Department of Purchasing
Akron, OH 44325-9001
(330) 972-7340 Office
(330) 972-5564 Fax
Page 1
LECTURE, PERFORMANCE AND SERVICES AGREEMENT
for
STUDENT ORGANIZATIONS
(not to exceed $1,500.00)
TODAY’S DATE:
PURCHASER: The University of Akron
CONTRACTOR:
ENGAGEMENT DATE:
STUDENT ORGANIZATION NAME:
Obligations of the Parties
Contractor agrees to provide services at the place and time specified below (Engagement) in consideration for
Purchaser’s obligations to pay $
, a flat guarantee, and provide a licensed facility to perform. Payment,
by University check, will be made after Contractor has performed as agreed.
Contractor represents that neither Contractor, nor any agents of the Contractor, have paid or agreed to pay
directly or indirectly any person, firm, or corporations any money or valuable consideration for assistance in
securing this agreement and that no such money or reward will be hereafter paid.
Contractor further represents that: no Purchaser employees, or their family members, have a financial interest
in Contractor submitting this Agreement; Contractor is not, and has not been an employee of the Purchaser;
and that the Contractor does not have any relatives or family members employed by the Purchaser. To the
extent that Contractor cannot make all of these representations, Contractor understands that Contractor must
complete a more extensive disclosure, attached as Exhibit B.
Each of the Contractor’s team members agree to be bound jointly and severally to the obligations and
conditions of this Agreement. Each team member may enforce this Agreement. However, any terms and
conditions listed in Exhibit A are not made part of this agreement prior to review, approval and signature of
appropriate University representative(s).
Failure to Give Notice
If the Contractor fails to give Notice of cancellation pursuant to the terms of this Agreement, the Contractor
will reimburse the Purchaser for all documented, bona fide out-of-pocket expenses incurred in the promotion
and/or implementation of the Engagement upon Contractor’s receipt of a certified statement of such expenses.
If the Purchaser fails to give Notice of cancellation pursuant to the terms of this Agreement, the Contractor
may seek reimbursement for all documented, bona fide out-of-pocket expenses incurred by Contractor in
reliance upon the Engagement.
Integration
This Agreement and the Purchase Order terms and conditions represent the entire Agreement between the
Contractor and the Purchaser. In the event of conflict between the two, the terms and conditions of this
Agreement shall control.
Department of Purchasing
Akron, OH 44325-9001
(330) 972-7340 Office
(330) 972-5564 Fax
Page 2
Signature (sign below)
Contractor must sign and return this Agreement by:
. Payment is conditioned on such signature and
return of the Agreement. The person signing this Agreement on behalf of the Contractor represents that all
personnel used by the Contractor are bound to the obligations and conditions of this Agreement.
PURCHASER
The University of Akron
Signature:
Name: Andrew Roth, Director
Purchasing Department
The University of Akron
Akron, Ohio 44325-9001
Phone: (330) 972-7340
Date:
CONTRACTOR NAME/AGENCY
Agency or Company Name
Signature:
Printed Name:
Title:
Address:
Suite/Room:
City/State/Zip:
Phone:
Ext:
Date:
Please return one (1) copy of the signed contract to (hiring department information):
The University of Akron
c/o UA Contact Name
Dept Name UA Dept Name
302 Buchtel Common
Akron, OH 44325-UA Zip+4
This form, The University of Akron Lecture Agreement, has been approved by General Counsel on May 5, 2014. Last revision April
2015.
Department of Purchasing
Akron, OH 44325-9001
(330) 972-7340 Office
(330) 972-5564 Fax
EXHIBIT A
ENGAGEMENT SPECIFICATIONS
1.
ENGAGEMENT ADDRESS:
2.
TOPIC/TITLE OF PRESENTATION:
3.
DATE OF ENGAGEMENT:
TIME:
Start:
Finish:
4.
TICKET PRICE (if applicable): $
5.
UNIVERSITY CHECK MADE PAYABLE TO:
Social Security #:
Corporate ID #:
6.
TIME OF CONTRACTOR’S ARRIVAL:
7.
TIME OF SET-UP:
8.
