SUPPLEMENTAL/CONSULTANT SERVICES PAYMENT REQUEST
I. SERVICES RENDERED
NAME
SS#
ADDRESS
CITY
STATE
ZIP
PROJECT TITLE
BUDGET CODE
SERVICES PROVIDED WERE
DATE(S): FROM
TO
* NEW employees must complete I-9 for in Personnel before being paid.
II. BUDGET SUMMARY
(If this project is supported through outside funds, the service must have been approved in the internal budget).
1) Number of
hours or
x proposed
or
rate of
=
$
2) Travel (attached explanation and subject to EKU travel policy)
$
3) Per diem (not to exceed state regulations and subject to EKU travel policy)
$
4) Other
$
5)
TOTAL
$
III. EKU EMPLOYEE
I certify that a REQUEST FOR APPROVAL OF OUTSIDE EMPLOYMENT FORM was approved on
and that the requested consultant services will not exceed EKU policy regarding cumulative weekday consultant hours claimed/paid. (FACULTY/STAFF HANDBOOK: Outside Activities.)
Signature
Date
IV. APPROVED
Project Director
(If appropriate)
Date
OR
Budget Unit Head
Date
Graduate Dean
(Required for GAs only)
Date
***********************************************************************************
This request is in accordance with the approved budget and funds are available.
Division of Accounts:
Date
OR
(Grants/Contracts & Special Programs Funds)
Vice President for Financial Affairs:
Date
OR
(Other Funds)