Normally A-114s are used to reimburse people who used their own cash to pay for something over $50 (use A-150 petty cash for reimbursement of less than $50). Envelope must include an original receipt for purchase in the envelope. If an equipment purchase is
made then the A-114 should first be sent to Purchasing. (If a person wants his/her receipt returned they should include a note requesting that service.)
Student Stipends may be paid via A-114. A signed copy of the limited services agreement must be included on the envelope plus the registration form or equivalent that shows the student's name, permanent address and social security number in their own writing that verifies they are part of the program.
Limited Engagement Form
Payments may be made to consultants who are at UC for just a day or so. The signed Limited Services Engagement Form must be included in the envelope.
Payments may be made to consultants who have a Personal Services Contract. A fully executed copy of the PSC form must be included in the envelope.
Occasionally payments may be made to outside vendors via A-114 if a copy of the invoice plus fully executed A-910 contract paperwork is included in the envelope. A-114 should not be used if there is a PO in place for the purchase already. (Many reimbursements of the practice corporations are paid this way when they have contracts with the VA.)
Payments can be made for Malpractice Insurance using an A-114. The commodity
code that should be used when making payments is 3000-34 or 3002-34.
Other Information:
All Academic Health Center A-114s for $2,000 or greater must be sent Academic Health Center
Management, Finance & Support Services for the signature of the VP.
All A-114s must have two signatures. Both signatures may be in the "approved" box or one can be in the submitted box.
Just keep making photocopies of the Limited Services Engagement form. It is not available in quantity from Central Stores.
If the electronic file is used, it still must be printed and attached to an A-114 envelope plus the number on the envelope must be the one you print on the form.
Versions of A-114 dated 8/97 and earlier will no longer be accepted by Accounts Payable.
You know after processing if the check was sent to a person's home, held for pick-up or mailed to the UC mail location by looking in CUFS at the A-114 entry in OLGL. If the form number is correct with no final digit it was sent to the person's home. If it has an "A" at the end of the A-114 number, it was sent to the UC mail location or held for pick-up based on what was requested.
You can download the A-114 Excel Template below to your computer. Enter the necessary data (remember to enter the A-114 document number from the envelope) that is needed for reimbursement or payment. Print out the form and then attach it to an A-114 and send it off for processing.
