Requisition to Purchasing - Please return to: Purchasing Department, Sullivan Building, or Fax to ext. 5841
Budget Number Date Ordered Date Required
Submitted By
Name E-Mail Address
Department Telephone #
Authorized Departmental Approver
Signature Required
Vendor Information (If vendor is new to Babson a completed W-9 form must accompany this request)
Company Name Email Address
Address Line 1 Telephone #
Address Line 2 Fax #
City
State Postal Code
Itemized List
Description Quantity Unit Price Amount
Do you have a complete Certificate of Insurance from this company? Yes No
Do the liability limits meet Babson's requirements? Yes No
At a minimum, vendor will be required to supply evidence in the form of a certificate of insurance for: (1) comprehensive automobile insurance
including non-owned & hired $1,000,000, (2)worker’s compensation statutory; employer’s liability $500,000; (3) commercial general liability
including blanket contractual liability; premises-operations & completed operations $1,000,000 each occurrence, $2,000,000 aggregate. As
allowed by law, insurance conditions # 1 & 3 above will name Babson College as additional insured.
Do you have a complete Data Security Agreement from this company? Yes No
Must be executed for all contacts and agreements in which a third party vendor or service provider will have access to personal information (first
& last name or first initial & last name in combination with one or more of the following; Social Security #, Drivers License # or state ID card #,
Financial Acct #, credit or debit card #, access code or personally identifiable ID # or password that would permit access to a
resident’s financial account.
Have you completed and attached a Database Summary Form (Required for contracts & agreements)? Yes No