Question 1 - Scope of Work - Select the check box indicating how full specification of scope of work to be completed will be provided. Options include complete page 3 of this document or attach separate sheets.
Question 2 - Need - Indicate why the services to be provided are essential and cannot be provided by
University personnel.
Question 3 - Customary Fee - What is the customary fee for services of this nature? Cite previous cases, if
possible. Include all documentation you may have received. Select Yes or No from the "Is supporting documentation attached" drop-down list if documentation is attached
Question 4 - Qualified Consultants table - Table consists of four columns, a header row, and five rows for data. Column 1 reads "Place an X before the name of the preferred consultant. Column 2 - Enter consultant names. Column 3 - Enter complete address of the consultant. Column 4 - Enter
consultant rate (itemized expenses not included in rate) and select Yes or No from the "Is informal quote or other supporting documentation attached" drop-down list
Question 5 - Criteria for Selection - Specify the required criteria for selecting a suitable consultant for the scope of work to be performed.
Funding Source -
Question 6a - Is the consultant to be paid utilizing sponsored award funds? Select Yes or No. If no, proceed to question 7
Question 6b - if 6a is Yes - Is sponsor approval required? Select Yes or No. If sponsored approval is required, a copy of request for approval, and an indication of the status of the request, must be submitted as supporting documentation.
Question 6c - If 6b is Yes to sponsor approval - enter the Prime Contract Number
Question 6d - If 6b is Yes, provide the Research Administrator's name and email address
Contract Information -
Question 7a - From Date - Select the beginning date consultant is to provide services
Question 7a - To Date - Select the ending date consultant is to provide services
Question 7b - Will the consultant to be required to travel as part of the engagement? Select Yes or No from drop-down list
Question 7b - If Yes - are travel expenses included in the quote? Select Yes or No from the drop-down list.
Individual Responsible for Making the Request -
Question 8 - Name - Enter the name of the individual responsible for making this request
Question 8 - Title - Enter the title of the individual responsible for making this request
Question 8 - Email Address - Enter the email address of the individual responsible for making this request
Scope of work - To be complete if Scope of Work section on page 1 is checked. If attaching separate documentation, enter "see attached documentation" in the space and go to next page. Please include details such as description of deliverables, completion time line, ownership of materials, payment schedule (ex., monthly, milestone), etc.
Justification - Check either the:
Consultant is specifically named by the funding source award documents, inter-agency agreement, or clinical trials agreement box and proceed to step 19, or
Unavailable from any other source box and proceed to step 20.
If the Consultant is specifically named by the funding source award documents, inter-agency agreement, or clinical trials agreement box is checked, enter the Office of Sponsored Programs (OSP) number and page number of the award that names the supplier for Central Procurement to confirm with information provided. If Unavailable from any other source box is checked answer all questions below
Unavailable Question 1 - Describe the unique qualification which make this consultant the only qualified consultant for the services to be performed. Give very specific characteristics or other supporting research to justify the need for this particular consultant)
Unavailable Question 2 - Describe the process used to select this consultant. What other consultants did you solicit information from? Include reasons for rejecting other consultants
Unavailable Question 3 - Provide supportable evidence that due diligence has been performed in objective market analysis and proof of fair and reasonable rates.
Unavailable Question 4 - What are the consequences of not securing this particular consultant?
Enter the name and title of individual making request
The requester must provide either their digital ID (electronic signature) or provide a hand-written signature
If the requester provided their digital ID, skip this field. If the requester provided a hand-written signature, enter the date the form was signed
Complete the supporting documentation checklist and upload the documents to the PSUbuy Purchase Requisition
