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.

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. Please read the Notice of Procedural Change for additional details.

Instructions for Completing and Submitting Form

  1. Please obtain the following attachments (as applicable) and adhere by the documentation requirements:
    • Quote
      • Required for all Capital Equipment requests. The quotation must be valid, current, in USD, and from a university-wide contracted supplier. This quote must also have an expiration date that is no less than 30 days (45 days preferred) from date submitted.
    • Certificate of Insurance with required minimums
      • Required for all installation, training, maintenance, or other services performed on university property. The University of Pittsburgh must be named as an “Additional Insured” and as the certificate holder.
    • Directed or Sole Source Justification
      • Required for all purchases that are $10k+ and not with a university-wide contracted supplier. Your DSSJ form must be completed using DocuSign to obtain a signature of approval from the HCC Director.
    • EH&S approval
      • Required for all purchases involving lasers or laser-related equipment, chemical fume hoods, gas cabinets, and biological safety cabinets. You must acquire approval from EH&S prior to submitting your request, you will be asked to attach a pdf copy of the EH&S approval email while completing the form.
    • For Purchases over $50,000 only
      • Acquire separate documents for each of the following:
        • Installation and site preparation requirements
        • Specifications
        • Training requirements
        • Warranty information
        • Delivery schedule
        • Maintenance support options
        • Testing requirements
  2. Please complete and submit the following form: Capital Equipment Request Form via DocuSign