"Pcard Contract Summary Form" - Florida

The Florida Department of Juvenile Justice has released this version of the "Pcard Contract Summary Form" on August 9, 2012.

This form may be used by all Florida residents: download the printable PDF by clicking the link below and use it according to the applicable legal guidelines.

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Download "Pcard Contract Summary Form" - Florida

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STATE OF FLORIDA
DEPARTMENT OF JUVENILE JUSTICE
I N T E R O F F I C E M E M O R A N D U M
DATE:
TO:
Finance & Accounting
FROM:
SUBJECT: PCard Contract Summary Form
(This is to be used for the State Purchasing Card only on Direct Orders)
I, _______________________, certify that I am the Contract Manager and the provided
information is true and correct; the goods and services have been satisfactorily received
and payment is now due.
I understand that the office of the State Chief Financial Officer reserves the right to
require additional documentation and/or to conduct periodic post-audits of any
agreements.
Contractor/Vendor/Payee: ________________________________________________
Purchase Order (P.O.) #: _________________________________________________
P.O. Start Date: _________________________________________________________
P.O. End Date: __________________________________________________________
Payment Amount: $______________________________________________________
The previous amount paid $ ________________________________________________
P.O. Manager’s or On Behalf Of (OBO) Name: _________________________________
P.O. Manager’s or OBO Signature: __________________________________________
Revised August 9, 2012
2737 Centerview Drive  Tallahassee, Florida  32399 (850) 921-6793
Rick Scott, Governor
Christina K. Daly, Secretary
The mission of the Department of Juvenile Justice is to increase public safety by reducing juvenile delinquency through effective
prevention, intervention, and treatment services that strengthen families and turn around the lives of troubled youth.
STATE OF FLORIDA
DEPARTMENT OF JUVENILE JUSTICE
I N T E R O F F I C E M E M O R A N D U M
DATE:
TO:
Finance & Accounting
FROM:
SUBJECT: PCard Contract Summary Form
(This is to be used for the State Purchasing Card only on Direct Orders)
I, _______________________, certify that I am the Contract Manager and the provided
information is true and correct; the goods and services have been satisfactorily received
and payment is now due.
I understand that the office of the State Chief Financial Officer reserves the right to
require additional documentation and/or to conduct periodic post-audits of any
agreements.
Contractor/Vendor/Payee: ________________________________________________
Purchase Order (P.O.) #: _________________________________________________
P.O. Start Date: _________________________________________________________
P.O. End Date: __________________________________________________________
Payment Amount: $______________________________________________________
The previous amount paid $ ________________________________________________
P.O. Manager’s or On Behalf Of (OBO) Name: _________________________________
P.O. Manager’s or OBO Signature: __________________________________________
Revised August 9, 2012
2737 Centerview Drive  Tallahassee, Florida  32399 (850) 921-6793
Rick Scott, Governor
Christina K. Daly, Secretary
The mission of the Department of Juvenile Justice is to increase public safety by reducing juvenile delinquency through effective
prevention, intervention, and treatment services that strengthen families and turn around the lives of troubled youth.
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