Forms

The listing below includes regularly used checklists, forms, agreements, certificates, and worksheets important to Purchasing and Payment functions. If you are looking for a Purchasing or Payment related document and cannot find it here, please contact Customer Service. Note the following:

You must have Adobe Reader to view the forms in PDF format. Download the latest free version of Adobe Reader.
Some forms and checklists are interactive and include show/hide functionality. These forms work best when downloaded and opened in a desktop reader app. Users may experience compatibility issues or errors if opening these within their internet browser or on mobile devices.
To submit fillable forms, please do not save completed forms from your browser as it may result in the application deleting your entered content. To save and submit forms please use one of the following methods. (1) Download form and save to your desktop or local drive, open from your downloaded location, fill out the form, save, and submit. (2) Fill out the form in your browser and use the print functionality to print to PDF. You must change the printer from your default printer to the “save as PDF” option from the print dropdown.

20-Factor Test	This tool is designed to help determine whether a worker or class of workers hired by the University to perform services should be classified as an employee or as an independent contractor. Visit this page for more information and access to the tool.
Amendments	To submit a Services Agreement amendment, please submit through the Contracts + module of the PantherExpress System.
Conference & Event Agreement Checklists: - Hotel Checklist - Non-Hotel Checklist - Signature Venue Checklist	Visit the Conferences and Events page to learn more about each checklist and ensure all Conference & Event materials are in order.
Conflict of Interest Disclosure (formerly known as Conflict of Interest Certification superform/PDF)	Use this link to access information about submitting a conflict of interest disclosure through MyDisclosures. This is required in order to gain access to the following payment methods: PantherExpress System and OneCard. Visit this page for more information about obtaining access to these payment methods.
DEA Licenses and Controlled Substances	Visit this page for information about DEA licenses and Controlled Substances and review the guide for ordering DEA Controlled Substances.
Directed or Sole Source Justification Form	Use this form to document the reason for recommending a supplier that was not selected through competitive bidding or was not the lowest bid.
Federal Flowdown Schedule (Short Form)	This Schedule contains required FAR/DFAR flowdown clauses applicable to service agreements of $15,000 or less. This Schedule is incorporated by reference in the Services Agreement (Short Form) template.
Foreign National Information Form	Use this form to acquire information about University payments to foreign nationals providing independent personal services or who are receiving an award or stipend. Visit this page to learn more.
[Guest]Speaker/Participation Content Recording Agreement	If you desire to record speakers or retain rights to the content presented, you must document the speaker’s grant of permission and transfer of rights in writing using the "Speaker/Participation Content Recording Agreement". If you need to pay an honorarium recipient, honorarium payments for visitors are now processed through Concur. Review this page for more information.
Loan for Use Agreement	Use this agreement template when contracting with a supplier who is loaning equipment to the University on a short-term, trial basis for evaluative purposes. In the context of this agreement, short-term is to mean no more than six months. Complete the Loan for Use agreement. If the total fair market value of the equipment is $15,000 or less and no changes have been made to the agreement template, the supplier and an authorized individual in the department signs. If the fair market value is greater than $15,000 and/or changes were made to the agreement template, create a PantherExpress System Contracts+ Contract Request using the Contract Request template and Contract Type “Services Agreement”. Attach the completed, UNSIGNED agreement. The agreement must be executed by Purchasing Services.”
New Account Number Request (with Reference Code)	Only use this form to request a 32-digit account number with a reference code. Requests will be reviewed manually. The new reference code requested will not be generated automatically.
OneCard Change Request - Cardholder Initiated	Use this form to request changes to a OneCard such as the account number and limit, or to close/cancel the card.
OneCard Change Request - Supervisor Initiated
OneCard Software MCC Authorization Form (formerly the OneCard Software Purchases Authorization Form)	This form must be completed by OneCard holder individuals who desire to purchase computer software licenses using their OneCard and require the Merchant Category Codes to be opened.
OneCard Software Purchases Checklist & Certification (formerly the OneCard Software Purchases Certification)	This checklist and certification form must be completed for every OneCard purchase of software or software license. Also the completed form must be attached as documentation to your Concur expense reconciliation report upon purchase of the software/software license along with the Vendor Security Risk Assessment approval.
PantherExpress System User Profile Form	View this page for further information on the use of this form.
PantherExpress System Departmental Approval Form	View this page for further information on the use of this form.
