Independent Contractor Agreement Template
Contractor: Company:
Site Location:
Hours of Service:
This Independent Contractor Agreement (the “Agreement”) is entered into by and between the parties listed above. The Contractor has been requested by the Company to provide contracting services as requested by the Company in accordance with the terms, set forth below.
1. Term. The term of the Agreement shall be as set forth above, unless earlier terminated as provided herein.
2. Services. The Company hereby engages the services of Independent Contractor, and Independent Contractor agrees to provide, the services described further herein at the location set forth above. Nothing contained herein shall preclude the Contractor from representing, performing services for or being employed by such additional clients, persons or companies as the Contractor in its sole discretion sees fit, so long as such activities do not conflict or interfere with the Contractor’s performance under the Agreement. Except to the extent that the Company may determine it to be more convenient for Independent Contractor to use equipment and supplies already owned by the Company at site(s) where Independent Contractor is performing services, Independent Contractor shall be responsible for furnishing, at his expense, all equipment and supplies necessary for the provision of his or her services hereunder. Contractor agrees to provide workers' compensation insurance for Contractor's employees and agents and agrees to hold harmless and indemnify Corporation for all claims arising out of any injury, disability, or death of any of Contractor's employees or agents.
3. Independent Contractor. The Contractor shall be an independent contractor in the making and performance of the Agreement and is not, and shall not be construed to be, an employee, agent or servant of the Company. The Company shall have no liability whatsoever for withholding, collection or payment of income taxes or for taxes of any other nature on behalf of the Contractor, and the Contractor hereby agrees to indemnify the Company for any liability, cost or expense incurred by the Company as a result of the Company’s failure to withhold. Under no circumstances shall the Contractor have or claim to have power of decision hereunder in any activity on behalf of the Company, nor shall he have the power or authority hereunder to obligate, bind or commit the Company in any respect. It is specifically understood that the Company shall not, with respect to the Contractor’s services, exercise or have the power to exercise such control over the Contractor as would indicate or establish that an employment relationship was created.
4. Payment of Fees for Services. The Fee for services shall be confirmed through the AllShifts Marketplace app, be invoiced through the app, and shall be payable through application for the convenience of the Contractor.
5. HIPAA Confidentiality. The Contractor understands and acknowledges that during the term of the Agreement he/she may have access to and become acquainted with certain confidential information and or HIPAA information. To the extent that Contractor and Company may qualify as a “business associate” as defined by the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), and privacy regulations published by the U.S. Department of Health and Human Services contained at 45 CFR 160 and 164 (“HIPAA Regulations”), which may be periodically revised or amended, and other applicable laws, you and Company agree to protect and provide for the privacy and security of Protected Health Information (“PHI”), as defined by HIPAA. The parties agree as follows: (1) Contractor and/or agents shall use appropriate safeguards to prevent the use and/or disclosure of all PHI relating to patients, patients’ family members, Company’s employees, and other healthcare providers—made available by or obtained from any source. Contractor shall not: (a) use or further disclose any PHI except as provided with the prior written approval of Company (b) use or further disclose any PHI in a manner that would violate the provision of HIPAA or its regulations.
6. Hepatitis B Declination. It is the policy of the Company that any service provider that has direct contact with patients receive a Hepatitis B vaccination series. The service provider is responsible for procuring their own vaccination series. By signing this Contract, it is understood that while Contractor is not providing Company with Contractor’s Hepatitis B vaccination series results, Contractor will not hold Company liable for any future expenses or liabilities should Contractor contract Hepatitis B.
7. Elder Care Abuse & Neglect Policy. All service providers at Company are responsible for reporting any suspected cases of abuse, domestic violence or neglect as seen in any patient at the center. The purpose of this is to make every effort to protect the patient from any further abuse, violence or neglect. The items listed below is designed to assist staff in recognizing the signs of abuse and neglect. Abuse can be physical, sexual or emotional in nature and may occur in combination with one another. Definitions: Physical abuse may include beating, burning, rough physical handling and sexual abuse. Neglect may include both willful and un-willful disregard, abandonment, confinement, malnutrition, starvation, over and under medicating and withholding of personal and medical care. Emotional or psychological abuse may include verbal harassment, threats, enforced physical and emotional isolation and any behavior, which causes fear. Financial abuse includes withholding or stealing funds and exploitation of personal property. By signing this Contract, Contractor agrees that Contractor has successfully completed training for Elder Care Abuse & Neglect and fully understand the policies/procedures referred to herein.
8. Governing Law/ Arbitration. The Agreement shall in all respects be interpreted, enforced and governed under the laws of the state in which the services are performed. All disputes between the Contractor (and his attorneys, successors and assigns) and the Company (and its affiliates, shareholders, directors, officers, employees, agents, successors, attorneys, and assigns) relating in any manner to any and all disputes arising out of or relating to the Agreement or the interpretation or breach thereof (“Arbitrable Claims”) shall be resolved by arbitration. Arbitrable Claims shall include, but are not limited to, contract (express or implied) and tort claims of all kinds, as well as all claims based on any federal, state, or local law, statute, or regulation, excepting only claims under applicable workers’ compensation law and unemployment insurance claims. Arbitration shall be final and binding upon the parties and shall be the exclusive remedy for all Arbitrable Claims. THE PARTIES HEREBY WAIVE ANY RIGHTS THEY MAY HAVE TO TRIAL BY JURY IN REGARD TO ARBITRABLE CLAIMS. The Federal Arbitration Act shall govern the interpretation and enforcement of this Section. The fees of the arbitrator shall be split between both parties equally.
9. Entire Agreement; Amendments. The Agreement sets forth the entire agreement between the parties and fully supersedes any and all prior agreements or understandings between the parties relating to the subject matter hereof. Any amendment or modification to the Agreement must be made in writing and signed by both parties. Nothing contained herein shall affect the Contractor’s rights or obligations as a director of the Company or any other compensation he may receive in such capacity.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the date above.
Contractor Signature:
Contractor Name:
Address:
Company Signature:
Company Name: