enforcement SPLIT (Why) O Police O Other Line Item: . Budget Code: Anticipated Amount: _ Funds Available 0 Yes oN ° Line Item: : Budget Code: Anticipated Amount: Funds Available 0 Yes 0 No Line Itém: Budget Code: Anticipated Amount: Funds Available 0 Yes 0 No Jf marked “No” above- please document budget allocation plan Purchasing Employee: Date: L understand that ALL purchases need prior written approval by my department bead before a purchase can. be made, Department Head Approval: ; : Date: Department Head Approval (if split): Date: Department Head Approval (if split): Date: L understand that all purchases from my department budget require prior written approval before a purchase can be made by any employee designee. Administration Approval (above $500 only): Date: _ This form must be attached to receipt and ot invoice to be included with each voucher for payment