National Procurement OfficeCONTRACT REVIEW REQUEST FORM (CRRF)CRRF-2011.10 (Created 10/11)

New Contract Amendment to Existing Contracts: Amendment #: PO/SOW controlled by MSA (Effective Date Click here to enter a date.) Contract Value: $ _____ If this contract meets one of more of the following criteria, please call the Contract Administrator to schedule a kick-off call with the legal department. New Vendor MSA Annual Value over $50,000BUSINESS OWNER CONTRACT INFORMATION

Name Email Telephone

Today’s Date: Click here to enter a date. Standard Review (11 business days) Rush Review (5 business days)If you request a rushed review, provide a detailed reason for this request:

DOCUMENT INFORMATIONClick here to enter a date. Click here to enter a date.

TERM START DATE END DATE VALUE

VENDOR INFORMATION

Vendor Business Name Vendor Contact Name

Vendor Business Address Contact Phone Contact Email

Has Vendor agreed to terms via RFP? YES NOOvernight Courier Address

PRODUCT / SERVICE INFORMATIONPRODUCT/ SERVICE DESCRIPTION

DELIVERY INFORMATIONWhere will the product be delivered?Will any or all of the product be delivered electronically?Where and by whom will the product be used?EXPLAIN ROI, EXPENSE REDUCTION, INCREASED PRODUCTIVITY OR REDUCTION

FINANCIAL INFORMATIONTOTAL COST OVER CONTRACT TERMADDITIONAL SPEND ANTICIPATEDBUDGETED? YES NO CAPITAL BUDGET OPERATING BUDGET

ADDITIONAL INFORMATION APPROVALS

Project Code #

Business Unit (LOB) Requestor Signature Department Head Signature

Dept. ID (to be charged) By signing/approving this document, I am attesting that I have reviewed the rates and business terms of the associated document(s) and agree that they meet my expectations.

Send the completed form, any attachments and an unprotected MS Word version of the contract via email to:contractadministrator@_com. Incomplete submissions cannot be processed.