Form Apr 94 – Fill Out and Use This PDF

UNIVERSITY OF ALASKA

SHORT FORM CONTRACT FOR GUEST SPEAKERS OR PERFORMERS

This agreement becomes effective when accepted and signed by the authorized Purchasing official.

CONTRACT NUMBER			SSN/Tax ID
(to be completed by Purchasing)			(SSN entry applies only to sole proprietors or individuals.
			All others require entry of federal Tax ID numbers.)
NAME & ADDRESS OF CONTRACTOR: (Contractor may not be a current UA employee.)				NAME & ADDRESS OF UA DEPARTMENT:
________________________________________________			______________________________________________
________________________________________________			______________________________________________
________________________________________________			______________________________________________

THIS AGREEMENT, entered into by the University of Alaska and the Contractor named above, documents the understanding of the parties. (This form must be signed and dated by the Contractor before it is submitted to Purchasing.)

1. SCOPE OF SERVICES: (one time non-recurring) The contractor shall perform all services described below for the amount stated:

GUEST SPEAKER Topic						(Topic must be shown for a Guest Speaker.)
PERFORMER
	[DEPARTMENT MUST CHECK ONE BOX ABOVE & FILL ALL BLANKS BELOW TO COMPLETE THIS SECTION.]
Event				Date	_____________________________
Location				Time	_____________________________
Contractor agrees to provide the following equipment/items for this agreement:
							.

University agrees to provide the following equipment/items for this agreement:

.

2.COMPENSATION: Contractor will be paid in a lump sum amount not to exceed $______________. Total compensation includes all costs related to the scope of services, including but not limited to:

_____________________________________________________________________________ (i.e. travel, phone calls, hand-out materials).

3. TERMS OF PAYMENT: [TO BE COMPLETED BY THE DEPARTMENT]

Payment to the contractor within 30 days upon receipt of invoice, payable after performance is verified by the department.

Payment to the contractor within 10 days after completion of the engagement.

Payment to the contractor upon close of the engagement.

4.INDEMNIFICATION AND HOLD HARMLESS AGREEMENT. To the fullest extent permitted by law, the Contractor shall defend, indemnify, and hold harmless the Contracting Agency, its Board of Regents, officers, and employees from and against any and all loss, expense, damage, claim, demand, judgement, fine, charge, lien, liability, action, cause of action or proceedings of any kind whatsoever (whether arising on account of damage to or loss of property, or personal injury, emotional distress, or death) arising directly or indirectly in connection with the performance or activities of the Contractor hereunder, whether the same arises before or after completion of the Contractor's operations or expiration of this Contract, except for damage, loss, or injury resulting from the Contracting Agency's gross negligence or willful misconduct.

5.TERMINATION. This contract may be terminated at no cost to either party upon ____________ DAYS ADVANCE WRITTEN NOTICE. (30 unless otherwise indicated)

6.OTHER. Contractor is an independent contractor and will pay all applicable state, local and federal taxes associated with this agreement. This agreement is the complete & exclusive understanding of the parties. Time is of the essence in this agreement.

The following attachments are a part of this agreement:									.
CONTRACTOR							UNIVERSITY OF ALASKA
By:						By:	________________________________
			(Signature)				(Procurement Officer Signature)
Name & Title:						Name:______________________________
			(Type or Print)				(Type or Print)
Date:						Date:_______________________________

APR 94

UNIVERSITY OF ALASKA