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ON-LINE FORMS
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PROCUREMENT SERVICES
Purchase Requisition Form 4330 (Microsoft Excel file)
Purchase Requisition Form for those staff members that do not have access to the M-Pathways systems to create an online requisition. Complete all required fields on this form and mail or fax it to Procurement Services.
U-M Requisition for Tax-Free Alcohol Form (Adobe Acrobat format)
The University is maintaining a central distribution process for Tax-Free 190 proof and 200 proof Ethyl Alcohol. Click here to view the ordering process effective as of October 17, 2006.
Sole Source Justification Form (Microsoft Word file)
This form should be sent as an attachment with your requisition when your purchase cannot be competitively bid.
Conflict of Interest Disclosure Form (Microsoft Word file)
Departments need to complete this form and submit it to Procurement Services when a purchase of goods/services is from a University of Michigan employee or from a supplier with which an employee has a relationship. The completion of this form does not constitute approval of this COI purchase. The form will be used to assist Procurement Services in determining whether the justification provided in this document is sufficient to submit this request to purchase for Regent approval.
Disclosure Of Significant Relationships With Relevant Companies Statement Form (Microsoft Word file)
This form should be sent as an attachment with your Non-Competitive Purchase Award Form. The University of Michigan Health System has established standards and guidelines in accordance with the University's Standard Practice Guide Policy on Conflict of Interest (S.P.G. #201.65-1) for individuals participating in purchasing decision-making.
PeoplePay Multiple Payment Release Form (Adobe Acrobat Format)
This form is to be used when creating a payment to an individual against an M-Pathways contract. Do not use this form when one transaction will be processed with multiple payment release dates automatically scheduled. Complete this form, along with an ePro req, to initiate each individual payment throughout the course of the contract. This multiple payment release form serves as the individual's invoice for each payment against the M-Pathways Contract. This form is required even if the individual provides an invoice. If an invoice is provided, please submit it with this form to PeoplePay Procurement Services as back-up.
ACCOUNTS PAYABLE
Application for tax free reimbursement of high-speed Internet service installed in a private residence (Microsoft Word file)
This form is used to provide evidence that the Internet service being paid for is provided solely for the convenience of the University and that the service will be used exclusively to conduct official University business.
Imprest Cash Fund Request/Change (Microsoft Excel file)
Use this form when requesting an Imprest Cash Fund or when making changes to an existing fund. The form provides Financial Operations and Accounts Payable with the information necessary to approve, record, and disburse an Imprest Cash Fund. This form must be signed by the custodian and the higher administrative authority. This form was last updated November 2009.
Lump Sum Advance Expense Detail Form (Microsoft Excel file)
This form is used to report final expenditures within 30 days of the final voucher date. The expense detail form should be an accumulation of all expenditures that were made using Lump Sum Advance Funds. This form is used with the Lump Sum Advance Voucher Form (see below).
Lump Sum Advance Promissory Note Form (Microsoft Excel file)
This form is a non-interest bearing promissory note for the total amount of the lump sum advance. It must be filled out to request a Lump Sum Advance. The note must be signed by the custodian and witnessed. This Promissory note authorizes the University Payroll Office to deduct any portion of the advance that is not properly vouchered by the time limits on the note. This form must be submitted in combination with the Lump Sum Advance Request Form (see below).
Lump Sum Advance Request Form (Microsoft Excel file)
Use this form in combination with the Lump Sum Advance Promissory Note Form (above) and when requesting a Lump Sum Advance. The form provides Financial Operations with the information necessary to approve, record and disburse a lump sum advance.
Lump Sum Advance Voucher Form (Microsoft Excel file)
Receipts must be kept with all expenditures and submitted monthly with this Voucher Form. Within 30 days of the final voucher date, this form must be submitted for the final time, with the Lump Sum Advance Expense Form for final accounting, reimbursement or payment to take place.
Michigan Sales and Use Tax Certificate of Exemption (Adobe Acrobat format)
University purchases are exempt from the payment of Michigan sales and use tax. Several other states also allow this exemption. Some vendors may request a copy of a document describing the University's sales tax exempt status. The form can be photocopied and faxed to a vendor.
Non-PO Voucher Form (Microsoft Excel file)
This form is used if your unit does not have access to M-Pathways and when a reimbursement, payment to a vendor or refund needs to be made. With access to M-Pathways, this form is available online as a Non-PO voucher.
Subject Fee Payment Form (Microsoft Word File)
This form must be used for payments to human subjects.
P-CARD
Mileage Log Form (Microsoft Excel file)
Use this form when claiming mileage reimbursement for business use of personal vehicles. This optional form is recommended in order to provide P-Card auditors with information required to process mileage reimbursements. Submit the mileage form with the P-Card Cash Withdrawal and Out of Pocket Expense Reconciliation Form with the applicable P-Card Statement.
P-Card Application for Non-Concur Users (Microsoft Word file)
This form should be used by faculty and staff in units that are not yet using the Concur Travel and Expense Management System to apply for a University P-Card. This form was last updated October 2009.
P-Card Application for Concur Users (Microsoft Word file)
This form should be used by faculty and staff in units using the Concur Travel and Expense Management System to apply for a University P-Card. This form was last updated October 2009.
University of Michigan Purchasing Cardholder’s Agreement Form (Adobe Acrobat format)
This form must be read and signed by the P-Card Holder after completing the P-Card Online Training and prior to a P-Card being issued. This form was last updated June 1, 2008.
P-Card Dispute Transaction Form (Adobe Acrobat Format)
Use this form to dispute a P-Card transaction you believe is in error. Note: You must first attempt to resolve the dispute with the merchant before notifying JP Morgan Chase. This form was last updated April 29, 2009.
