University of California Departmental Purchase Order

***INVOICE MUST SHOW PURCHASE ORDER NUMBER***

***ONLY ACCEPT PAYMENT FROM UNIVERSITY OF CALIFORNIA***

PURCHASE ORDER NUMBER:

Date:

TO: / SHIP TO: University of California Cooperative Extension
Vendor Address: / Address:
Vendor City, State, Zip: / City, State, Zip:
Telephone: Fax:
Vendor Contact: / INVOICE TO: University of California Cooperative Extension
Address:
City, State, Zip:
Delivery by: / FOB Point: / Pricing Reference: / Business Contact:
Name:
County:
Payment Terms:
Net 30 / Carrier: / Agreement Number: / Technical Contact:
Line # / Quantity / Unit / Description / Catalog/Part # / Unit Price / Total Price
1
2
3
4
5
6
7 / Sales tax
8 / TOTAL

Terms & Conditions – Show permit number when billing California Use Tax. If this order includes services which may be reportable for income tax purposes, and if you are an individual proprietor or a partnership, please indicate on your invoice your taxpayer reporting number (Social Security Number or Employer Identification Number) in accordance with requirements of the Internal Revenue Service, pursuant to Federal Privacy Act of 1974, Section 6011and 6051 of Subtitle F of the Internal Revenue Code and Regulation 4, Section 404, 1256, Code of Federal Regulations, under Section 218 Title 11 of the Social Security Act, as amended. Social security number is used to verify your identity. The principal use of the number shall be to report payments to Federal and State Governments. This Contract shall be governed by the laws of the State of California. Prices specified include all taxes and shall not be increased by failure of Seller to have included any applicable tax or as a result of any change in Seller’s tax liability. No variations, deletions, price increases, changes or modifications shall be effective without written approval by the University of California. Indicate order number on all packages, packing ships, and invoices. Itemize invoices, showing number of units and unit price. Invoices not printed on billhead must be signed by claimant or agent, showing signer’s title. If this purchase is being picked up, it is recommended that the vendor contact the UC Davis ordering department to verify authorization. Require identification, such as a driver’s license, obtain the signature of the person picking up the order, and record the numbers of the ID presented. In the event that a UC Davis Purchase Order is fraudulently presented to a vendor, the University will not honor any billing charged as a result of such transaction. The University of California is not liable for late payment penalties or interest charges imposed by a vendor’s invoice unless the University has agreed thereto in writing.

AUTHORIZATION: / PICKED UP BY:
(signature) (date) / (signature) (date)
Printed Name:
, County Director / Identification: