Subcontract Request Form

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                                                                                                               Subcontract Number:__________________ 
 
Subcontract Request Form 
Georgia State University 
Office of Sponsored Proposals
 &.Awards
Complete all sections to request a new or amended subcontract and send the form with required materials to OSPA, 
Room 217 Dahlberg Hall or P.O. Box 3999, Atlanta, GA. 30302‐3999. Do not send via email. 
 
For additional guidance on subcontracts under sponsored accounts at GSU go to 
Please note that final GSU authorized signatures cannot be obtained on subcontracts until a Project Number has been established on the Prime 
Award this excludes pre‐award and advance accounts. 
 
Project Number: 
Prime Agency: 
Georgia State University Information 
PI Name: 
Dept. Contact Name: 
PI Department: 
Dept. Contact Telephone: 
PI Email: 
Dept. Contact Email: 
PI Telephone: 
Subcontractor Information 
Subcontractor Legal Entity Name: 
Mailing Address: 
 
 
Performance Address: 
 
 
DUNS No.: 
EIN No.: 
Congressional District: 
Registered in CCR ☐ 
Subcontract Principal Investigator 
Subcontractor Administrative Contact 
Name: 
Name: 
Telephone: 
Telephone: 
Email: 
Email: 
Project Title: 
☐ New Request 
☐ Change to Existing Subcontract 
Period of Performance  
Period of Performance 
Start Date:                                              End Date: 
Start Date:                                             End Date: 
☐ Scope of Work (attach with this form) 
☐Scope of Work (attach with this form) 
☐Budget for Current Performance Period:  
☐Budget for Current Performance Period:  
(attach budget for this amount) 
(attach budget for this amount) 
☐ No Cost Extension                          Extend to: 
Other: (explain) 
☐Carry Forward     From Year:                              To Year: 
 
Amount: 
 
Other: (explain) 
 
Negotiated F&A Rate Agreement:   ☐Attached  or  Website Address:  
 ☐Cost Share (if applicable):  Amount 
How often do you want subcontractor to submit invoices? 
☐ Monthly     ☐ Quarterly     ☐ Scheduled (provide schedule)     ☐Other (attach explanation) 
Payment Terms: ☐Standard (30 days from the date of invoice)     ☐Other (attach explanation) 
Is the Subcontractor a Foreign Entity?  
No
Principal Investigator’s Signature and Certification 
I certify that I understand my responsibilities for monitoring this subcontract in accordance with University and agency policies and guidelines 
 
PI Signature:_____________________________________________       Date:________________________ 
 
 
OSPA Internal USE: CR/F          Officer Approval Date: ________________          Officer Signature:________________________________________ 
 
 
 

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