2043 College Way
Forest Grove, OR 97116-1797
503-357-6151
LETTER OF AGREEMENT
This agreement, entered into on ____________________, 20_____ is between Pacific
University (PU) and ____________________________, a self employed contractor, not as an
employee of PU, to provide services to PU for
____________________________________________________________________________
____________________________________________________________________________
[ ] more specific requirements added as an attachment.
(Requires Dean/Director signature)
Dates of service are _________________________________.
CONTRACTOR IS RESPONSIBLE for reporting and paying all applicable federal and state
taxes and expenses, including, but not limited to, federal and state income tax, social security
tax, unemployment insurance tax, workers compensation insurance, and business license fees.
IN CONSIDERATION of services provided PU agrees to pay contractor $____________
upon satisfactory completion of the services.
Note: Properly signed W-9 must be on file with PU before payment can be made.
THIS AGREEMENT may be modified by mutual written consent or terminated upon 10 day
written notification by either party.
Pacific University
Contractor
Name _____________________________
Business Name _____________________
Address ___________________________
__________________________________
Email _____________________________
Phone # ___________________________
EIN/SSN__________________________
____________________ ______
Budget Officer Signature Date
__-_____-_________-________
Account Number
________________________
Dean/Director Signature
(if $ 2,500.00 or greater)
_________________________________
Contractor Signature
Agreements for $5,000.00 and over require the signature of Director, Office of Legal Affairs:
__________________________
_____________
Signature
Date
Agreements for $25,000.00 and over require the signature of Director, Office of Legal Affairs and the
Vice-President for Finance & Administration. A Purchase Order is required for $25,000.00 &
above.
__________________________
Signature/VP Finance
_____________
Date
For information/Instructions on payment to Non U.S. citizens please visit the Accounts Payable
website at http://www.pacificu.edu/about-us/offices/business-office/accounts-payable
Revised 4/15