UPMC Hillman Cancer Center Capital Equipment Request Form

Use this form to request the purchase of any individual piece of equipment.

Please provide at least 30 days notice to process this request.

The Hillman Capital Budget assures that all expenditures for fixed and major movable assets are based upon carefully planned institute-wide programs for development. Capital Expenditure is defined as any individual piece of durable equipment with an original cost of $5,000 or more and a minimum useful life of two years.

Instructions for Completing and Submitting Form

  1. Please obtain the following attachments (as applicable) and adhere by the documentation requirements:
    • Vendor’s description of product
    • Quote from vendor (expiration date needs to be no less than 30 days from date submitted)
    • Certificate of Insurance
    • Directed or Sole Source Justification
    • Contracted Supplier
    • Equipment Screening Certificate (required only for 05-accounts using a Federal grant to purchase a single piece of equipment valued at $10,000 or more)
  2. Please complete and submit the following form: Capital Equipment Request Form via DocuSign