Hilltop’s Purchasing Department

Use the Credit Card Request Form to apply for a Hilltop Purchasing Card (P-Card).

1. A member of Senior Leadership must approve all new P-Cards
2. Submit completed form, with appropriate signature approval, to the Purchasing Department
3. The P-Card is property of Hilltop and should be used for work-related purchases only

Use the Cell Phone Request Form to apply for a Hilltop Company Cellphone

1. Must meet two of the 5 criteria below to be eligible:

• Employee is regularly scheduled to work away from their desk
• Employee is required to be available by phone while they are not at their desk
• Employee is needing phone access for safety due to the nature of their job/position
• Employee is required to read and respond to e-mails while away from their desk
• Access to e-mail is deemed to be time sensitive

2. Supervisor must sign

3. Operational Director (Ops Leader) must sign

Preferred Vendor Lists (by Vendor and Category)

1. This is a compiled list of key vendors that Hilltop/GVA has contracts, agreements, or partnerships with and should be the first consideration when choosing vendors for purchasing needs.

Use the Purchase Order Request Form if any of the following apply:

1. The order for goods, service or repairs totals $2,000 or more.
2. You need a record of details such as, part number, cost, vendor name or date purchased for warrantied goods or services (regardless of dollar amount).
3. The vendor requests or requires a PO number (e.g., Patton’s Printing).
4. The product you want is online and you do not have a Hilltop credit card.

Guidelines to follow:

1. Select whether a Hilltop (Tax-Exempt) purchase or a GVA (Taxable) purchase.
2. Please enter a valid delivery date. Noting “ASAP” as a delivery date is not appropriate and could result in unnecessary expedited charges or a later than needed delivery. Please consider things such as Mfr. Lead Times, Shipping Time, etc., when noting a delivery date.
3. The appropriate signature authority is required for processing (please refer to Hilltop Signature Authority List).
4. Forward the fully completed and approved/signed form to the Purchasing Department.

Use the Project Request Form if:

1. The physical change to a facility is over $2,500.
2. The project requires multiple vendors and is over $2,500.
3. The expenditures will be capitalized.

Use these School District Forms for all orders placed with them.

Use the Sam’s Club Order Form for Sam’s Club Orders ONLY

Use the Hilltop Credit Card (P-Card) if:

1. You possess a card in your name or have rights to a program card. Purchases over $2,000 require a Purchase Order prior to the purchase. Individual credit card limits will apply.

Use the Check Requisition process if:

1. Funds are needed in advance for product, registrations, subscriptions, service, dues, travel, etc. Form is available in the Fiscal Department.

Use the Petty Cash process if:

1. You do not have a Hilltop credit card.
2. The purchase is small and needed immediately. Each facility has its own allowable balance.

Use the Expense Voucher process if:

1. You do not have a company credit card.
2. You personally paid for a company expense and are seeking reimbursement.
3. Mileage incurred by your personal vehicle was for company purposes.

Hazardous Waste Inventory Form

Contractor/Vendor Application packet

Department Account List

PAT (Project Action Team) FORM
Please click the button to the right and fill out the form.

Hilltop Tax-Exempt Certificate and DR-5002 State of Colorado Affidavit of Exempt Sale Forms

A DR-5002 form may be required by vendors/companies that Hilltop does not have accounts with (e.g. hotel accommodations, Hobby Lobby, Michael’s, etc.) and would not have our tax-exempt details on file.

• Form is to be completed at time of purchase
• Complete the following fields:
1. Select “Purchase by religious or charitable organization (exemptions may vary by jurisdiction” (2^nd box down)
2. Select “Paid by purchasing card bearing information of the exempt organization”
3. Legal Name of Company “Hilltop Health Services Corp.”
4. Purchaser Name (Your Name)
5. Address “1331 Hermosa Ave, Grand Junction, CO 81506”
6. Phone “970-242-4400”
7. State/Driver License (Enter your ID info)
8. Description of Normal Course of Business “Not For Profit”
9. Sign and Date

ACH Authorization Form

GVA W-9 Form