Accounts Payable Payment Request Form

Accounts Payable Payment Request Form

Effective 2/05/2024, prior approval required by appropriate Vice President or GMC Executive Director on direct pay or blanket PO payment requests over $10,000. Review and approval workflow for direct pay is made as part of Smartsheet. For zero dollar blanket PO payment request over $10,000, email approval from VP must be attached with the payment request form.

Please submit one invoice per form and do not combine business unit. This form can be used for the following Request Types:

Direct Pay - Vendor Payment Request Direct Pay
PO/Contract PMT - Vendor Payment Request for PO/Contract
Wireless Device & Service - Authorization for business related wireless device and service

Business Unit*

Check the appropriate Business Unit below.

Select

Requester Name*

If you don't see your name (or email) in the list, select "Other" and type in your name in the box below. Email carrie.schmidt@sonoma.edu to add your name to Requestor Name list.

Select

Requestor Name (Other)*

Please provide your name. Workflow will not be available.

Requester phone*

Requester Email*

Request Type*

Select

Department Name and Number*

Select

Retention Payment Request*

Select or enter value

Buyer Name*

Select the Buyer name for retention payment request review

Select or enter value

SOSSE & EA Approvers*

Select

Vendor/Supplier Name*

Vender Supplier Number (VID)*

Please provide the VID number. Put "New Vendor" if this is a new vendor. Active vendor VID can be found in CFS.

Due to data security requirement, vendor/supplier must upload the completed 204 form to Financial Services website. Form and instruction are avaliable at https://finance.sonoma.edu/procurement/vendor-registration. DO NOT SUBMIT 204 FORM WITH PAYMENT REQUEST.

Any Direct Pay request submitted without a 204 form on file will be retained by Accounts Payable for 30 days. If completed 204 not provided by Supplier within 30 days, Direct Pay request will be returned to the department.

Invoice Date*

Vendor Payment Request Direct Pay Payment Type*

Invoice must be upload to the File Upload box below. One invoice per request. Ineligible direct pay expense items include: IT hardware, software, payments to CSU or state employees and service payments to students without HR approval.

Select

Invoice Number*

One invoice per request. If no invoice number provided on the invoice, please provide the invoice number in accordance with the following naming convention:

For service - SV-State where services were performed-date of service-amount (Example for $1000 services in CA: SVCA050322-100000 or $250 in NY: SVNY072322-25000)

For participant - P-State where participation occurred-semester-year (Example for a participation in CA: PCAFALL2022 or participant in NY: PNYSPRING2023)

For refund - RF-date of event-amount (Example: RF010122-75000)

Payment Type Category - Other*

Please describe the type such as organization membership ,utilities, governmental or regulatory fees, etc

Service Location*

Where is service provided?

Select or enter value

Participant Location

Select

Remit to address (for refund)

Invoice Total Amount*

Please provide the total invoice amount including tax, shipping and handling.

PMT ORSP Identification*

Select "Yes" if a "Q" fund/ORSP fund is used as fund number for this request

Select

Invoice Total Amount over $10,000*

Select "Yes" if invoice total amount is over $10,000

Select or enter value

Vice President Review*

Select the Vice President of your division

Select or enter value

Tax Rate Verification*

Select one from the following

Select

CFS Data Warehouse Expenditure Description*

Up to 30 characters

Confirming Order Determination*

Select "Yes" if this payment request fits one of the following criterias which will be consider confirming order and further review is required:

-Commodity over $500

-Non-contractual service over $2,500

-Contractual service at any dollar amount

Select

Confirming Order Question No. 1*

Why was the correct process (EREQ) not followed?

Confirming Order Question No. 2*

What measures will be implemented to ensure compliance with procurement policies and procedures?

PO/Contract Number*

Please provide the PO/Contract Number

PO/Contract CFS line number and amount*

Please identify CFS line number(s) and amount to be paid for each line. For example total invoice amount (service) is $5,000

PO line 1 - $2,500

PO line 2 - $2,500

For commodity invoice, please identify the qty for each PO line.

Employee Name*

Employee ID*

Employee Email*

Mailing Address*

Reason wireless device/service is required*

Please select the applicable reason(s)

Select

Wireless Device & Service Policy Requirement Justification*

Please provide a detailed business explanation according to policy requirements

Wireless Request Vice President Approval

Vice President Reimbursement Request select President's Office Email Address for Approval

Select

Wireless Reimbursement Type

Select

Wireless Device Reimbursement Frequency*

Device reimbursement is only allowable every 2 years. Put " First Request" if this is your first request. If this is not your first request, please indicate the date of your last request and it must be 2 years or more.

Wireless Device Purchase Amount*

Please select one from the following

Select

Wireless Service Plan Reimbursement Period*

Select

Wireless Service Plan Amount*

Select

Wireless Service Reimbursement Total*

Reimbursement may not exceed actual expenses incurred. A most recent bill should be uploaded to the File Upload box below.

Chartfield String Type

Select

Multiple Chartfield String*

Please provide the amount and completed CFS chartfield string in this format - Account Number/Fund Number/DeptID/Program/Class/Project ID Please put "0" or "NA" for category that is not applicable.

Example: $450 total invoice amount 660003/SO100/3067/0000/0000/0000 $250

660003/SO100/3060/0000/0000/0000 $200

Single Chartfield String - Account Number*

Select

Hospitality Account Code*

Select

Wireless Device & Service Reimbursement Account Code*

Select

Single Chartfield String - Fund Number*

Single Chartfield String - Program Code

Single Chartfield String - Class Code

Single Chartfield String - Project/Grant No

ORSP Principal Investigator*

Please select the PI

Select

Zero Dollar PO/Contract Chartfield String

If PO/Contract is set up a zero dollar encumbrance, please provide the chartfield string(s), amount and DOA approval for the chartfield string. Please attach Vice President's email approval for any invoice amount over $10,000.

Receiving Notification

For commodity only - Please confirm that Receiving department is notified prior to submit payment request.

PO/Contract service date within the term*

By checking the box below, department verified that the service duration stated on the invoice is within the PO/Contract term. If it is not, please submit an EREQ to amend the PO/Contract prior to submit the payment request.

Wireless Device & Service Reimbursement Taxable Income Acknowledgement*

Employee understands upon separation, Accounts Payable will review the current allowance for the potential of taxable income reporting. By clicking the checkbox below, employee has read, understands, and agrees to Wireless Device for Business Use Policy - https://policies.sonoma.edu/policies/wireless-devices-business-use.

Wireless Device Reimbursement Receipt*

Please upload the purchase receipt to the File Upload box at the bottom of the form. Reimbursement may not exceed actual expense incurred.

Wireless Service Reimbursement Receipt*

Please upload the most recent bill to the File Upload box at the bottom of the form Reimbursement may not exceed actual expense incurred.

SOASI Dual Approvals*

2 approvals are required for all SOASI payment. Check this box if this is a SOASI payment request and 2 email approvals must be uploaded to the File Upload box below.

Notes to Account Payable

File Upload

Drag and drop files here or

Send me a copy of my responses

Privacy Notice|Report Abuse