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REDLANDS UNIFIED SCHOOL DISTRICT <br /> AGREEMENT FOR CONSULTANT SERVICES FORM <br /> FOR OVER $5000 <br /> INSTRUCTIONS <br /> I FORM Fill out agreement form completely, with dates, times fees the Consultant's signature and your Site <br /> Administrator(and fund administrator, if necessary) Assistant Superintendent, Business Services (CBO)who <br /> is a board authorized contract signer will co-sign the documents AFTER the Board meeting authorizing the <br /> agreement The signed documents will be returned to you after approval by the board with a copy of your <br /> purchase order <br /> 2 CONSULTANT QUALIFICATIONS Please give a brief summary of consultant's qualifications below both in <br /> education and experience, and the name of the management code/funds to be charged <br /> 3 REQUISITION Please submit an electronic requisition for payment of consultant Please send this <br /> attachment, Certificates of Insurance (naming us additionally insured), and agreement with the <br /> requisition number noted on it along the path of the Requisition Each approver must see the <br /> agreement in order to approve your requisition Business Services will insert the Board approval date on your <br /> requisition after agendizing the agreement The requisition and agreement MUST BOTH be received in <br /> Business Services for the Agreement to be agendized (You DO NOT need to attach a printed copy of the <br /> requisition to the agreement) IF you have any issues obtaining the Property and Liability Insurance or <br /> Workers Compensation Insurance please call Purchasing BEFORE submitting your requisition <br /> 4 CONSULTANT REQUEST FOR PAYMENT FORM Please give the consultant a Payment form (also <br /> included in this file) for submittal after services are performed Consultant will need to return this payment <br /> form to YOUR department and it will need to be signed by an administrator to verify that services have been <br /> received Please complete your site info on this form before you send it to the consultant If they have their <br /> own invoice that is also acceptable for them to use <br /> 5 IMPORTANT Agreements for consultant services must be Board approved BEFORE services are <br /> rendered If the agreement forms are submitted to Business AFTER date of service, you MUST attach a <br /> statement to this agreement form signed by your administrator indicating why this happened <br /> 6 PLEASE NOTE This form is for outside consultants ONLY Employees of RUSD or any school district will <br /> need to submit a "Request To Employ"form though Human Resources <br /> MEMORANDUM <br /> Req# From Student Services School/Dept Code Fund <br /> (management code) <br /> Consultant will be working individually with students unsupervised (Attach criminal records check form, proof of TB <br /> and finger print clearance ) <br /> X will be working individually with students while site staff supervises <br /> will not be working individually with students <br /> will be working with students more than 5 times (attach proof of TB test clearance) <br /> Consultant Qualifications (for board description) <br /> THIS PAGE TO BE COMPLETED BY REDLANDS UNIFIED SCH DISTRICT <br /> Rev 2/24/12 0 <br />