Request for Subagreement
Please attach a statement of work and budget for
a subcontract/subgrant and c
ontractor a
greement.
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 Consulting Agreement Contractor 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 y
our 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: _______________
