Non-Sponsored Funding Billing AgreementBilling Agreement • September 19th, 2016
Contract Type FiledSeptember 19th, 2016Paying InstitutionName:Address: Receiving InstitutionName:Address: Departmental Contact Departmental Contact Agreement Reference # This Billing Agreement is a new agreement or anamendment, No. to an existing agreement Period of Performancemm/dd/yyyy to mm/dd/yyyy Total Authorized Amount $ Purpose Title: 1) Paying Institution shall provide Receiving Institution the above referenced total authorized amount for agreed upon services. All invoices shall be submitted using the Receiving Institstuantdairdoinnvo’icsing practice. Questions concerning invoice receipts or payments Contact. 2) Purpose Description: Paying Institution Contacts Receiving Institution Contacts Departmental Administrative ContactName:Title:Telephone:Email: Departmental Administrative ContactName:Title:Telephone:Email: Date: __ Date: __ Center Number: Not Required, But Helpful for Processing Center Number: Not Required, But Helpful for Processing Financial ContactName: Address: Financial ContactName:Address: Teleph