SIGNING AUTHORITY DELEGATES
FROM: Contract Proponent:
University Department/Unit:
E-mail:
Phone:
DATE:
The attached proposed contract is submitted for your signature on behalf of the University pursuant to Signing
Authority Policy 4.40
CONTRACT PARTICULARS
College/Department/Unit:
Other Contracting Party:
Start Date:
Completion Date:
Nature of contract/performance:
As contract proponent, to the best of my knowledge, information and belief the due diligence exercise
contemplated by the Signing Authority Policy 4.40 has been fulfilled:
Applies Template #:
OR
Contract in standard form consistent with form previously used
Potential for conflict of interest/perception of conflict of interest has been investigated
Board of Governors approval not required
under Part D of the Policy, including: cost below
$500,000; resource commitment 10 years or less;
no precedent-setting or sensitive issues
Date of Board of Governors approval:
OR
ENDORSEMENT by or on behalf of the Dean/Unit Head
There are sufficient financial, human and
physical resources under this contract or within
the program/unit/division/department to fulfill
the University’s obligations
appears on contract
OR
attached
Other University Resources approved by:
OR
COMPLIANCE with applicable legislative/regulatory/University Policies/practices/procedures:
No approvals required
OR
See Appendix #:
re: list of approvals
No conflict with legislative or regulatory requirements, University Policies, collective agreement or other
known legal obligations of University
Intellectual
Property issues
not applicable
Is not a derivative &
contains no embedded
derivatives
OR
Intellectual Property issues are addressed: see
Appendix #___________
Derivative will be reported to Financial Services
ADVISORS - CONTRACT PREPARATION
Contract drafted/reviewed by:
Risk Management Division:
Intellectual Property - Industry Liaison Office Contact:
Legal/tax/other technical issues:
See attached list of consultations with other University Departments, units or programs
Issues/Concerns:
See Appendix #
If contract is acceptable and you have no conflict of interest, please sign and return to
please call 966to arrange for pick-up OR mail to: _______________________________________
Contract Proponent Signature:
Form Revised: November 16, 2011
INTERNAL CONSULTATIONS – UNIVERSITY UNITS/DEPARTMENTS/PROGRAMS
Check all boxes that apply. For each needed section, complete Particulars and Contact
sections, and describe any concerns and issues pertaining to the contract.
DEPARTMENT/UNIT
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PARTICULARS OF CONSULTATIONS
CONTACT
Purchasing Services
Research Services
Corporate Administration
Risk Management & Insurance Division
Consumer Services
Facilities Management Division
Financial Reporting
Student Accounts & Treasury
Global Relations
Human Resources Division
Health, Safety & Environment
Huskie Athletics
Industry Liaison Office
Integrated Planning
Information Technology Services
Division of Media & Technology
Provost & Vice President Academic
Student Enrollment & Services Division
University Advancement
Communications
Development
Centre for Continuing and Distance
Education
Library Administration
University Colleges/Institutes
Legal Counsel
FURTHER PARTICULARS OF CONSULTATIONS
Form Revised: November 16, 2011