Instructions for Completing Independent Contractor Invoice

Independent Contractor Invoice

This form is used to request direct payment of services up to $10,000.00 (separate and/or combined total per fiscal year) provided by an independent contractor who is not an employee of the University. For those services over $10,000.00 (separate and/or combined total per fiscal year) contact the Purchasing Department.

Payee Name and Address: Payee must be an individual, not a company. Only one payee per form will be accepted. Address information is required.

Social Security Number/Federal ID #: Enter the social security number or Federal ID # provided by the independent contractor. This information is required, as payment information will be reported to the Internal Revenue Service and Franchise Tax Board as required by law.

Payee Data Record Form (STD 204): All vendors must have a Payee Data Record Form on file in order for payment to be made. Please check box indicating whether the Payee Data Record Form is already on file with Accounts Payable (call x5155 and ask for 204 verification) or is attached to the Independent Contractor Invoice. Departments are responsible for obtaining completed Payee Data Record forms if not already on file in Accounts Payable.

Guest Lecturer/Other: Please specify the type of service.

Department Name, Department Contact, Contact Phone #, Contact Email: Fill in complete information for department receiving services.

Chart field: Enter the chart field string that the expense is being charged to.

Service Period Covered and Amount: Specify the date(s) and time(s) of the event or service. Enter the amount being requested in payment of the event/service. Payment(s) from any funding source exceeding $10,000.00 per fiscal year require prior Purchasing approval. Please contact Purchasing at x5142 for specifics.

Signature of Independent Contractor: Signature of payee performing services.

Signature of University Manager/Designee Supervising Service/Event: Signature of individual certifying he/she has reviewed the Independent Contractor Procedures and that the events stated on the Independent Contractor Invoice have been performed.

Submit original form and supporting documentation to:

Accounts Payable

Sierra Hall 105

Independent Contractor Invoice

Created 5/22/04

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