UITS To Buy Form
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Contact Information
First Name
Last Name
Email
Contract Information
Supplier Name
Is a new contract or an amendment to a contract being made?
Yes
No
I do not know
Name, Title, Address and Email of person signing for the Supplier
Name, Title, Address and Email of person answering questions on this contract for Supplier
Purchasing Information
Purchase Type
Please select...
New
Renewal
Select the type of purchase either new or renewal.
x
Have you verified funds in your budget for this purchase?
Yes
No
Reason:
Purchasing Method
Please select...
E&I
Internet2
MHEC
Nercomp
NoBid Justification
Other
State of MA Contract
UMass Contract
Unknown
Select ONLY if you know, otherwise choose unknown
x
Other Purchasing Method
Business Justification
Vendor Data Access Requirements:
Will the supplier have access to university data (physically or logically)?
Please select...
Yes
No
Will the supplier have access to any UMass network (physically or logically)?
Please select...
Yes
No
Will the supplier host UMass data
(Including Cloud Providers)
Please select...
Yes
No
Will the supplier develop software
for use by UMass?
Please select...
Yes
No
Product Information
Product Type
Please select...
Hardware
Software
Licenses
Subscriptions
Professional Service
Other
Choose the appropriate purchase type for what you are buying. If other please list.
x
Other Product Type
Product Name
Product Description
Purchasing Financial Information
Multi Speed Type Purchase?
Yes
No
Department Cost
OR
Split Amount
Enter the cost OR the amount you are splitting with the other department.
x
Purchasing Department Speed Type Description
Purchasing Department Speed Type
Invoice Approver
Additional Speed Types and Amounts
Enter Campus or Department, Speed Type and Amount
x
Maintenance Database Information
Include in Maintenance Database
Please select...
Yes
No
Any purchase that will require annual renewal should be included in the maintenance database.
x
Contract Start Date
If known, the date the agreement begins.
Contract End Date
If known, the date the agreement will terminate.
Coverage Start Date
This is used in the maintenance database and used for budgeting purposes.
Coverage End Date
The date coverage ends.
Renewal Payment Information
Select Yes if you want the renewal amounts and speed types to match the Purchasing information above. Otherwise, select No and enter the Campus or Department Speed Type and amount for renewal. Enter as many lines as needed.
Same as Purchasing Information
Yes
No
Renewal Speed Types and Amounts
Enter Campus or Department, Speed Type and Amount
x
Other Information
Technical Contact
Additional Notes
Please let us know any additional information relevant for this purchase.
x
Required Uploads
Please be sure to include any relevant information, such as vendor quotes, statement of work, etc.
TESTING
Technical Contact ID
For assistance with this form please contact Jean Maynard at the this
address
.
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