Consultant Agreement Form

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CONSULTANT AGREEMENT

This Agreement is between:*

a non-profit corporation that is exempt from taxation under Section 501(c)(3) [or a governmental entity], and

Consultant:*
The effective date of this Agreement is:*
Consultant Name:*
Consultant Title:*
Library Rep Name:*
Library Rep Title:*

Library Information

Name:*
Phone Number:*
Fax Number:
Address:*
City:*
State:*
Zipcode:*
Library Contact Person:*
Email Address:*

Consultant Information

Name of Consultant:*
Consultant Phone Number:*
Consultant Fax Number:
Consultant Address:*
Consultant City:*
Consultant State:*
Consultant Zipcode:*
Vendor Contact Person:*
Consultant Email Address:*
EIN Number:

List of 3 references with which you have or have had contracts of a similar nature:

Name 1:
Phone 1:
Name 2:
Phone 2:
Name 3:
Phone 3:
Description of Products or Services to be provided by Consultant:
Deadline for Submission of Products or date Services are to be provided:
Fees for Products/Services:
Verification:
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