Request for Subagreement
Please attach a statement of work and budget for a subcontract/subgrant and contractor agreement.
Please visit the ORSP website for more information on the distinction between a subcontract/subgrant,
consulting agreement, and vendor. For additional questions, contact your Project Administrator.
Subcontract/Subgrant
Contractor Agreement
Consulting Agreement
Project Period: _____________________ Performance Site: __________________________________________
Organization Information
Organization/Contractor Name: ________________________________________________________________
Address: __________________________________________________________________________________
Phone (work): _____________ Phone (home): _____________ Social Security Number: ____________________
SUBAWARD/SUBGRANT ONLY: Does the subawardee have responsibility for substantive project design,
implementation or programmatic reporting?
Yes
No
Please attach any reporting requirements and scheduled deliverables required by the subawardee.
CONTRACTOR ONLY: Is the contractor a U.S. citizen?
If no, please contact your Project Administrator.
Yes
No
Technical Contact:
Name: _____________________________________________ Email Address: ________________________
Address: __________________________________________________________________________________
Contractual Contact:
Name: _____________________________________________ Email Address: ________________________
Address: __________________________________________________________________________________
Funding (If more than one task or assignment, please indicate; use additional pages if necessary)
Contractor Rate: __________________________ Hour
Day
Travel Total: ___________________
Miscellaneous Expense Total: ____________________ TOTAL CONTRACTOR FUNDING: _______________
Additional Travel: _________________________ Cost-Share Commitment: _____________________________
Payment Breakdown: ________________________________________________________________________
Monthly by cost reimbursable, fixed price, scheduled payments, task, upon delivery of items, reports, or other.
Budget to Charge
Fund: ________________________ Org: ________________________ Account: ________________________
Invoice Approval:
DU PI Name: _____________________________________________________________________________
Department: ____________________________________ Office Phone: ______________________________
Certification and Approvals:
PI Signature: _________________________________________________ Date: _________________________
Dean/Chair/Budgetary Director: _________________________________ Date: _________________________
ORSP Approval:
Agreement Number: ____________________ Federal Prime Sponsor Name: ____________________ CFDA: ____________________
Purchase Order: __________________________________________
Regular PO
Blanket PO
Line Item
Grant/Contract Number: _______________ Debarment/Suspension Checked (Date): __________________ Initials: _______________
Project Administrator: _________________________________________________ Date Received: ____________________________
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Independent Contractor 1099 Status Test
FOR CONTRACTORS ONLY – Taken from Payroll Options Unlimited, Inc.
Yes
No
1. Do you instruct the person as to when, where and how work is performed?
2. Did you train the person to perform services in a particular way?
3. Are the person’s services vital to your research?
4. Is the person required to perform the work personally?
5. Is the person prohibited from hiring, supervision, and paying assistants?
6. Does the person perform regular and continuous services for you?
7. Do you set the hours of work for the person?
8. Does the person provide services on a substantially full-time basis to your research?
9. Is the work performed on your premises?
10. Do you control the sequence or the order of the work performed?
11. Do you require the person to submit regular oral or written reports?
12. Do you pay the person by the hour, week or month?
13. Do you pay the person’s travel and business expenses?
14. Do you furnish tools or equipment for the person?
15. Does the person lack a “significant investment” in facilities, tools or equipment?
16. Can the person realize a profit or loss from his/her services to your company?
17. Is your project the sole or major source of income for the person?
18. Does the person make services available to the general public?
19. Do you have the right to discharge the person at will?
20. Can the person terminate the relationship without liability?
ADDITIONAL COMMENTS (Include potential conflicts of interest):
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