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<br />e <br /> <br />e <br /> <br />City of La Porte, Texas <br />CREDIT CARD REQUEST AND AUTHORIZATION <br /> <br />Employee/Official Name: <br /> <br />PositionlTitle: <br /> <br />Authorized Limit: <br /> <br />Date of Request: <br /> <br />Cardholder Acknowledgement <br /> <br />I hereby acknowledge receipt of the City of La Porte written Credit Card <br />Policy, and certify that it has been reviewed with me, I understand that by <br />accepting this card, I am aware that it is to be used ONLY for the purposes of <br />official business for the City of La Porte and I accept full responsibility for its <br />safekeeping, I further agree to abide by the City of La Porte Credit Card <br />Policy and Procedures Manual, and understand that I may be personally liable <br />for any unauthorized charges made by me and agree that any such charges <br />may be deducted from my paycheck, <br /> <br />Prospective Card/wider <br /> <br />Date <br /> <br />Authorizing Officer (City Manager) <br /> <br />Department Approving Official <br /> <br />Audit Committee Approval <br /> <br />Program Administrator Approval <br /> <br />Date Request Processed <br />Date Card Issued <br /> <br />Finance FonnCCRA <br />11101102 <br />