Photographer/Videographer Agreement	Use this agreement template when contracting with a photographer or videographer. If the value is $15,000 or less and no changes have been made to the agreement template, the supplier and an authorized individual in the department signs. The department submits in the PantherExpress System using the Short Form Services Agreement Specialty Form. If the value is greater than $15,000 or changes were made to the agreement template, create a PantherExpress System Contracts+ Contract Request using the Contract Request template and Contract Type “Photography & Videography”. Attach the completed, UNSIGNED agreement. The agreement must be executed by Purchasing Services.
Product Classification Certification	The Office of Research Security & Trade Compliance has created a Product Classification form, which you can provide to the supplier, to help you obtain the Export Controls classification. Certain departments must include Export Controls classification information and other required supporting documentation with a requisition to the Purchasing Services department for purchase order creation. Learn more here.
Request for Quote (RFQ) Template	Use this Request for Quotation template when soliciting quotes for goods or services valued at $75,000 or less. Contact your assigned procurement specialist with any questions.
Requisition Checklist - Federal Grants	Use this version of the Requisition Checklist when making purchases using Federal grant funding. Checklist includes both Federal Uniform Guidance and University purchasing requirements.
Requisition Checklist - Federal Contract, OTA	Use this version of the Requisition Checklist when making purchases using Federal contract or OTA funding.
Requisition Checklist – Non Federal Grant, Federal Contract or OTA Funding	Use this checklist when making purchasing with non-Federal grant, non-Federal contract or non-OTA funds.
Requisition Form (paper)	Some areas of the University still use this form. The Requisition Form (paper) is available through University Business Forms (UBF). Visit my.pitt.edu, search for and select UBF Select Forms Library from the left-hand navigation Select the Reimbursement form, then follow the submission instructions on the form.
Schedule A - Scope of Services	Use the Scope of Services template for the Contracts + submission or if you need a separate attachment for the Services Agreement (Short-Form Domestic). Review these tips for writing a Scope of Services.
Services Agreement Checklist - Federal Grants	Use this version of the Services Agreement Checklist when making purchases using Federal grant funding. Checklist includes both Federal Uniform Guidance and University purchasing requirements.
Services Agreement Checklist - Federal Contract, OTA	Use this version of the Services Agreement Checklist when making purchases using Federal contract or OTA funding.
Services Agreement Checklist - Non Federal Grant, Federal Contract or OTA Funding	Use this checklist to ensure all Services Agreement materials are in order.
Services Agreement (Short Form - Domestic)	The Services Agreement (Short Form – Domestic) is for use at the departmental level and is intended to be reasonable and appropriate for smaller value services needs. Note the requirement under Instructions and Guidelines for Use to contact your assigned procurement specialist in certain situations. Submit through the Short Form Services Agreement Specialty Form in the PantherExpress System.
Services Agreement (Short Form - International)	BEFORE using this Short Form International Services Agreement at the departmental level, review all information available on the International Services Agreements webpage. Note the requirement under Instructions and Guidelines for Use to contact your assigned procurement specialist in certain situations. Submit through the Short Form Services Agreement Specialty Form in the PantherExpress System.
Supplier Verification Form	This form is used to verify supplier demographic. Visit this page for more information about the supplier verification process and utilizing the DocuSign template, including how to add/change supplier information.
Terms & Conditions	Use this document to review the University's Standard Terms & Conditions.
Travel Advance	Instructions to request an advance for business travel funds and to access to the form are available on this page. Please note, the preferred payment method for travel expenses is the OneCard.
Travel & Business Expenses	This page provides instructions for submitting expenses incurred during travel and/or other University business.
Travel - Reimbursement of Foreign Currency Expenses Worksheet	Use this worksheet to calculate foreign currency exchange gains and losses.
University's Federal IRS Tax Exempt Status 501(c)(3) Determination Letter	The University of Pittsburgh is classified as tax-exempt under the Internal Revenue Code section 501 (c)(3). This determination letter confirms the University's federal tax-exempt status.
University's PA REV-1832	Use this certificate if a vendor requests a PA REV-1832.
University's Pennsylvania Sales Tax Exemption Certification	Use this certificate to verify the University's tax exempt status (in Pennsylvania) as a Nonprofit Educational Institution. Visit this page for more information about tax exemption.
University's Sales Tax Exemptions in Other States	Use this list to identify states other than Pennsylvania that also grant tax exempt status to the University of Pittsburgh for goods and services purchased while in their state.
University's W-9	Use this certificate to confirm the University’s Tax Identification Number (TIN).
Vendor Security Risk Assessment	All purchases or uses of information technology products and services originating from any campus or University location, including products that store or use University data and/or end-user personal information require a vendor security risk assessment. Visit this page for more information.
Wire Transfers & Foreign Currency Transactions	This includes the instructions and the form for submitting a foreign currency wire request.

Forms

Need Help?

University Resources