Vendor Payment Form

Please fill out all required fields.

Please fill out all Ministry Lead information.
Date of Submission * / MM / DD YYYY
Ministry Lead Name * First Last
Ministry Lead Email *
Notes / Payment Instructions
Details of Vendor Information
Vendor Name *
Vendor Point of Contact *
Vendor Email
Vendor Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Details of Vendor Payment Information
Date of Vendor Payment / Date of Service / Due Date * / MM / DD YYYY
Vendor Payment Amount * $ . Dollars Cents
Ministry Code *
Details on Spending *
Upload Invoice *

Attach Files Attach Files
Please email Payments@odpcec.org if you have any questions regarding the Vendor payment process.

By submitting this form, I confirm that items/services purchased (or will be purchased) will be used solely for the ministry specified above. I have made a reasonable effort to get the best price possible and confirm that there were no conflicts of interest in making this purchasing decision.
Full Name *

I confirm the above statement.
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