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Forms

Purchasing, Equipment Management and Storage Forms

PO Lien Removal Lien Removals    
Purchase Order Requisition File Name: Poreques.doc ; Size33KB Rev. 1/98 pr.pdf
Storehouse Requisition File Name: Shreques.doc ; Size 22KB Rev. 10/97 sr.pdf
Equipment Purchase Order File Name: Eqpo.doc ; Size 20KB Rev. 3/98 ero.pdf
Equipment Repair Order File Name: Eqrepair.doc ; Size 27KB Rev. 10/97 ero.pdf
Request for Delivery File Name: Reqdeliv.doc ; Size 17KB Rev. 10/97 rfd.pdf
Records Storage Requisition File Name: storagerecord1.xls; Size 21KB Rev. 12/99 rsr.pdf
Consent to Photograph File Name: flmcnsnt.doc; Size 24KB Rev. 04/01 fcsnt.pdf
Appendix A (8-99)11 File Name:AppendixA(8-99)11.doc, Size 52 KB Rev. 11 Appendix A (8-99)11.pdf
Single Source Justification File Name: SSSJ.DOC; Size 22KB Rev. 08/00 sssj.pdf
Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion – Lower Tier Covered Transactions File Name: ExhibitA.doc ; Size 30KB Rev. 12/06 ExhibitA.pdf

Certification and Disclosure regarding payments to influence certain federal transactions

File Name:EXHIBITB.doc; Size 26KB Rev. 12/06 EXHIBITB.pdf
Certification Regarding Debarment, Suspension, Proposed Debarment, and other Responsibility Matters File Name: EXHIBITC.doc; Size 31KB Rev. 12/06 EXHIBITC.pdf
Special Terms and Conditions for Federal Government Contracts File Name: supplement5.pdf; Size 15KB Rev. 12/06 Supplement 5.pdf
Supplier Vendor Setup Form FileFile Name: VendSetupForm.pdf; Size 61KB Rev. 05/07 VendSetupForm.pdf
Business Contract Forms

Business Agreement Request Form

busafrreq.doc; Size 85KB Rev. 05/06 busagrreq.pfd
School of Medicine Training Affiliation Request Form somtaa.doc; Size 86 KB Rev. 05/06 somtaa.pdf
School of Nursing Training Affiliation Request Form sontaa.doc; Size 80KB Rev. 06/06 sontaa.pdf
School of Pharmacy Training Affiliation Request Form soptaa.doc; Size 78 KB Rev. 06/06 soptaa.pdf
General Liability Certificate of Insurance Request Form coi_rf.doc; Size 45 KB Rev. 05/06 coirf.pdf
Facility Rental & Event Forms
Contract Document Path File Name: FR_CDP.doc ; Size 197KB ; Rev.3 02/02  
Deposit & Event Payment Process File Name: FR_DEPPnew.doc ; Size 97KB ; Rev.6/27/02  
Interactive Facility Rental Form File Name: FR_IFRF.doc ; Size 44KB  
Campus Agreement Catering Form File Name: CateringForm.doc ; Size 56KB  
Clauses File Name: Clause.doc; Size 29KB clauses.pdf
Westin St. Francis Engagement Form File Name: WSF_Engagement.doc; Size 133KB  
Template Low Value Facility Rental File Name: FR_TLV.doc ; Size 71KB  

PMO forms

Preventative Maintenance Order (PMO) File Name: PMO.DOC ; Size 34,854 Rev. 10/97 pmo.pdf
Term&Condition (PMO) File Name: PMOTC.DOC ; Size 32,680 Rev 10/97 ddpgtc.pdf
Supplement 4 (PMO) File Name: PMOS4.DOC ; Size 32,725 Rev 10/97 s4.pdf

<><><>Independent Consultant Agreement Forms

Amendment

File Name: Amendment.doc

Size: 22k

a.pdf

Delegation of Authority

File Name: ICADelegationForm.doc

Size: 21k

doa.pdf

Submittal Memo

 

 

 

Independent Consultant Agreement

 

 

 

Certification of Completion

File Name: ICACompletionForm.doc

Size: 20k

coc.pdf

Pre Hire Worksheet

File Name: ICAPre-Hire.doc

Size: 48k

phw.pdf

Independent Consultant Agreement w/PHI

 

 

 

Conflict of Interest Reporting

File Name: ICAConflictofInterest.doc

Size: 25k

coir.pdf