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Charge Request
Original of this form is your authorization to charge
(Must be submitted to Payment Services before reserving travel)
CR #:
-
see
instructions
BUSINESS UNIT:
BKCMP
BKASI
BKFDN
BKSTU
BKSPA
Car Rental
(insurance provided for employees; do not purchase additional insurance)
Car Rental Agencies
that accept this form.
"I am in possession of a valid California driver's license. I certify that I have not been issued more than three moving violations or have been responsible for more than three accidents (or any combination of more than three thereof) during the last twelve-month period."
_________________________________ _____________________
Signature of Applicant Date
UNIGLOBE Air Travel
(Quote/receipt with price must be attached)
Local Hotel (for Guests)
Hotels
that accept this form
VENDOR (Uniglobe, Enterprise, etc.):
TRAVELER:
VENDOR CONTACT:
DEPT CONTACT:
ADDRESS:
DEPT:
CITY:
CONTACT EXTENSION:
STATE & ZIP:
__________________________________
Signature of Applicant / Requestor
Dept. Head (Print Name-REQUIRED)
__________________________________
Dept. Head Signature
QUOTED COST(including tax):
* Quote must be attached
LOCATION &
DATES OF
EVENT/TRAVEL:
PURPOSE OF
EVENT/TRAVEL:
Fund:
Department:
Account:
Program:
Project:
Class:
SEND INVOICE TO:
California State University, Bakersfield
ADM 35 - Payment Services
9001 Stockdale Highway
Bakersfield, CA 93311-1022
Accounting Approval
Date
Original to be retained in Payment Services for processing.
NOTE: Make sure values on form are correct as
VALUES ARE CLEARED BEFORE PRINTING AND FORM IS REFRESHED!
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