HomeMy WebLinkAboutP-CardApplication2015CITY OF IOWA CITY
COMMERCIAL CARD PROGRAM
CARDHOLDER APPLICATION
Cardholder Name (name you will sign the card with):
Division Name:
Department Name:
Division Address (if other then City Hall address):
E-mail address at which you will receive monthly email notifications:
Work Phone Number:
Last four (4) of Employee ID Number:
Date of Birth:
Mother’s Maiden Name:
Single Transaction/Daily/Monthly Dollar Limit (Choose one of the following):
o $250 Single, $500 Daily, $1,000 Monthly
o $500 Single, $1,000 Daily, $2,000 Monthly
o $1,000 Single, $1,500 Daily, $2,000 Monthly
o $1,500 Single, $2,500 Daily, $5,000 Monthly
o $5,000 Single, $10,000 Daily, $20,000 Monthly
City Manager Signature Required: Date:
Division Head/Supervisor Signature: Date:
Department Head Signature: Date:
Purchasing Agent Signature: Date:
I have received the P-Card usage and reconciliation training:
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To be used by Purchasing only:
Card Number: Card Cancelled:
Card Number: Card Cancelled:
Card Number: Card Cancelled:
RETURN APPLICATION TO PURCHASING
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To be used by Purchasing only:
Card Number: Card Cancelled:
Card Number: Card Cancelled:
Card Number: Card Cancelled:
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