Form PC-1 "Requisition Form" - Connecticut

What Is Form PC-1?

This is a legal form that was released by the Connecticut Military Department - a government authority operating within Connecticut. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on October 1, 2013;
  • The latest edition provided by the Connecticut Military Department;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form PC-1 by clicking the link below or browse more documents and templates provided by the Connecticut Military Department.

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Download Form PC-1 "Requisition Form" - Connecticut

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STATE OF CONNECTICUT - MILITARY DEPARTMENT
RESET
PRINT
REQUISITION FORM - PC-1
REQ #:
A. REQUESTOR TO COMPLETE:
(REV OCT 2013)
DATE:
BLDG#/ROOM#
FACILITY:
REQUESTER:
PHONE #
FAX #
SHIP TO:
DESCRIPTION OF SERVICES/MATERIALS :
(IN DETAIL -ATTACH ADDITIONAL SHEETS IF REQ'D - $10k > REQUIRES SOW/SPECS)
JUSTIFICATION/EXPLANATION:
(BE SPECIFIC TO DECIDE PRIORTY CODES BELOW)
DATE REQ'D:
CORE ID#
CONTRACT# OR GL71 LTR
SUGGESTED VENDOR
VENDOR CONTACT
FEDERAL FUNDS AMT
EST.TOTAL COST
FED REF #
AMSCO/EEIC #
B. MANAGEMENT APPROVALS :
CFMO BRANCH MANAGERS ONLY
PROG MANAGER
STATE FISCAL
INITIAL
FISCAL
TO PURCH
FOS
P&P
DPM
CA
ENV
FMM
FED
STATE
& DATE
ADM MGR
DEPT
INITIALS
DATE
FMO /BASE CE USE ONLY
S
R
M
OTHER______________________________________
MINOR CONSTRUCTION
B100 REQ'D
DCS APPROVAL
:
420r REQ'D
#1
#2
#3
PRIORITY CODE SELECTED BY FOS
> $50k
REQ'D > $10k
E M E R G E N C Y A U T H O R I Z A T I O N O F F U N D S
(NOTE: BOTH SIGNATURES REQUIRED)
DATE:
STATE FAM
DATE:
CFMO/ BASE CE
C. STATE FISCAL:
AMT ONLY=LS
DIST BY AMT
DIST BY QTY
PURCH INITIAL
PO #
FUND
DEPT
SID
PROGRAM
ACCOUNT
BUD REF
BUD PER
CF#1
CF#2
AMOUNT
FACILITY NOTIFIED
REASON FOR REJECTION/DENIAL BELOW (FUNDING, ADDITIONAL INFO REQ'D, USE P-CARD, ETC.)
REJECTED/DENIED BY:
DATE:
STATE OF CONNECTICUT - MILITARY DEPARTMENT
RESET
PRINT
REQUISITION FORM - PC-1
REQ #:
A. REQUESTOR TO COMPLETE:
(REV OCT 2013)
DATE:
BLDG#/ROOM#
FACILITY:
REQUESTER:
PHONE #
FAX #
SHIP TO:
DESCRIPTION OF SERVICES/MATERIALS :
(IN DETAIL -ATTACH ADDITIONAL SHEETS IF REQ'D - $10k > REQUIRES SOW/SPECS)
JUSTIFICATION/EXPLANATION:
(BE SPECIFIC TO DECIDE PRIORTY CODES BELOW)
DATE REQ'D:
CORE ID#
CONTRACT# OR GL71 LTR
SUGGESTED VENDOR
VENDOR CONTACT
FEDERAL FUNDS AMT
EST.TOTAL COST
FED REF #
AMSCO/EEIC #
B. MANAGEMENT APPROVALS :
CFMO BRANCH MANAGERS ONLY
PROG MANAGER
STATE FISCAL
INITIAL
FISCAL
TO PURCH
FOS
P&P
DPM
CA
ENV
FMM
FED
STATE
& DATE
ADM MGR
DEPT
INITIALS
DATE
FMO /BASE CE USE ONLY
S
R
M
OTHER______________________________________
MINOR CONSTRUCTION
B100 REQ'D
DCS APPROVAL
:
420r REQ'D
#1
#2
#3
PRIORITY CODE SELECTED BY FOS
> $50k
REQ'D > $10k
E M E R G E N C Y A U T H O R I Z A T I O N O F F U N D S
(NOTE: BOTH SIGNATURES REQUIRED)
DATE:
STATE FAM
DATE:
CFMO/ BASE CE
C. STATE FISCAL:
AMT ONLY=LS
DIST BY AMT
DIST BY QTY
PURCH INITIAL
PO #
FUND
DEPT
SID
PROGRAM
ACCOUNT
BUD REF
BUD PER
CF#1
CF#2
AMOUNT
FACILITY NOTIFIED
REASON FOR REJECTION/DENIAL BELOW (FUNDING, ADDITIONAL INFO REQ'D, USE P-CARD, ETC.)
REJECTED/DENIED BY:
DATE: