(1) Agency assigned contract number or outline agreement and amendment number. For those contracts for which payment will be made wholly or in part against a Method of Financing, enter the assigned Method of Financing on the contract form.

(2) Date the agreement was signed by the agency and the contractor, the outline agreement or contract number and the vendor number. Also enter the agency's code (or business area) and title, division, if applicable, and the contractor's Federal ID number, name and address.

(3) Funding source: State, Federal, Cash, Trust or Other (specify).

(4) Any resources to be provided by the agency to the contractor as part of the agreement.

(5) Name of the agency representative who will represent the agency in coordinating the work of the contractor.

(6) Disclose all information as required under the terms of any existing Executive Order. The contractor shall also require the subcontractor to disclose the same information. Any existing Contract and Grant Disclosure and Certification Form shall be used for this purpose.