ICT Procurement Form

The ICT Procurement Form must be completed by requesting departments for all technology purchases identified in the categories pertaining to ICT.This form will be reviewed by CSUN’s ATI Procurement Group to determine the accessibility impact of an ICT purchase. Regardless of the outcome of the impact review, departments are expected to reasonably accommodate an individual's request for a disability-related accommodation. Information about the university's process of reasonable accommodation can be found at the Equity and Diversity website.

Information and Communication Technology (ICT) form (PDF)

For additional information refer to the Purchasing & Contract Administration's ATI Procurement website.

 Before filling out the form

Please review the following instructions for successfully completing the ICT Form:

• Use the latest version of Adobe Acrobat Pro or Adobe Reader to complete the fillable PDF forms.Contact your IT department to obtain the latest version of Adobe Acrobat Pro or download Adobe Reader for free through the Adobe website. To download, go to Get Adobe Reader.
• Please save the form to a location on your computer such as to your desktop or documents folder before filling it out. Do not complete the form within your web browser; your data will NOT be saved. You must SAVE the form to your computer first and then fill it out. For assistance, review the Guide for Saving an ICT Form (PDF).
• Once you have saved, open the saved form and begin filling it out.
• All fields marked by an asterisk (*) are required. Forms with incomplete required fields will be returned.
• Please respond to the form as accurately as possible. Failure to do this may result in delays to approve your purchase request. Instructions on how to answer each section is provided below.

 Instructions For Completing The ICT Form

• Section 1: Purchase Request

  Provide general information about the purchase request. For state purchases, provide the requisition number and/or Pcard case number. If the request is “other”, specify the type of request the product or service is (e.g. non-state and/or zero dollar value).

  

  
  
• Section 2: Requester Information

  The requester is the person who is requesting the product and who will be responsible for all executive decisions of the product or service, including the accessibility compliance. The requester may appoint a contact to complete the ITC form for the requester but this person is not responsible for the product/service.

  

  
  
• Section 3: Product Information

  Provide general information about the product including a brief description of what the product or service does.

  Example description: “Product XYZ is an online survey development application. The product is used for creating customizable surveys, collecting feedback/data, data analytics, reports, online evaluation and more. ”

  

   

  
  
• Section 4: Location and Usage

  Question 4A: check all the areas where the ICT product/service will be used. If the product will be used in a website, provide the web address where the final product will be used.

  Question 4B: check who will be the users for this product and provide the annual total of users for each applicable group.

  • If students will be using this product, check the box next to students and in the text field below input an estimated annual number of student users.
  • If this ICT will be used by students in a classroom setting, the total number of users is determined as Number of students X number of sessions X number of semesters. If the number of sessions per semester is a range, please calculate the highest possible number.
  • Example: 30 students will be using product XYZ in a class. There are 5 sessions of this class and it is offered in the fall and spring semesters (2 semesters). Therefore, the total annual number of student users would be 30 (students) X 5 (sessions) X 2 (semesters) = 300 student users.

  

  
  
• Section 5: Accessible Technology Initiative (ATI) Information/ Impact

  The questions in Section 5 are critical to determine the impact of the ICT product/service being procured.  The responses in this section must be clear in order to process any ICT forms within the 15 business days time frame.

  • Question 5A: This question asks about the intended usage of the product/service being procured. Please provide clear information on how the user(s) will utilize this product or service on campus. THIS QUESTION IS CRITICAL TO DETERMINE THE ACCESSIBILITY IMPACT OF THE ICT PRODUCT/SERVICE. Examples on how to respond to this question are listed below.
  • Example 1: This product will be used by students to fulfill their class requirements. Students will access this web application online by creating user accounts. They will be using it to complete a project by uploading documents, collaborating with their teammates, searching for resources and tracking the completion of the project.
  • Example 2:This product will be used to create and distribute climate surveys to the University. University staff will create the surveys and will post a link to complete the survey on the main university website. Anyone who visits the website can respond to the survey including students, faculty, staff and other university patrons/visitors.
  • Example 3: This product will be used to create and distribute climate surveys for College ABC. Staff in the college will generate the surveys and students and faculty in the college must fill out the surveys. The students and faculty will receive the surveys via email and will be required to respond by the deadline specified.
  • Example 4: This product will be used by a department for meetings, scheduling, communications, and tracking department data.
  • Example 5: This product will be used by staff to create a website/mobile application where students/faculty/staff/public will be able to accomplish task XYZ.
  • Question 5B: If this product will be a website or mobile application, provide information about who will be the final audience of the finished product.
  • Example (if yes): The final website/mobile application for the department of ABC, will allow students/faculty/staff/public to remain up to date with department news.
  • Question 5C: Select all statements that are applicable to the product or service being procured.
  • Question 5D: this question is only applicable to products if they are intended to be used in a classroom setting. Provide the course information and additional information that may be applicable to the product.

  

  
  
• Section 6: Voluntary Product Accessibility Template
  • The VPAT is the first step to understand the accessibility of an ICT product/service and must be submitted as part of your ICT request.
  • If the vendor does not have a VPAT, a template to the VPAT is found in the link that says “blank template” on the form.
  • If a vendor needs guidance to understand CSUN’s ICT requirements or for assistance on completing VPAT, refer them to UDC’s ICT Vendor Page.

  

  
  

 Submitting the Form

• When the form is complete, save the completed form to your computer.
• NOTE: The form must be saved as a fillable PDF in order for your request to be processed. Scanned PDF's and non-fillable PDF's will not be accepted!
• The form must then be attached to an email addressed to and
• NOTE: both departments must receive the ICT form in order for your request to be processed!
•  If the VPAT obtained is a PDF, attach to the same email as well.
• Please allow 15 business days to process your ICT request. If additional information is needed or if the form is incomplete, the review window will begin again at the time any issues with the form are resolved.

 Assistance

• For assistance in completing this form, contact the Purchasing and Contract Administration Office at                       818-677-2301.
•  If your request is an non-state and/or a free product/service, please follow up with the Universal Design Center to check on the status of your request.
• For any technical issues with the form, contact the Universal Design Center at 818-677-5898.