Personal Service Contract Number PS

PERSONAL SERVICE CONTRACT Between EASTERN KENTUCKY UNIVERSITY

and

Name of Individual and/or Firm (The Second Party)

The undersigned hereby certifies that neither he/she nor any member of his/her immediate family having an interest of 10% or more in any business entity involved in the performance of this contract, has contributed more than the amount specified in KRS 121.056(2), to the campaign of the gubernatorial candidate elected at the election last preceding the date of this contract. The undersigned further swears under the penalty of perjury, that neither he/she or the Company which he/she represents, has knowingly violated any provisions of the campaign finance laws of the Commonwealth, and that the award of a contract to him/her or the Company which he/she represents will not violate any provisions of the campaign finance laws of the Commonwealth.

The undersigned hereby certifies that they are legally entitled to enter into this contract, and that it has not and will not violate any conflict of interest statutes (KRS 45A.330-45A.340).

Any foreign corporation (outside the State of Kentucky) must obtain a certificate of authority from the Secretary of State as is required by KRS 271B.15-010. https://secure.kentucky.gov/sos/ftbr/Welcome.aspx

• Certificate #:

• Claimed exemption:

Any “person” (business or individual) making retail sales in the state are to be registered to collect Kentucky sales and use tax. If the foreign individual (or business) is making retail sales they should be registered for Kentucky sales and use tax purposes by completing a Tax Registration Application (form 10A100), available at the link below. If they are under contract to perform services that do not include the sale of tangible personal property or digital property, or do not perform services subject to tax per KRS 139.200 (such as admissions, provision of telecommunication services, sewer services, and so on), then they are not required to register.

• Consumer Use Tax Account number: ___
• Sales Tax Account Number: ___
• IMPORTANT CHANGES TO THE LAW GOVERNING INVOICING OF PERSONAL SERVICE CONTRACTS * HB 387, which passed during the 2010 Regular Session and became law upon the approval of the Governor on April 5, 2010, requires that “no payment shall be made on any personal service contract unless the individual, firm, partnership, or corporation awarded the personal service contract submits its invoice for payment on a form established by the committee. This form can be found at http://www.purchasing.eku.edu/. The vendor’s invoice should be attached to this as well.

Contractor (Second Party)

Signature Date

Title

Name of Company or Corporation

TAXPAYER IDENTIFICATION NUMBER REQUEST