Center for Care Innovations – Contract Request

To request a contract from the Center for Care Innovations (CCI), please complete the following contract request.

For any questions regarding the contract, email a[email protected]. You will be contacted if there are any questions or missing components for this request.

Contractor Information

May be contracting organization or individual name

You may upload here or submit W-9 through Tides' secure portal.
CCI / Tides Information

CCI lead for this contract

If multiple PIDs apply, separate with a semi colon

If multiple RIDs apply, separate with a semi colon

Scope of Work

Date that the SOW was finalized between CCI & Contractor.

Date that work payable under this contract will begin

Date that work payable under this contract will end
Provide a Scope of Work document with containing as much detail as possible.

Scopes of Work allow us to manage budgets, project needs, and pay based on mutually agreed-upon deliverables. Details also provide a set of obligations so that all parties are aligned on expectations. Be sure to include concrete deadlines.



Maximum amount budgeted for hourly contract. Should equal Hourly Rate * Total # Hours Budgeted

Maximum amount budgeted for contract.

Maximum budget for professional fees.

Maximum budget for additional expenses

If you are uncertain what your funder requires, require expense receipts.

Before submitting, please verify the details below: