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Origin of Contract:
Business purpose of the Contract:
Business Contract or Academic Contract
Counterparty Contact Person:
Counterparty Address and Telephone:
Is the contract for goods or services ?
Is the contract a purchase or lease ?
Contract Period: Begin Date:
Does the contract provide for automatic renewal or extension? No Yes If yes, by what date must notice
of nonrenewal be given?
If contract is for the use of a university facility by a third-party, enter building code:
Is the contract for the purchase/license of computer software? Yes No
Is the contract for the lease or purchase of computer hardware? Yes No
University expenditure per fiscal year: $
University expenditure for life of the contract: $
Dean /Department Head Approval:
Contract Originator Date Dept. Head/ Dean Date