SLU/Purchasing Signature

Authorization To Pay Federal Express Charges


PART I.


Date Shipped/Received ______________________


(Check One)    FEDEX    Letter [____]    Package [____]


Estimated Cost ______________        Airbill Number ____________________________


Budget Unit Name To Be Charged ___________________________________________


Budget Unit Number _________________        Expenditure Category         539602          


Approved By ___________________________________   Date ____________________
                                            Budget Unit Head


PART II.


AFFIRMATION OF RECEIPT

I certify the Federal Express service provided has been performed satisfactorily.


Shipper/Receiver ________________________________   Date ___________________
                                                Legible Signature


Note:   Attach copy of airbill to AUTHORIZATION TO PAY form.

Forward completed form and airbill copy to the Purchasing Department’s Administration Building bin or campus mailbox (10800) no later than (1) working day following shipment or charged delivery.