DEM Shared Services Purchasing Form Use this form to request a purchase from DEM Shared Services. Please email dem_support@em.wisc.edu if you have any questions. CommentsThis field is for validation purposes and should be left unchanged.Name(Required) First Last Email(Required) Additional EmailIf someone else should be informed about this request (your supervisor, a co-worker, etc) enter their email here. Purchase Type(Required)Select oneMembership or Subscription RenewalTechnical EquipmentSoftware and LicensesOffice SuppliesFood Purchase for EventPurchase over $5,000Conference Registration or Travel ExpenseBusiness Cards or NametagsOtherPlease list office supplies needed belowOffice supplies should be purchased from Staples, if available. Please look at Staples first and provide links to the specific items you’re requesting. If not available on Staples, please provide links to alternate vendor. Provide quantity and color if applicable.Conference City and State/Province/RegionDeparture Date Return Date Justification(Required)Describe the purpose of the travel/event and provide detailed explanation of who, where, when, how, and why it will benefit your role/project and/or department and/or supports or advances the goals, objectives, and mission of the University.Early Bird Registration Deadline Travel FundingIf you know your funding, please provide it here (Cost Center, Driver Worktag ID, Fund, Function). Please provide any additional funding notes here, including if funding needs to be split across multiple accounts).Estimated CostTravel Funding Certification I certify that the items requested are allowable, reasonable, and advancing the mission of UW – Madison.Cost ComparisonCost comparisons can be obtained in the form of Concur screenshots when booking via Concur or obtained from the designated travel agency (request documentation such as emailed quotes from agents). A valid Concur or agency cost comparison includes: Proof that the cost comparison was done on the same date as the purchased actual airfare. Proof that the travel dates shown on the comparison correspond with the UW business dates. I understand that a cost comparison will be required for reimbursement of indirect travel. I understand that a cost comparison will be required if I choose a less efficient or cost-effective transportation method (e.g., driving or train instead of flying when flying is the most efficient and economical option). I understand a cost comparison will be required if I depart from or return to an airport outside Wisconsin or more than 100 miles from the Wisconsin border for personal reasons (including voluntary remote work locations) Purchases over $5,000 Please contact Kelly Layton and Mallory Oller directly for any purchases over $5,000. Food Vendor Name(Required)Food Vendor Contact PersonFood Vendor Contact informationPlease enter phone number and/or email address of food vendor.Event Date(Required) Budget/Cost(Required)Please include how much you would like to spend.Details(Required)Please provide as many details as possible about your request (ex. delivery instructions, expected number of attendees, contact name and cell phone of onsite person, delivery time, other support needed)PDF of invoice, quote, or other documentationPlease ask the vendor to produce an invoice for payment. If they are unable to, please attach the quote here and let us know you need us to call the vendor directly to pay. Do not upload files that contain sensitive information. Please combine multiple files into 1 optimized PDF prior to uploading. Drop files here or Select files Accepted file types: jpg, pdf, doc, eml, Max. file size: 10 MB, Max. files: 10. Attendance List & AgendaPlease upload a PDF your expected attendance list and agenda for your event here. If you will not have these until after the event, please continue past this prompt and email us the attendance list and agenda after your event. Drop files here or Select files Accepted file types: jpg, pdf, doc, eml, Max. file size: 10 MB, Max. files: 10. Do you need additional supplies for this event? Paper Plates Napkins Plastic Cutlery Do you need an official function form signed prior to purchasing food for this event?(Required)Official Functions forms are needed if your event is purely celebratory, or you know you will exceed per diem limits. Please reach out to Kelly Layton or Mallory Oller for questions on Official Functions forms. Yes No I don’t know Business Meal Per Diem Limits as of 7/1/2025 Type of Meal Continental US All Other Locations Breakfast $28 $35 Lunch $31 $40 Dinner $46 $60 Refreshment Break $14 $20 Safe Food Handling Guidelines Keep it Fresh: Minimize time spent in temperature danger zone (between 41 and 135 degrees F). Replace empty serving dishes with fresh food; don’t add new food to filled dishes. Discard ALL leftovers that were sitting out.Do: Get food from licensed & approved suppliers Store food 6″ off the ground Wear a hair restraint Cover food and condiments Keep raw meat in a separate cooler Use and have extra serving utensils Use containers that contain a small volume of food and replace them oftenDon’t: Bring food made at home Touch ready-to-eat food with bare hands Eat, drink, smoke, vape in food areas Serve or prepare food when sick Let customers serve themselves Pick up or have food delivered more than one hour before your eventCertification(Required) I certify that the items requested are allowable, reasonable, and advancing the mission of UW – Madison. I certify we will follow safe food handling guidelines as outlined above. I certify that I have reviewed and understand purchasing policy for this request. Vendor Name(Required)Vendor Contact PersonDescription & Order Details(Required)Description of the item and quantity needed. For items like swag please include color, logo, etc.Cost(Required)Justification(Required)Describe the purpose of the purchase and provide detailed explanation of who, where, when, how, and why it will benefit the project and/or department.PDF of invoice, quote, or other documentationDo not upload files that contain sensitive information. Please combine multiple files into 1 optimized PDF prior to uploading.Accepted file types: pdf, Max. file size: 10 MB. Funding Approval I am both submitting and authorizing this purchase. No additional authorization is required. I have received funding approval for this purchase and can provide written documentation of that approval if asked. Other FundingIf you know your funding, please provide it here (Cost Center, Driver Worktag ID, Fund, Function). Please provide any additional funding notes here, including if funding needs to be split across multiple accounts).Funding Certification I certify that the items requested are allowable, reasonable, and advancing the mission of UW – Madison.Do you need business cards, nametag, or both? Nametag only Business cards only Both Name to display First Last Pronouns (will appear next to name if you want them)Position Title to displayDepartment to display under nameAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzechiaDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussian FederationRwandaSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTürkiyeTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country PhoneEmail Website Number of business cards1002505001000Policy Certification(Required) I certify that I have reviewed and understand purchasing policy for this request