AUTHORITY TO SIGN AGREEMENT (CONTRACTS FOR GOODS, SERVICES, LEASE OR PROPERTY TRANSFER) Please complete this form and submit it to the Legal Office with the final version of the Agreement or other legal document to enable the Contracts Officer to process it for signature by the delegated officer. Project Title/Short Description _______________________________________________________________ __________________________________________________________________________________________ Contractual Parties: UNE and ________________________________________________________________ Primary Cost Code: _________________ Total Contract Value (GST inclusive): _____________________ I certify that: The Agreement As the person with operational responsibility for the project or matter (Project) to which the agreement relates, I confirm I have read the agreement and recommend that UNE enter into the agreement. Procurement The agreement is / is not [select one] for goods or independent contractor services valued above $10,000.1 If above $10,000, please attach either the quotes, tender approval or approved exemption form. GIPA (Government Information (Public Access) Act 2009 (NSW) (GIPA Act). The total value of this agreement (including variations) is / is not [select one] above $150,000 (GST Inclusive) Budget As the person with operational responsibility for the Project, I confirm that the Project is budgeted for, including amounts UNE is liable to pay under the Agreement. If above $150,000 (GST Inclusive) including variations, please complete the attached GIPA Act Compliance - Contract Information Form. ___________________________________ Name of UNE Project Officer _____________________________ Signature and date __ / __ / __ Approval by Head of School, Director or equivalent: ___________________________________ Name of HOS, Director or equivalent _____________________________ Signature and date __ / __ / __ If the Project value exceeds $10,000, then endorsement is required by Executive with portfolio responsibility: ___________________________________ Name 1 _____________________________ Signature and date __ / __ / If the Agreement is for goods or independent contractor services, and is valued above $10,000, you must ensure that the appropriate number of quotes have been acquired or the tender process is completed or exemption approved (in accordance with UNE’s Procurement Policy and Procedures). Government Information (Public Access) Act 2009 (NSW) COMPLIANCE – CONTRACT INFORMATION PART A Class Class 1 (S29 GIPA Act) Class 2 (S30 GIPA Act) Which Class does this contract belong to? (S27 GIPA Act) Description Information Required A contract is a Class 1 contract if it has (or is likely to have) a value of Yes / No $150,000 (GST Incl) or more including variations If Yes, please provide information against Class 1 in Part B below AND check if this contract falls into Class 2 as well A contract is a Class 2 contract if it meets the meets the criteria for being Yes / No a Class 1 Contract and, in addition, any of the following applies: (a) there has not been a tender process, the proposed contract has not If Yes, please provide been made publicly available and the terms and conditions of the information against Class 1 AND Class 2 contract have been negotiated directly with the contractor, OR in Part B below (b) the proposed contract (whether or not made publicly available) has been the subject of a tendering process and the terms and conditions of the contract have been substantially negotiated with the successful tenderer, OR (c) the obligations of one or more parties under the contract to maintain or operate infrastructure or assets could continue for 10 years or more, OR (d) the contract involves a privately financed project as defined by guidelines published by the Treasury (as in force from time to time), OR Class 3 (S31 GIPA Act) (e) the contract involves a transfer of a significant asset of the agency concerned to another party to the contract in exchange for the transfer of an asset to the agency. A contract is a Class 3 contract if it meets the criteria for being a Class Yes / No 2 Contract and, in addition, it has (or is likely to have) a value of $5 If Yes, please provide million (GST Incl) or more information against Class 1, Class 2 AND Class 3 in Part B below Part B. Please provide the required information, on the following basis: For Class 1 Contracts – provide responses in Class 1 section only For Class 2 Contracts – provide responses in Class 1 AND Class 2 sections only For Class 3 Contracts – provide responses in Class 1, Class 2 AND Class 3 sections Class Class 1 Required Information under GIPA Act S 29-31 Will there be any related bodies corporate* that will be involved (e.g. sub-contracted by the contractor) in carrying out the contractual obligations? If so, please provide the following information for each entity: (a) name (b) address (c) its relationship to the Contractor Response * A body is a “related body corporate” of another body if is it either (i) a holding (parent) company; or (ii) a subsidiary; or (iii) a subsidiary of a holding (parent) company, of the other body. What are the renegotiation (variation) provisions in the Legal Office will complete this contract? section What was the method of tendering (e.g. open tender, select tender, closed tender)? What were the main criteria against which the tenders were assessed? Are there any provisions for payment to the contractor for operational or maintenance services? Class 2 Will there be any future transfer of significant assets to and from UNE? If so, provide particulars Was a cost-benefit analysis done and, if so, what were the results? Provide particulars of how risk will be apportioned, if relevant Provide particulars of any significant guarantees or Legal Office will complete this undertakings between the parties section Provide particulars of any other key elements of the contract Class 3 Copies of class 3 contracts must be published, subject to the Please contact the Legal Office to redaction of any information that can be withheld in assist you with these requirements accordance with s32 of the GIPA Act*. for Class 3 contracts Are there any reasons why a FULL copy of the contract should not be made publically available on the UNE web? If not, please provide: (a) the reasons why the contract or those provisions should not be included in the register?, AND (b) a statement as to whether it is intended that the contract or those provisions will be included in the register at a later date and, if so, when it is likely that they will be included?, AND (c) if some but not all of the provisions of the contract have been included in the register, a general description of the types of provisions that have not been included. * UNE can withhold the following confidential information relating to a contract: Details of any unsuccessful tender; any matter that could reasonably be expected to affect public safety or security; or any information where there is an overriding public interest against disclosure.