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Limited-Value Purchase Order

Pharmacy

Not valid if net amount exceeds $500.

If you wish to increase your price cap to $5000, you must agree to our Terms and Conditions.

Choose Vendor: [View Vendor Information]

Note: You can order from one vendor at a time. If you would like to order from another vendor, you must submit a new order.


Price Cap:

Description of Item(s) Ordered
Product Code: *
Quantity: *
Unit of Measures:
Description:
Unit Price: * $

Note: You may order multiple items from the same vendor in one order by clicking the Add Item link at the top, once this item has been submitted.

* Required Field

Requisitioner/Shipping Information

PI Name: *
Buyer Name: *
Department: *

Delivery Room Number: *
Buyer Email: *
Buyer Phone: *
MPA Contract #:
(Master Price Agreement)
(If unknown, leave blank.)
Chartfield String: *
Object Code: *
Special Instructions
* Required Field

Note: Your purchase is limited to $500. However, if your order exceeds $500, you must agree to certain Terms and Conditions, which can be done at any time before submitting your order.