Note: Where the Intended Supplier Is a Self-Employed Individual Or an Individual Providing
Instructions: This form is to be completed when seeking approval to award a contract:
· With a total value of £50k+, following a procurement exercise that complies with the University’s Procurement Regulations; or
· With a total value of £10k+, where an exception(s) to the University’s Procurement Regulations is being sought
PART A : Procurer
Name: / School / Department: / Date:
PART B : Contract / Framework Agreement / Order Details
Description of Goods / Services / Works:
Contract : / Total Value of Contract / Framework Agreement / Order:
Start Date / End Date / Extension option / (incl. any extension options)
Ex. VAT / Incl. VAT
£ / £
If a Purchase Order, is the intention that a ‘Blanket’ Order be placed?
(A ‘Blanket’ Order is raised to cover requirements over a period of time, for a total aggregated value, against which individual requirements are drawn down over that period) / YES / NO
PART C : Any Saving / Efficiency
Description of Saving/Efficiency: / Value:
£
PART D : The Supplier (Address and contact details only required where the Procurement Team has not managed the exercise)
Organisation: / Tel: / Address:
Contact: / Email:
Note: Where the intended supplier is a self-employed individual or an individual providing their services through an intermediary (e.g. their own limited company, a personal service company, a partnership or an individual), you are required to apply HMRC’s Employment Status Check to establish whether PAYE/NI tax deductions must be made from the pay to the individual.
Is the supplier a self-employed individual? / YES / NOIs the supplier an individual providing their services through an intermediary (e.g. their own limited company, a personal service company, a partnership or an individual)? / YES / NO
If you answered ‘Yes’ to either of the two questions above, you are required to apply HMRC’s Employment Status Check to establish whether PAYE/NI tax deductions must be made from the pay to the individual…
…Does the application of the Employment Status Check result in the individual being classed as employed for tax purposes?(Please attach Employment Status Check result) / N/A / Employed /
Not Employed
PART E : The Procurement Process:
Tender Reference No. where the procurement exercise was undertaken by the Procurement Team / LU
Was this a collaborative procurement exercise? / YES / NO / If ‘Yes’, who were the collaborators?
Is the proposed contract a call-off of a Framework Agreement (that has not already been approved through this process)? / YES / NO
Was the contract opportunity the subject of an open advert? / YES / NO
…If ‘No’, how many quotations/tenders were sought and obtained? / …sought, and… / …obtained
Was an EU compliant tendering procedure followed?* / YES / NO
*An EU compliant tendering procedure must be followed for Supplies and Services contracts with a total value of £181,302+ and Works contracts with a total value of £4,551,413+. The total contract value must include any extension options
PART F : Any exception(s) to the Procurement Regulations: (ONLY COMPLETE PART F IF AN EXCEPTION)
Type of exception(s) to the Procurement Rules: / (Tick) / Reason for requesting exception(s) to the Procurement Regs:
· Mandatory Contract not to be used
· University Standard Terms & Conditions not to be used
· Extension where no option in the contract
· Substantial variation to contract
· E-tender system (Delta) not used, where £50k+
Not competed in line with Procurement Regulation 1.6(b) because:
· Sole supplier
· Compatibility issue
· Unforeseen urgency
· Other:
Procurement Team’s response to the exception request:
Name:
PART G : Conflict of Interest Declaration:
(‘Conflict of Interest’ refers to situations in which personal interests (which may include financial interests) may compromise, or have the appearance of, or potential for, compromising professional judgement and integrity when making the decision as to who to award a contract)
Staff involved in making the contract award decision / Interest / If ‘YES’ please state nature of interest
1: / YES / NO
2: / YES / NO
3: / YES / NO
PART H : Approvals
School / Department
Name (Print) / Signature (electronic acceptable) / Date
Procurer
Dean of School /
Head of Professional Service
Procurement Team
Name (Print) / Signature (electronic acceptable) / Date
Category Manager
(where £10,000 to £49,999 and an exception to Procurement Regulation 1.6(b))
Head of Procurement
(where £50,000+) / JAMES TROTTER
Director of Finance
(where £50k+ and an exception to Procurement Regulation 1.6(b)) / ANDY STEPHENS
Note: If the award of the contract is approved, and the supplier is new to the University, then it will be necessary for the supplier to be added to the finance system (or payroll system, if HMRC’s Employment Status Check establishes that PAYE/NI tax deductions must be paid). In order to upload a new supplier to the system, the Supplier Creation Form must be completed and e-mailed to Finance Shared Services at
PROCUREMENT TEAM USE ONLY: / Replacement/extension of contract already recorded in the Contracts Register? / YES / NO / Don’t know / Social (incl. environmental or economic benefit) clause included in the contract? / YES / NO
Procurement Team(November 2016)