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Get Contract Coversheet - University Of Houston-victoria

E Name of Vendor City, State Date of Receipt Total Cost Vendor s Telephone Number Description of Purchase and Benefit/Purpose Certification While on official university business I incurred the expense described above. I have lost, misplaced, or did not receive the receipt documenting payment. I am submitting this affidavit in lieu of the missing receipt. Cardholder s Signature Date Cardholder s Name Printed APPROVAL Supervisor s Signature Date Supervisor s Name Printed No.

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