NEW SUPPLIER REQUEST FORM Please provide the following information for a new supplier to be added to Oracle. Fields marked with an asterix (*) are mandatory and must be completed for your form to be processed.

*Business Unit/Faculty Name: *Contact Name:

*Telephone Number: *Date:

Is the supplier a sole trader? If "Yes" use the link below to complete the contractor management tool. Attach the completed form along with the contractor agreement, available from UTS Legal on Ext 1286. www.fsu.uts.edu.au/tax/Forms/UTSContractorManagementTool.xlsm

Yes No

*Is this supplier associated with a staff member? If yes, please refer to 4.4 on Conflicts of Interest in theUTS ‘Code of Conduct'. Attach a copy of the completed and authorised Conflict of Interest DisclosureStatement with this New Supplier Request form.

Yes No

*Does a UTS Preferred Supplier arrangement already exist for these goods/services?

Refer to the UTS Buying Guide www.fsu.uts.edu.au/procurement/staff-only/UTS_Buying_Guide_index.htmlYes No

PROCUREMENT POLICY CHECK Which procurement threshold applies for this supplier?

Under $10,000 per year State value $

$10,001 and $50,000 per year Were 2 Quotes Obtained? Yes No

$50,001 and $100,000 per year Were 3 Quotes Obtained? RFQ process Yes No

$100,001 and $250,000 per year Was a Simple Tender Process Undertaken? Yes No

Over $250,00 plus Was an Open Tender Process Undertaken? Yes No If you answered ‘No’ to any of the policy check questions above, did you obtain exemption approval via the applicable UTS Policy Exemption Form? Forms available at: www.fsu.uts.edu.au/procurement/staff-only/Policy.html

Yes No

Comment if applicable:

Staff member declaration I have completed this form in accordance with the Procurement Policy and I understand the potential penalties involved in knowingly being in breach of that policy.

SUPPLIER’S DET AILS

Supplier’s Banking Details Validation In order to minimize risk related to fraud, all bank details will be validated before entering or updating this information in Neo. For both, local and international suppliers, staff MUST provide evidence of the supplier’s bank details by providing either of the following 2 documents:

1. A bank deposit slip that shows Account Name, Number and BSB for local supplier and Swift Code, Account Number or IBAN (if applicable) for international suppliers.

2. An extract of a bank statement with the supplier’s banking details and BSB for local supplier and Swift Code, Account Number or IBAN (if applicable) for international suppliers.

Please submit evidence of bank details along with this New Supplier Request Form. Supplier will NOT be created if the information is incomplete.

*Supplier Name:

*Describe the goods/services to be supplied:

*Australian Company (ACN) or Business Number (ABN):

*Street Address, PO Box & Mailing Address:

*Telephone:

*Fax:

*Email:

*Contact Name:

* Does the supplier accept UTS’ 30 day payment terms? Yes No

*If other payment terms are proposed, please stateand provide reasons.

7 Days 14 days Immediate

*Reason:

*Currency:

*I have attached the following document for Bank Details Validation Bank Deposit Slip Extract of bank Statement

Last updated July 2018

Note: Processing of new supplier requests can take up to a week and it is subject to verification of supplier's bank details.