APPROXIMATE LENGTH OF LECTURE:
Does this include questions and answers from audience?
9.
10.
OTHER ACTIVITIES TO BE PERFORMED BY CONTRACTOR
TRANSPORTATION ARRANGEMENTS AGREED TO:
11. HOTEL ACCOMMODATIONS:
Page 3
Department of Purchasing
Akron, OH 44325-9001
(330) 972-7340 Office
(330) 972-5564 Fax
12. AUDIO/VISUAL EQUIPMENT NEEDED:
Equipment to be provided by:
13. PROMOTIONAL MATERIAL TO BE SENT TO PURCHASER:
To be sent by (date):
14. CORRESPONDENT(S) FOR PURCHASER:
Name:
Title:
Phone:
Name:
Title:
Phone:
15. OTHER ARRANGEMENTS AGREED TO:
Page 4
Department of Purchasing
Akron, OH 44325-9001
(330) 972-7340 Office
(330) 972-5564 Fax
Page 5
THE UNIVERSITY OF AKRON
INDEPENDENT CONTRACTOR CHECKLIST
Name of proposed independent contractor:
Contractor Name
Departmental Requisition Number:
1. Items to be completed by the Independent Contractor:
a.
I provide similar services to other clients and/or businesses.
YES
NO
b.
I engage in entrepreneurial activities in an established trade, occupation or business and am at
risk for profit or loss.
I am a current or past employee of The University of Akron. (If you answer YES, please list
dates of employment from:_______________ to:______________ the name of the
Department and job duties.)
YES
NO
YES
NO
I will maintain worker's compensation coverage or will present proof of exemption as a sole
proprietor.
YES
NO
e. I agree that The University of Akron will withhold no taxes from the payments made to me and I
will be solely responsible for payment of local, state, and federal taxes.
YES
NO
f.
YES
NO
c.
d.
I agree that I will be paid by the job, will furnish all tolls and materials needed to do the
contemplated work, and will pay for all of my own business expenses.
Items to be completed by the University Department wishing to use the services of this Independent Contractor:
2.
The individual to perform the services:
a.
Will receive little or no training, supervision, or instruction from University personnel, other than
conveying the scope of service desired.
YES
NO
b.
Will be responsible for determining the means and methods to use to perform the requested
services.
YES
NO
c.
Will provide his/her own supplies, equipment, forms, etc., necessary to perform services, and
the cost of these is included in rate or total fee.
YES
NO
d.
Will set his/her own priorities on time, amount of effort, and hours of work, to accomplish
services within stated time frame.
YES
NO
e.
Is not providing services similar to those currently being provided by any University
employee(s).
YES
NO
f.
Will be paid on the basis of a completed project, progress payments or in a manner consistent
with others in the same trade, occupation, profession or business.
YES
NO
Either party must provide a detailed explanation of any questions that were answered "No", with the exception of 1. c.
I certify that to the best of my knowledge the above is correct.
Independent Contractor’s Signature
Date
Authorized University Departmental Supervisor’s Signature
Date
Note: This form must be signed by the department chair or his/her designee. Please return to the Department of Purchasing, Zip +
9001 with the completed Professional Services Agreement.
Department of Purchasing
Akron, OH 44325-9001
(330) 972-7340 Office
(330) 972-5564 Fax
Page 6
EXHIBIT B
VENDOR DISCLOSURE
I, authorized person for Contractor Name, do hereby state and affirm that neither I nor
any agents of the above-named company not any other party acting on company’s behalf
have paid or agreed to pay directly or indirectly any person, firm, or corporations any
money or valuable consideration for assistance in securing this agreement for the
following: Services Provided. I further agree that no such money or reward will be
hereafter paid.
Do any University of Akron employees, or their family members, have a financial interest
in the organization submitting the agreement?
Yes
No
If so, please attach a statement giving details.
Are you currently or have you been an employee of The University of Akron?
Yes
No
If so, please attach a statement giving details.
Does the affiant have any relative/family members employed by The University of Akron?
Yes
No
If so, please identify the employee and relationship.
Employee Name
Independent Contractor’s Signature
Relationship
Date