AUTHORIZED SIGNATURE CARD

DEPARTMENT  NAME:______________________________________

Signature Authorization Level                      (     )  Up to and including $10,000

(Check only one)                                           (    )   Over $10,000 and up to and

                                                                                 including $50,000

                                                                       (    )  Over $50,000

Able to sign in Department Head’s Absence:         (    )Yes      (    )No

Effective Date: _________________________________

NAME OF INDIVIDUAL:  ________________________________

(Please print or type)

AUTHORIZING SIGNATURE OF INDIVIDUAL:  ____________________________

INITIALS OF INDIVIDUAL:  _______________________

NAME OF INDIVIDUAL BEING REPLACED:___________________________-

AUTHORIZED:        __________________________________

                                   Department Head

This signature card applies to all financial documents including: Voucher Requests,

Requisitions, Interdepartmental Billings, Journal Entries, Budget Revisions, Contract

Payments,Wire Transfers, Payroll Registers and Payroll Time Checks, Written Contracts,  Contract Amendments and Change Orders.