Purchasing Card

The following documents are the official forms of the DOAS State Purchasing Division. DOAS requests that you do not alter these forms.

Purchasing Card Claims Statement of Disputed Item
Bank of America official form required when a cardholder disputes a transaction on the monthly billing statement (does not have an official SPD form number because it is the Bank’s form)
(Ms Word, 72K)

SPD-CC001 - Designation of PA Form
Official form for Agencies and Institutions to notify State Purchasing as to who serves as the Purchasing Card Program Administrator and/or Travel Card Program Administrator.
(MS Word, 124K)

SPD-PC001 - Purchasing Card Cardholder Agreement
Sample for Agencies and Institutions to develop the agreement the purchasing cardholder must sign in order to be issued a purchasing card.
(Ms Word, 75K)

SPD-PC002 - Purchasing Card Profile
Form used by Agencies and Institutions to request new or modified spending limits for purchasing cardholders.
(Ms Word, 82K)

SPD-PC003 - Purchasing Card Special Approval Request
Submitted to the State Card Program Manager by the Agency or Institution Card Program Administrator in order to obtain prior, written approval for any exception to State Purchasing Card Policy. Cardholders should follow established internal procedures for sending requests to their local Program Administrator and not directly to the State Card Program Manager.
(MS Word, 102K)

SPD-PC004A - Purchasing Card Log
Form to be used by cardholders to make a record of purchases on the card. No password is needed to unlock the form. In Word 2003, click the “padlock” icon. In Word 2007, click Protect Document/Restrict Formatting and Editing/Stop Protection.
(MS Word, 79K)

SPD-PC004B - Purchasing Card Log Sample
Example of completed Purchasing Card Log.
(Ms Word, 79K)

SPD-PC005 - Lost Receipt/Invoice Affidavit
Form to be used by cardholders when invoice or receipt is not available.
(Ms Word, 63K)