P-Card Hosting Form (Microsoft Word file)
The P-Card Hosting Form must be completed and attached to the P-Card statement with receipt/proof of payment for any P-Card billing cycle in which hosting activities occur.
P-Card Cash Withdrawal and Out of Pocket Expense Reconciliation Form (Microsoft Excel file)
This form must be completed and attached to the P-Card statement in the same billing cycle that a P-Card cash withdrawal was made. It is also used to report out of pocket expenses that occurred in the same cycle. Use the Per Diem Calculator Tool (included in this form) to determine the total domestic travel meals and incidentals reimbursement due to the traveler (if applicable). This form was last updated November 2009.
P-Card ATM Cash Withdrawal/Miscellaneous Expenses Form (Microsoft Excel file)
This form is to be used for the P-Card billing cycle that ended 10/14/09. The form must be completed and attached to the P-Card statement in the same billing cycle that a P-Card cash withdrawal was made. It is also used to report out of pocket expenses that occurred in the same cycle.
P-Card Subject Fee Form (Microsoft Word file)
If you are approved to pay subject fee transactions on your P-Card, this form must be used to support all subject fees.
P-Card Maintenance Form for Non-Concur Users (Microsoft Word file)
This form should be used by units not yet using the Concur Travel and Expense Management system to make changes to the P-Card holder profile (e.g., changes to cardholder name, address, default ShortCode). This form was last updated June 2008.
P-Card Maintenance Form for Concur Users (Microsoft Word file)
This form should be used by units using the Concur Travel and Expense Management system to make changes to the P-Card holder profile (e.g., changes to cardholder name, address, default ShortCode). This form was last updated July 2009.
P-Card Limit Change Form for Non-Concur Users (Microsoft Word file)
Use this form to request changes to the monthly credit and/or cash advance limit. A clear business purpose for an increase must be provided and signed by an authorized unit approver. This form was last updated June 1, 2008.
P-Card Limit Change Form for Concur Users (Microsoft Word file)
Use this form to request changes to the monthly credit and/or cash advance limit. A clear business purpose for an increase must be provided and signed by an authorized unit approver. This form was last updated October 2009.
Authorization by Signature (Microsoft Word file)
Use this form to delegate approval authority for transactions pertaining to the P-Card, business travel, business hosting, and other expenses. Both the delegator and the assignee must sign the form. This form was last updated September 2009.
TRAVEL
Travel Advance Form (Microsoft Word file)
This form is a non-interest bearing promissory note for the total amount of travel advance. It must be filled out to request an advance. This promissory note authorizes the University Payroll Office to deduct any portion of the advance that is not properly reconciled within 45 days after return from the trip.
Travel and Business Hosting Expense Form (Employee) (Microsoft Excel file)
This form is an accounting for domestic travel and/or hosted event for employees who are not yet using the Concur Travel and Expense Management system. Use the Per Diem Calculator Tool (included in this form) to determine the total domestic travel meals and incidentals reimbursement due to the traveler (if applicable). This form was last updated November 2009.
Travel and Business Hosting Expense Form (Foreign/OCONUS) (Microsoft Excel file)
This form is an accounting for foreign/OCONUS travel or hosted event for employees who are not yet using the Concur Travel and Expense Management system. Travel meal/incidental per diems do not apply to foreign/OCONUS travel. Note that reimbursement for meals is actual subject to the current meal limits of $25 breakfast/$25 lunch/$55 dinner. This form was last updated October 2009.
Travel and Business Hosting Expense Form (Guest/Student) (Microsoft Excel file)
This form is an accounting of expenses for a non-University of Michigan employee (e.g., guests, students). Guests and students are not subject to the domestic travel meal/incidentals per diem. This form was last updated October 2009.
Travel and Business Hosting Expense Report – Expenses Prior to Oct 15 2009 (Microsoft Excel file)
This form should only be used to submit travel and business hosting expenses that pertain to travel and/or hosting events occurring prior to October 15, 2009. This form applies to both employees and non-employees.
Fly America Act Exception Form (Microsoft Excel file)
This form should be completed whenever non-U.S. flag air carrier service is used and intended to be charged to a federal project/grant. The completed form should accompany the Travel Expense Report and P-Card Reconciliation forms. This file also includes the Federal Travel Regulation sections that describe the requirement for the use of U.S. flag air carriers when charged to federal dollars, as well as the exception criteria used to determine when the use of a non-U.S. flag air carrier is acceptable.
VENDOR MAINTENANCE
Substitute W9 Form (Adobe Acrobat format)
The Substitute W-9 form is a method of collecting tax information for the IRS and other information that the University is required to report. It can cost the University tax penalties or cause contract violations if we are unable to report this information in a timely fashion. University units can assist with supplier certification by requesting the supplier complete the form. Payments to the supplier will be held until completed form has been returned to the U-M Vendor Maintenance Team. (This form was last updated November 2009)
Supplier Request Form (Adobe Acrobat format)
This form is to be used by University departments/units only to request additions or changes to vendor information in the M-Pathways vendor database so that the requisition, purchase order and payments can be linked to the correct information. (This form was last updated December 2008.)
Federal Identification Number Form W-7 (Adobe Acrobat format)
This form is used to obtain a Federal Identification Number.
Foreign Transaction Form (Microsoft Word file)
This form is used to obtain information from a vendor that you believe may be of foreign status for payments which are not related to royalties. Additional vendor information is needed in an effort to maintain compliance with IRS regulations.
Royalty Foreign Transaction Form (Microsoft Word file)
This form is used to obtain information from a vendor that you believe may be of foreign status for payments related to royalties. Additional vendor information is needed in an effort to maintain compliance with IRS regulations.
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