CONTRACT COVER SHEET EXHIBIT
Systems and Procedures
A Division of The Office of Budget and Finance
IN
Last Revision: 01/26/2022

CONTRACT COVER SHEET

Form Instructions

Section 1: Contract Cover Sheet

  1. Select the date the form is being completed
  2. Is there an outgoing payment by the University associated with this Agreement? Select Yes or No from the drop-down list
  3. If there is an outgoing payment associated with the Agreement, after consulting the SIMBA General Ledger Accounts and Payment Decision Matrix select the payment method from the drop-down list. Options include Purchasing Card and Non-PO Invoice
  4. If no selected above, is this a non-financial agreement (no payment incoming or outgoing)? Select Yes or No from the drop-down list
  5. If yes, continue to Supplier/Other Party Information section. If no, are there incoming funds/payments to the University? Select Yes or No from the drop-down list
  6. If yes, continue to Supplier/Other Party Information section. If no, provide an explanation and continue to Supplier/Other Party section.

Section 2: Supplier/Other Party Information

  1. Enter the Supplier/Other Party Name
  2. Enter the name of the Supplier/Other Party contact person
  3. Enter the telephone number, including area code, of the Supplier/Other Party contact person
  4. Enter the email address of the Supplier/Other Party contact person
  5. Is this Supplier/Other Party a foreign entity? Select Yes or No from the drop-down list. If yes, see Non-U.S. Citizen Payment Guidelines. Continue to Section 3: Contract Information

Section 3: Contract Information

  1. Enter the dollar value of the contract (if applicable). If unknown, enter To Be Determined, TBD, or unknown
  2. Is this a contract renewal? Select Yes or No from the drop-down list
  3. Provide a brief description of contract, including any special notes
  4. Enter the date of contract service/performance (list date range if applicable)
  5. Is any data being shared with, manipulated, stored, or managed by the Supplier/Other Party? Select Yes or No from the drop-down list
  6. If yes, per Policy AD95 Information Assurance and IT Security, which category of data will be involved (select all that apply and provide brief description)
  7. If contract is for use or purchase of third-party content include a description of how content will be used
  8. Does contract require a Certificate of Insurance to be supplied to the Supplier/Other Party? Select Yes or No from the drop-down list and continue to Section 4: Initiating Department

Section 4: Initiating Department

  1. Enter the College, Administrative Area, or Campus Name
  2. Select the Business Area number from the drop-down list
  3. Enter the name of the person completing this form
  4. Enter the telephone number, including area code, of the person completing this form
  5. Enter the Penn State email address of the person completing this form
  6. Enter the name of the contract primary contact person, if different than person completing this form
  7. Enter the telephone number, including area code, of the contract primary contact person, if different than person completing this form
  8. Enter the email address of the contract primary contact person, if different than person completing this form

If part of Agricultural Sciences Cooperative Extension, continue to Section 5: Agricultural Sciences Cooperative Extension. If not, continue to Section 6: Contract Processing.

Section 5: Agricultural Sciences Cooperative Extension

  1. Is this event sponsored by the University? Select Yes or No from the drop-down list
  2. If yes selected above, will an employee be present and in charge? Select Yes or No from the drop-down list. If yes, continue to Section 6: Contract Processing.
  3. If a volunteer will be present and will be in charge of the event, STOP HERE and contact The Wood Agency to process the contract.

Section 6: Contract Processing

  1. Is this an electronic click-through agreement (online terms)? Select Yes or No from the drop-down list. If yes, skip this section and go to Section 7: Electronic Agreement Questions. If no, check the appropriate option:
    • Option 1 - Signature Required - By selection Option 1 for signature, the employee completing this form affairs on behalf of their department, that they or the primary contact have read and agree with the terms, including if any, the financial obligations and business terms, and will comply with the following:
      • Initiating Department must forward the signed contract to the Supplier/Other Party as this will not be done by Procurement Services or the Assistant Treasurer's Office
      • Initiating Department must alert Procurement Services if the Suppler/Other Party does not accept any changes made by the University
      • Initiating Department must secure and maintain a copy of the contract that has been signed by all parties as the official University record. For the University's Record Retention policy refer to Policy AD35 University Archives and Records Management
    • Option 2 - Review Only - By selecting Option 2, the employee submitted this form is not requesting a signature and instead is only requesting a contract review and for feedback to be provided back on the contract

If this is NOT an electronic click-through agreement then save the completed form now to route to psucontracts@psu.edu with the contract.

Section 7: Electronic Click-Through Agreement - only to be completed if this agreement is an electronic click-through agreement:

  1. Provide the link where the electronic agreement can be viewed. If no link is available, please submit the electronic agreement separately with this cover sheet.
  2. Select the type of electronic agreement to be reviewed from the drop-down list. Options include: Conference exhibition registration, Purchasing equipment, Vendor registration, Use of third-party content (e.g., photos, videos, audio, etc.), Facility Use Agreement, or Other
  3. If other selected above, please specify
  4. Select the appropriate Electronic Agreement Acknowledgment option
    • Option 1 - Department is requesting approval for a one-time delegation to permit department to accept the contract electronically on behalf of the University. The employee completing this form affirms, on behalf of their department, that they or the primary contact have:
      1. read and agree with the terms, including if any, the financial obligations and business terms in the electronic agreement, and
      2. acknowledges that the department is responsible to keep a copy of the agreement along with the one-time delegation on file as the official University Record. For the University's Records Retention Policy refer to Policy AD35 University Archives and Records Management
    • Option 2 - the employee submitting this form is not requesting an approval for a one-time delegation and instead is only requesting a contract review and for feedback to be provided back on the contract.

Save the completed form and route to psucontracts@psu.edu. If no link is available for the electronic agreement, please include electronic agreement along with this cover sheet.

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