If the card is lost or stolen, the person responsible for the card must notify either the Purchasing Card Administrator or the bank and their Purchasing Card Liaison.
Violation of any of the above procedures
may result in revocation of all division or departmental procurement cards or personal liability
or all of the foregoing.
I agree to comply with the terms and conditions of this Agreement and the applicable provisions of the Purchasing Card Manual. I acknowledge receipt of the Manual and the list of restricted items and confirm that I have read and understand and will comply with all the terms and conditions.
I agree to use this card for the University of Arizona approved purchases only and agree not to allow anyone to use the card to charge personal purchases. I understand that the University will audit the use of this card and my department or I will be responsible for any discrepancies.
Should I terminate employment with the University or transfer to another department, I will return the card to my Purchasing Card Liaison or the Purchasing Card Administrator or the bank.
I further understand that improper use of this card may result in disciplinary action. If any person that I allow to use the card makes an unauthorized purchase, I will contact the Department Liaison along with the Purchasing Card Administrator immediately. I understand that the University of Arizona and the Department may terminate my right to hold and administer this card at any time for any reason. I agree to return the Card to the University immediately upon request. Should I fail to administer this card properly, I authorize the University of Arizona to deduct from my salary or from other amounts payable to me, an amount equal to the total of the improper purchases, together with interest, costs, expenses and attorney's fees. I also agree to allow the University of Arizona to collect any amounts owed by me even if I am no longer affiliated with the University.
Signature of cardholder: __________________________________________________ Date:______________________ Print Name: ____________________________________________________________As Department Head or Designee, I approve the issuance of a Purchasing Card to this university employee. I agree to uphold and enforce all applicable policies for the University of Arizona, Arizona Board of Regents, applicable laws of the State of Arizona, and all applicable federal policies and procedures and to assure that the card is turned over to my Purchasing Card Liaison immediately upon this employee's termination in my department. I agree that the department's budget will bear the cost of any misuse or loss resulting from the use of this card.
Department Head Signature: ____________________________________________________ Date:______________________ Print Name: _____________________________________________________________ Department Name: __________________________________________________________________ Dept Liaison ______________________________________________________________ Date _______________________
To be completed when card is picked up. I hereby acknowledge receipt of: Purchasing Card # (last 8 digits) ____|____|____|____| - ____|____|____|____| Expiration Date: ______________________________________ Signature: _______________________________________________________ Date: ______________________
Sign your card immediately upon receipt.