THE UNIVERSITY OF WEST FLORIDA
CONSULTING & PROFESSIONAL SERVICES FORM
UWF Requestor Name:
Rev 10/23/2017
CHECK ONE:
PART 2
INSTRUCTIONS: This form is to be completed when contracting with a professional for consulting or personal services. If the individual providing the service is
an employee of The University of West Florida (UWF), do not fill out this form; but instead process an Action Sheet and contact the Office of Human Resources
(OHR). Refer to the Consulting and Professional Services Instructions document located at: http://uwf.edu/media/university-of-west-florida/offices/procurement/
sops/SOP_110.02_C&PSFormOrContractProcedures.pdf
If the individual is a corporation or a government entity, the questions below in PART 1, do not need to be answered.
For individuals who are independent contractors/consultants and are not a UWF employee:
--If the cost is under $1,000: fill out this form in lieu of a Direct Pay Request Form; and, submit the completed form to Accounts Payable in Controller's Office for
issuance of check.
--If the cost is $1,000 or more: submit a Banner Requisition; complete this form; and, email this completed form as an attachment referencing the Banner
Requisition Number to procurement@uwf.edu
Mail payment to payee address listed below.
Contact UWF Requestor below when check is ready for pickup.
Department Name:
Bldg. / Rm: Phone: Email:
PART 1:
If the answer of any of questions 1 - 5 is "YES", do NOT fill out/submit this form; instead process an Action Sheet and contact OHR
YES
NO
YES
NO
YES
NO
YES
NO
YES
NO
YES
NO
YES
NO
2. Is there a regular or on-going relationship with the individual? For example, are you hiring them for more than a one-time task?
3. Are the services of the individual integrated into your organization and performed on a continuing basis as part of our department's
on-going operations?
1. Does the individual currently work at or for UWF?
5. Is the UWF department providing on-going training and step-by-step direction concerning how to complete the task or does a UWF
department have the right to change the processes the individual is using to complete the task?
7. Does the individual bear the risk of making a profit or losing money under this agreement?
6.
Does the individual provide the same or similar services to others?
4. Is a UWF department providing long-term assistance and support to the individual, such as personnel support, supplies, equipment,
etc.?
If the answer to questions 6 and 7 are "NO", do NOT fill out/submit this form; instead process an Action Sheet and contact OHR.
Payee Name (Payee Name must match IRS tax records):
Payee Address:
City/state/Zip:
Phone:
Fax:
Email:
Business Type - CHECK ONE:
Corporation / Government Partnership
Individual / Sole Proprietor
Payee ID Number - Please Enter Banner ID:
Residency - CHECK ONE (If the individual is a nonresident alien (foreign national), contact Controller's Office for filing all necessary IRS, foreign declaration and withholding
forms in
additional to verification of an approved Visa.
I am a United States citizen or permanent resident.
I am a non-resident alien.
PART 3 - Scope of Work and Expected Outcome: (If additional space is required, attach sheet)
Dates of Service:
Payment Terms:
PRINTED NAME:
Date:
AUTHORIZED SIGNATURE:____________________________________________________________________________________________
BANNER CODING:
Index Code Commodity Code Account Code Activity Code $ Amount
