date received: / / contract request form

CONTRACT REQUEST FORM Date Received: / /

This form should be used whenever an entertainer, performer, speaker, etc. is brought to campus by a student group,

organization, and/or department/office and seeks payment. The process to complete a contract must be started 10 weeks prior

to the event to ensure payment can be available at the time of the service. The invited guest(s) must submit a written quote,

along with all technical requirements at the time of contract request. Please contact Brenda Young at

brenda.young2@utoledo.edu or (419) 530-4701 if you have any questions. Please note: this form must be completely filled out

before submitting or the contract process will be delayed.

Student Org. Name: *Please attach a copy of the event request form and flyer if available.Student Org. Representative(s):Name: E-mail:Phone:

Name:E-mail:Phone:

Performer(s)/Speaker(s) Name(s):

Company: Address: E-mail: Phone:Type of Service/Performance: (BE SPECIFIC): _________________________________________________

Cost to be paid: _____________ Does this include travel costs? Yes No If not, how will travel costs be paid?Check payable to: __________________________

How do you plan to pay this vendor/performer? UT account/SAC funding External account(s) Both Other:

Event Name: Topic of Presentation: Day/Date: _______________________ Time: ___________________________ Location:

Will tickets be sold for this event: Yes No If yes, total # if tickets available:

University Student Ticket Price: Non-Student Ticket Price:

Technical Requirements or "Tech Rider": ___________________________________________________

Special Requests or "Hospitality Rider": _______________________________________________________________________

Office Use Only: / Budget Approval- Geni Hofbauer

/ Contract Created and Saved in File / Contract & W9 formed mailed (e-mail/postal) / Contract (signed by artist), reviewed form to VP / Signed contract returned from VP / 2 copies, W9 sent to GH for the check to be cut

Funding Source(s): Office Use Only

Org. Name Budget Line Amount