<p> UM 1819: Price & Supplier Justification Form For Purchases of Standard Goods and Services $10,000-$49,999.99</p><p>Option E: Replacement for a PO that Closed Unexpectedly at Fiscal Year End</p><p>Instructions: 1. Send this form to the EFS requisition preparer, or procurement specialist if it involves a PO change order. 2. The EFS requisition preparer or procurement specialist must: a. Create a requisition or PO change order for this purchase. b. Type “See attached Form UM 1819” in a header-level comment’s text box. c. Upload this form into the associated header-level comment. Do NOT combine this form with any other attachments or files. d. Do NOT click the <Send to Supplier> checkbox because this is an internal form. 3. The EFS approvers will review the requisition and the form to ensure compliance.</p><p>Questions? Contact Purchasing Services at: [email protected]. </p><p>Requester’s name</p><p>Requester’s email</p><p>Supplier name</p><p>Total amount of new requisition or PO</p><p>Original (Closed) PO number</p><p>Original PO’s total amount at the time of closure</p><p>How was the supplier originally selected? List one of the following: U Wide Contract, Price Comparison, Sole Source, Non PO, or RFP/Bid This form’s last revision was made on 7/01/2016 by Purchasing Services.</p>