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Request to Purchase
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Rockcastle County Schools
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School/Dept.RCMS/YSCP.O. # Assigned by
10th Planet
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Teacher/Dept.
Nicole LearCentral Office204 George Martin Drive
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Source of Funds
YSCDanville, Ky 40422
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Expenditure Code
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Qty.UnitDescriptionType of Unit PriceAmount
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Purchase
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(see below)
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55T-Shirts for 5th Grade Transition Day$5.00$275.00
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62xl$7.00$42.00
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13xl$8.00$8.00
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24xl$9.00$18.00
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Not to exceed $500.00
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Regina will pick upSUBTOTAL
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Enter Discount Percentage 0%
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+ Shipping
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TOTAL$343.00
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TYPE OF PURCHASE
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1. Bid
8. Replacement Parts
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2. Competitive Negotiations
9. Resale Item
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3. Small Purchases
10. Licensed Professional or Technician
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4. State/Federal/Gov't. Agency/Price Contract #
11. Insurance
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5. Emergency
12. Sale at reduced prices
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6. Single Source
13. Other/Explanations
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7. Perishable Items
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4-12-24Page 1 of 1
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Principal/Director
Date
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This is not a purchase order form. This form is to be used to request purchase approval and a pre-numbered purchase order form. Retain the pink copy for your records and send the other copies to the central office.
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Comments:
Shipping Address:
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Will Pick UP
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Attn:Regina M. Hull-Brown
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