State of North Dakota Purchasing Card Policy Agreement
This file contains the Purchasing Card Policy Manual Agreement for State employees of North Dakota. It includes terms of use, responsibilities, and procedures for the cardholders. Employees must comply with the stated provisions to avoid any penalties.
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How do I fill this out?
To fill out this form, you must read and understand the terms provided in the agreement. Ensure you provide accurate and complete information where required. The form must be signed and dated by both the cardholder and the supervisor for validation.

How to fill out the State of North Dakota Purchasing Card Policy Agreement?
1
Read the Purchasing Card Policy Manual thoroughly.
2
Fill out your personal and business information accurately.
3
Acknowledge the terms of use by signing and dating the form.
4
Ensure your supervisor reviews, signs, and dates the form.
5
Submit the completed form to the Agency Card Administrator.
Who needs the State of North Dakota Purchasing Card Policy Agreement?
1
State employees who need to comply with the Purchasing Card Policy.
2
New hires in the State of North Dakota who will be issued a purchasing card.
3
Supervisors who need to authorize the purchasing card use for their employees.
4
Existing state employees transferring to different departments.
5
Agency Card Administrators for processing card agreements.
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What are the instructions for submitting this form?
Submit the completed form to your agency's card administrator. You can send it via email, fax, or a physical copy. Ensure that all fields are correctly filled out and signed by both the employee and supervisor. Email to: cardadmin@state.nd.us, Fax to: (701) 123-4567, or mail to: Office of Management and Budget, 600 E Boulevard Ave, Bismarck, ND, 58505-0400.
What are the important dates for this form in 2024 and 2025?
For the year 2024-2025, ensure the form is submitted by January 15th each year to remain compliant with state policies.

What is the purpose of this form?
This form serves to ensure that state employees understand and comply with the Purchasing Card Policy. It outlines the responsibilities and terms of use for the cardholders. Ensuring compliance helps protect state assets and prevent misuse of state funds.

Tell me about this form and its components and fields line-by-line.

- 1. Cardholder Signature: Cardholder must sign to acknowledge understanding and compliance with policy.
- 2. Date: The date when the form is signed by the cardholder.
- 3. Cardholder Name (printed): The printed name of the cardholder.
- 4. Application Information: Includes user ID, name, date of birth, employee ID, business email, and telephone number.
- 5. Business Address: The address of the cardholder's business location including city, state, and ZIP code.
- 6. Home Address: The residential address of the cardholder including city, state, and ZIP code.
- 7. Supervisor/Fiscal Officer Signature: Supervisor must sign to approve the cardholder's use of the purchasing card.
- 8. Agency Card Administrator Signature: Signature of the agency card administrator for final approval.
What happens if I fail to submit this form?
Failure to submit this form may result in the cancellation of card privileges and possible disciplinary actions.
- Loss of Card Privileges: Cardholder will lose the right to use the state-issued purchasing card.
- Disciplinary Action: Employee may face consequences up to and including termination of employment.
- Reimbursement Requirement: The employee may be required to reimburse the state for any improper use of the card.
How do I know when to use this form?

- 1. New Card Issuance: Mandatory for all newly issued state purchasing cards.
- 2. Department Transfer: Required when an employee transfers to a new department within the state.
- 3. Card Renewal: Needed upon renewal of the existing purchasing card.
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