Contractual Services Payment Request Form

For services less than $5,000 during the calendar year or when payment cannot be made in PORT, payment can be processed on a Contractual Services Payment Request Form along with documentation from the department (memo and invoice).  This form should only be utilized for non-ECU employees or students.

Instructions for Completing the Contractual Services Payment Request Form

Section 1: Contractor/Payee OR COMPANY

The name must be completed as shown on the form, (First, Initial and Last). The name inserted in this section must be as it appears on the recipient’s social security card. You cannot establish an independent contractual relationship with an ECU or state employee.

Section 2: Banner ID Number for Payee

Enter the independent contractor’s Banner ID #.  If the independent contractor does not have a Banner ID #, one needs to be requested by going to PiratePort/Submit Vendor Request and following the instructions.

Section 3: Payee’s Address

Enter the permanent address of the recipient’s residence to include street address, city, state, zip, telephone number and country.

Section 4: Payee’s Present Employer

Provide the name of the recipient’s present employer and whether this employer is a N.C. State Agency and whether the recipient has an immediate family member working at ECU.

Section 5: Employer’s Address

Provide the address of the recipient’s present employer.

Section 6: Check Payable

Indicate who the check should be made payable to if the information is different than what is listed in Section #1.

Section 7: Program Participating In

Provide the name of the program in which the recipient will be performing the service.

Section 8: Dates of Participation

Enter the dates of services to include the beginning date and ending date. If the services exceed three days per month, a Personal Services Contract must be initiated through Materials Management. A copy is attached for your review.

Section 9: Contractor Certification

Obtain a signature of the independent contractor. This signature certifies that the independent contractor understands that the University is not required to withhold federal* or state taxes** or social security on payments made to independent contractors, who are NC residents. Independent contractors will be sent a Form 1099-Misc at the end of the calendar year if the payment(s) made during the year aggregate to more than $600.

*Foreign nationals may be subject to Federal withholding taxes up to 30% based on status.  Please contact Accounts Payable prior to entering in any contract for further guidance.

**Withholding from nonresidents for personal services – North Carolina income tax is required to be withheld from non-wage compensation (personal services income) paid to nonresidents for personal services rendered in this State. The requirement to withhold is 4%.

Section 10: Types of Services Rendered

Provide a detailed description of the services rendered by the recipient.

Section 11: Location of Services Rendered

Indicate if the services performed in accordance with the contract
or agreement were performed in the State of North Carolina.

Section 12: Reason for Selecting This Individual to Perform These Services

Indicate why this recipient was chosen to perform these services.

Section 13: Basis of Fee

Enter the daily rate x the number of days to be paid and the total of all services being paid.

*Foreign nationals may be subject to Federal withholding taxes up to 30% based on status.  Please contact Accounts Payable prior to entering in any contract for further guidance.

**Withholding from nonresidents for personal services – North Carolina income tax is required to be withheld from non-wage compensation (personal services income) paid to nonresidents for personal services rendered in this State. The requirement to withhold is 4%.

Section 14: FOAPAL Codes

This list contains the most commonly used account FOAPAL codes for personal services.  Please note this list isn’t all encompassing, and others may be used if reasonable.  Enter the corresponding FOAPAL code(s) and major Banner Account codes includes the payments to independent contractors, external organizations, and others for professional and consultative personal services engaged on a contractual basis.

Section 15: Services Provided For

Provide the name of the person contracting the services of the recipient, the department the services are being provided for and a phone number where this individual can be contacted if there are questions.

Section 16: Employee Certification

Provide the signature and typed name of the person contracting the services of the recipient. This signature certifies that the above services were rendered satisfactorily, that it has been determined that the payee is an independent contractor as defined by the “twenty factor test”, and that a contract was approved if more than 3 days and/or exceeding $5,000. Provide the typed name of the person completing the form if different than the person contracting the services.

Section 17: Chair/Director

Provide the signature at unit level by Chairman, Dean and/or Director. This signature certifies that the services and budget were authorized and approved.

Section 18: Vice Chancellor

Provide the signature at division level. This signature certifies that the services and budget were authorized and approved. The division is approved to sign up to their delegated authority amount granted by Materials Management.

Section 19: Materials Management

Provide the signature by Materials Management. This signature certifies that for services that exceed three days we are covered by a Personal Services Contract to ensure that the University does not experience any liability as a result of this service.

Section 20: Funding Source

Provide the signature by Grants Administration (if applicable). This
signature certifies that the services and budget were authorized and
approved.

Forms

Contractual Services Payment Request Form (XLS)

Any questions about this process should be directed to the Department of Materials Management (252) 328-6434.