UPMC Hillman Cancer Center Service Agreement Request Form
Use this form to request the purchase of any service agreement costing $2,000 or more.
PLEASE PROVIDE AT LEAST 30 DAYS NOTICE TO PROCESS THIS REQUEST.
The Hillman Operating Budget assures that all expenditures for service agreements are based upon carefully planned institute-wide programs for development. Major Expenditure is defined as any service agreement that costs $2,000 or more.
Instructions for Completing and Submitting Form
- Please complete Sections I-IV.
- Please submit the completed form electronically and as a hard copy:
- Electronic Submission:
- Click the 'Preview & Confirm (Electronic)' button at bottom of completed form.
- You will be asked to confirm your information before final submission. To make changes, simply change the information in the appropriate field(s).
- When all information is correct, click 'Submit & Generate PDF.'
- After submitting electronically, a copy of the PDF will be emailed to the address you provided. Save the file and print a copy of the completed form.
- Hard Copy Submission:
- Click the 'Preview & Confirm (Hard Copy)' button at bottom of completed form.
- You will be asked to confirm your information before final printing. To make changes, simply change the information in the appropriate field(s).
- When all information is correct, click 'Printable Version.'
- Secure any attachments required in Section IV to the printed copy of completed form.
- A signatures section (Section V) will be included on your printed copy. Signatures in Section V are not the applicant's responsibility but this page should be included with submission.
- Send form and all attachments to:
Joan Neitznick
Administrator for Basic Research
Suite 1.25
Hillman Cancer Center Research Pavilion
- Electronic Submission: