Submit a P-Card Request

Submit a P-Card Request

New Card Application, Card Maintenance Request, User Agreement, Approver Agreement, Reconciler Agreement, Authorizer Delegation Agreement

Requester Name*

Name of Employee Submitting Form:

Requester Email*

Type of Request*

Application - New P-Card request

Card Limit Change: One time over limit, blocked merchant, or P-Card cash advance (Emergency/Travel)

Card Maintenance Request: Costco, close card, update accounting string/segments

Designate a Works Role: Works approver, authorizer, reconciler

Application Type*

Standard and Travel - Card embossed with employees name - only used by the that employee.

Card embossed with Department's name is assigned to one primary cardholder, and may be checked out to employees within the Department.

Standard

Department

Travel use only

Maintenance Request Type*

Card Replacement (damage)

Close card (Do not request more than two weeks before last date needed)

Update accounting distribution string

P-Card cash advance (emergency/travel)

Card Replacement (Damage)

Close Card (Submit no more than 14 days before last date of use)

Costco Membership

Reinstate Card from Suspension

Suspend Card

Update Accounting Distribution String

COSTCO MEMBERSHIP

Please check the box if you have a Costco Membership and are closing the P-Card OR if you are requesting a new Costco membership.

Exemption must be approved for the following categories (anything tied to existing state contracts):

Office supplies

IT/Computers/Electronics, etc.

Tools

Enter Updated Distribution Information*

New fund segments: Fund, Department, Cost Center, Account, Supplemental or Project

Check the box at the bottom of the section after reading through the compliance and foreign guidelines:

COMPLIANCE GUIDELINES:

University contract vendors must be the first choice for business purchases. Choosing an off-contract vendor based on pricing alone requires approval in writing from Procurement. Contract Vendors

DO NOT SPLIT THE PURCHASE AMOUNT:

If the amount of the purchase is over per transaction limit

Submit a P-Card Request for a card limit change for a one-time payment exceeding card limit - attachment required

IT GOODS & SERVICES:

OIT handles university purchases of all IT goods or services such as computers, software, web-based services, cell phones, and other IT products & services. Contact HelpDesk@boisestate.edu for assistance with IT purchases. Computers (including tablets). Network printers are ordered via OIT online site.

Software and web-based services require OIT SARB review in advance of purchase.

CONTRACTS & PRICE AGREEMENTS:

Vendor contracts and agreements (including online 'click' agreements) require advance review by the Office of the General Counsel. For detail, review boisestate.edu/generalcounsel/contract-administration/ OR boisestate.edu/policy/finance/university-contracts/

FOREIGN VENDORS:

Per IRS regulations, certain types of purchases may require tax withholding if purchased from a foreign vendor which may result in additional costs (tax and penalty) to your department. Typically taxable transactions include software, royalties (i.e., licensing of images, art, text, music, etc.), publishing services, and services performed by foreign vendors in the USA (i.e., conference registration fees paid to international vendors for conferences held in the USA). Goods delivered to the university are typically not subject to withholding. Review P-Card and International Vendors for details:https://www.boisestate.edu/vpfa-pcard/international-vendors/

Additional P-Card resources https://www.boisestate.edu/vpfa-ufs-training/purchasing-goods-and-services/p-card/

I have reviewed the above compliance guidelines with the cardholder and we understand the responsibility*

Card Limit Change or Restricted Merchant*

Limit increase temporary or permanent one time payment exceeding card per transaction limit (for a purchase requiring credit card payment (i.e. travel, registration, membership, subscription fees) or restricted merchant category

One Time Payment Exceeding Card Limit - Attachment Required

Payment to a Restricted Merchant - Attachment Required

Limit Increase (Temporary)

Limit Increase (Permanent)

Limit Decrease (Permanent)

Limit Decrease (Temporary)

Fuel Cards

P-Card Cash Advance (Travel/Emergency)

Designate a Works Role*

Works approver, reconciler, scoped accountant, scoped auditor, authorization of expense delegation.

Department card manager & reconciler are only for cards with the department's name embossed on the card.

Name of Designated Employee for this Role*

Designated Authorizers Title*

Designated Employee's Email*

If Replacing an Employee in this Role

If you are replacing another employee currently assigned to this role, please provide their name:

Effective Date*

Card Replacement*

Damaged or name change - Use the comments field to list name change. Report a compromised, lost, or stolen card to Bank of America 1(888)-449-2273

Damaged

Fraud

Lost/stolen

Name Change

P-Card Cash Advance*

Cash Advance must be pre-approved by your area's business manager and P-Card administrator.

Cash advance fees: Department is responsible for cash advance fees. Bank of America Cash Advance Fee 2% of transaction amount (minimum charge of $5.00) *The bank providing the cash advance may charge additional fees for cash advance.

Travel

Other

Travel Authorization #

Travel: A Travel Authorization number is required (leave blank if not a travel related request)

Department Name*

Select

Primary Cardholder First and Last Name (ALL CAPS)*

Cardholders are expected to manage their card responsibly and comply with university policy and procedures.

New or Existing Cardholder*

New

Existing

Card Last 4*

The last 4 numbers of the P-Card

Cardholder Employee ID*

Employee ID #or Affiliate Status (provide documentation)

Employee Hire Date*

Cardholder/Employee Status*

Permanent, temporary, student employee, or affiliate (please attach proof of employment for affiliates)

Select

Cardholder Job Title*

Cardholder Email*

Card Embossed Name*

Name to appear on card - either cardholder name or department name (20 characters or less)

(Enter in ALL CAPS)

Limit Reset End Date

For temporary limit requests or card suspension

Cash Advance Amount*

Cash Advance must be approved by your area's business manager: Cash Advance Fees: Your department is responsible for cash advance fees: Bank of America Cash Advance Fee 2% of transaction amount (minimum charge of $5.00) *The bank providing the cash advance may charge additional fees for cash advance.

Max Cash Withdrawal Per Transaction*

Cash advance maximum withdrawal per transaction - cash advance must be approved by your area's business manager:

Reason for Closed Card*

Separation

Transfer

Account no longer necessary

Date of Last Transaction: Optional

The cardholder may complete the section below to request an account closure. Signature from cardholder is not required for account closure

Provide Exact Amount of Purchase*

Used for restricted merchants, one-time over-limit request, or when requesting to close a card and you know the amount of the last transaction authorized (use N/A/ for closed cards only if this is unknown)

Vendor Name & Address*

Provide the supplier name for restricted merchant request.

Name Changed to*

Card replacement due to name change

Pre Approved Custom Limit -*

Pre-approved by P-Card Administrator - Provide the Works spend profile name, max per transaction and the max monthly spend. example: $1,000 per transaction | $30,000 monthly maximum

Select or enter value

Recurring Charge?*

Will this be a recurring monthly charge? Prior approval is required, contact your P-Card administrator

Select or enter value

International Vendor?*

Foreign Supplier - Preapproval needed, review P-Card and international vendors for details: https://www.boisestate.edu/vpfa-pcard/international-vendors/

Yes

Is there a Project associated with this purchase*

Yes

Sponsored Project Number*

I have contacted Office of Sponsored Projects for approval and the Project # is

Segment String*

Provide a default accounting string for P-Card expenses: Transactions posting in Works will default to this fund source. Transactions can be reallocated by the department before Works sign off. Enter the segment string in the following format: Fund.Department.Cost Center.Supplemental.Project --Example 1001.12345.1234567.0000000000.0000000000

If no supplemental or project is provided, the default segment (10 zeros) will be used.

Provide Brief Explanation & Business Purpose*

Business purpose - this provides an auditor with both the business purpose and location of the item purchased.

Cardholders Assigned*

List cardholders assigned, or provide the Works group name, or attach list of card holders/group members.

Attachments

Required for one time payments or payment to a restricted merchant

Drag and drop files here or

Will the designated card manager act as card reconciler?*

Yes

No (please submit a new reconciler request)

Supervisor Email*

Please provide the cardholder's immediate supervisor's email.

Works Approver Name*

The person responsible for the review, edit, and approver sign off of cardholder allocation entries in Works monthly on or by the university due date. Approver role is fully defined in p-card guides and training materials. (Please enter the name manually if it is not in the drop-down list.) This is a free form field)

Works Approver Title*

Works Approver Email*

Expense Authorizer Name*

Department head, director, dean, V.P., or business manager who is responsible for reviewing and authorizing p-card expenses monthly via signature. The authorizer has a fiduciary responsibility to ensure the p-card expense is approved in a timely manner and is in compliance with university policy. Delegation of signing authority must be approved by the respective dean or V.P. for the area and submitted to the university p-card administrator for review and approval by University Financial Services. (Please enter the name manually if it is not in the drop-down list. This is a free form field.)

Expense Authorizer Title*

Department Head, Director, Dean, V.P., or Business Manager

Expense Authorizer Email*

The Respective Dean or V.P. for the area*

Business Manager / Fund Source Manager Please enter the name manually if it is not in the drop-down list. This is a Free Form Field.