Request for Record

 Purchasing

 

Request for Services Agreement

Instructions: This form is used to request agreements to enter into a contract with non-ACC employees for consulting, professional services (such as architects, attorneys, and auditors), and honoraria services. Administrative rule 7.02.002

For consulting/professional service agreements, a proposal must be submitted with a request and invoices must be attached to the payment form. The requestor will be the Budget Authority of the Budget GL account funding the request.

PLEASE PLAN AHEAD. Faxed agreements will no longer be accepted. Original signatures are required on all service agreements.

All agreements must be approved by all parties before the work can begin.

Site visitors can navigate through the form — move from field to field — by pressing the TAB key. Pressing the ENTER key will submit the form.

 

Requesting Department
Budget Authority
 Department
 		Campus
 Phone

  Email 
(required for response)
[name@austincc.edu]
   

Agreement Information
 

Budget GL Account Number
(Example: 10-7-13006-XXXX-00)


Select type of Agreement
 Consulting
Honorarium
Professional Services

 


Amount of Request $ 
(Include all reimbursements)
Select Payment Options
 Single Payment
Multiple Payments

Provider/Vendor/DBA  Information  
  

Provider/Vendor Name

Address

City, State Zip Code

Phone Number

Fax Number
     
Brief description of Work:

 
Delivery Options 
   

I would like to pick up the agreement. [NOTE: You will be notified by email when the document is available.]

Please send the agreement through Intercampus mail.
   
 

When you submit this form, (1) a confirmation of your Request will be displayed and (2) your Request will be emailed to Purchasing for  processing.
 

 

Please contact Purchasing (223-1044 or 223-1300) if you have questions regarding this form.  Thank you.

Last updated: 01/07/2010