Form A23 - Subcontract Agreement Form

ADVERTISEMENT

Form A23
SUBCONTRACT AGREEMENT FORM
Complete and submit this transmittal form to obtain Network approval of subcontracts. Attach
the following as additional components of the complete Subcontract Agreement Package:
1. A brief (one page or less) explanation of the award process including all information
necessary to evaluate the reasonableness of the price or cost and the necessity or desirability of
incurring such cost.
2. Subcontract agreement consisting of:
A Subcontractor/Agency Agreement
B. Proposed SOW
C. Detailed Budget & Budget Justification
Review of subcontracts is done on a case-by-case basis and may require additional information.
AGENCY IDENTIFICATION
Agency Name:
Agreement Number:
Agreement and Budget Term:
Approved Program Budget:
:
Project Coordinator Name:
Phone Number
SUBCONTRACTOR IDENTIFICATION
Subcontractor or Consultant Name:
Address:
Total Subcontract Amount:
Is Subcontract: Single Year Agreement
Multi-Year Agreement:
If multiple year agreement, what is the entire term of the subcontract:
Current Fiscal Year Subcontract Amount:
Current Fiscal Year Subcontract Term:
Federal I.D. Number or Social Security Number:
:
Subcontractor's Project Coordinator:
Phone Number
(N/A for consultants)
Type of Subcontractor:
For-profit organization
Governmental Agency
Non-profit Organization
University
The Agency certifies that, for the above named subcontractor, all applicable terms and
conditions are included within the subcontract.
Project Coordinator Signature
Date

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Business
Go