Contract Monitoring Form

Contract Monitor:
(monitor is responsible for this plan and initiating amendments and/or renewals to contract)

1. Contractor/Vendor:
2. Contract Number:	3. Contract Term:
4. Description of Contract:
5. Payment Frequency:
6. Amendments: Yes No - Number and Date:
7. Budget Revisions: Yes N0 - Number and Date

8. Deliverables Reporting:

	Description:	Date Received :
a.
b.
c.
d.
e.

9. Action Summary

Document and date any activities, accomplishments, or barriers (if applicable) to the performance of this contract.

I, (printed name of the contract monitor), certify that , to the best of my knowledge, the above is an accurate account of the goods/services/activities in regards to this contract.

___________________________________________	_______________
Signature	Date

The University of Memphis, one of the Tennessee Board of Regents institutions, is an Equal Opportunity/Affirmative Action University.