HomeMy WebLinkAboutCraig Violante
-A.. "3 . lb' __-S
CITY OF AUBURN
. CONTRACTUAL AGREEMENT FOR PROFESSIONAL SERVICES
Name of Contractor
Address
Home telephone
Emergency contact
Relationship
Telephone number
w:
Social security number/BusinesslD
City Contact S
Description of work: r:;:
Start date
Services to conclude by (date)
Work location:
Terms of Service $ '10 G 0 h rs,
r
Keys to be issued? Number of keys issued
If working with children or developmentally ~ndividuals, are the two required background forms completed and returned to
the Human Resources Department? Yes No
The City may terminate all or part of this contract with or without cause at any time. The City may provide work references for the
contractor upon request.
The contractor hereby agrees to hold the City harmless from all loss or damage occasioned to it or to any third party or property by
reason of any negligent acts or om issions on the part of the Contractor, his or her employees, or persons working directly or
indirectly in the performance of the contract including joint acts or omissions, and shall give the City prompt notice of any such
damage, loss, or injury.
The contractor shall notify and receive approval from the Department Director or designee for any substitutes, changes or
cancellations in the above-named performed services. Subcontracting the services of this contract is not allowed unless the
Department Director receives prior approval.
The Contractor agrees and understands that he/she is an independent contractor and not the agent or employee of the City. The
manner and means of providing the professional services herein are under the sole control of the Contractor. The Contractor shall
be solely responsible for reporting his/her hours, earnings, income tax, and social security to the applicable federal and state
agencies. The Contractor understands that he/she is not entitled to any of the benefits provided by an employer to employees
including but not limited to paid leave, health insurance coverage, retirement programs or unemployment insurance.
The Contractor agrees to indemnify and hold the City harmless from any claims that may result from allegations that the Contractor
is not an independent contractor. Such claims may come from Internal Revenue Service, State of Washington Labor and Industries
and like agencies. The Contractor agrees to comply with all governmental requirements necessitated by independent contractor
statues including but not limited to the payment of taxes.
~f cd'ac/~
Gctoos S;g",'"'" Date
#5/!tJf+;
Dep,rt~ ~/n#1
Date I I
LlEmp loyment/Co ntractualAgreements/lndepContr AgreementT emp late090 1
-, ---------- I
v,,,. YIoo "'''' 11\1 l!1uU 1111 r H/\ fiU, ~UOjltJ4jtll 1-', U2/02
06/0~/2006 11:50 FAX 25~8161900 AUBURN FINANCE DEPT ~uu'"
.
.
CITY OF AUBURN
CONTRACTUAL AGREEMENT FOR PROFESSIONAL SERVICES
Name D ontnu:tor
Addre1l6
Home telephone
Emergency oonlact
Re Il!ltionship
Telephone humber 7b -q<loo
(.Ll~ -
Social eecurfty number/8u~lnesslD
City Contact
Oescrlptlon of work;
$tArt date
Services to CXim:lud. by (date)
WorK location:
Terma of ServlC9
Keys 10 bt!l luued? V.. NQ ~
If work/no WIth chndren Dr deveklpmerrt,ally dlubro<l il'ldi\ridloltlb, are the two required book\ll'Clund forms compl&lld lIf1d rstum~ to
the Human ResOllrcu Depliriment? Yea No NA
ThI!l City may lennlnato bII or p~rt of this connet with or WIThout c;aus. .1 any tIm.. The CIty may pravld, work refel'Gn~ for loe
l;;onll1llctor upon request.
The contr1lctor h.~by agTlMl! to hold the City harm leas from ell Iou or damage oconianwd 10 It or ta iny !hlnf p8/'Y Dr propariy by
1611&On of any M~Uge"t acts or omlnions on Iht part of the ConlreetQr. hies Of her enlplQyea, or pelSDlUI workln" directly or
I"dll'Cletly \1'\ Ule perfonnaf1C8 of the c:ontcsd Including jolnl aeie or OItli'$ionll, and ~hallllivll the Olty prom pI notioe (1( any such
damage, 10ill, or InJUI)f,
Th~ oonlrllctOr IShaB nollry lInd receIVe 2ppiOV;l1 trOll' the PGpar1ment Director or d,elgnt. for .nv aubslituw, Manoes or
C3.ncenlltlorv; In tho ~bow-named performed lervlces. SullcontraQtlnv tile 5ijl\llClell orthlll e.ontl1l~ i6 nOl .1lowed unless the
Do~rtmllnt DlreclOr ~, prlonpp'~l.
"\'he Conhll~tQr .II~ and undel'$t1ndll that 1M/she It; an Il1(\ependenl con~~or and not the agent or employ.. of tn, City. The
mlinnl!lr end means 01 providing !he profaSlonalleNlco; herein are unlierthe ,0111 control Of Itle Cr,mtl'8ctor. The Con\l'aetor sl1all
be solely !1:~iblc far repellting hl.Ih., hOlJ,.. ..mlnvs, Incam" tD:, and &<<b16eO\lrlly to the Bppllcabh~ red.,,, ."d stm.
agencll!ll!l. Th., Oonlraetof """e,,,bmd$lhBt hr:(,he it not ."tltled to Iny IJf lM ben<<(ll; provl~d by ao Qmployer to emplO)'ll9$
il'lc.luding bloll not limill!:<J to Jlaid lelll(l!I, health muran~ covetll;e, retirement p~ram' or unemp/tl)'menllni:uranco.
T~e COl1tr.otor IIQreea 00 indemnify and hold the City t1annlc~ from 111)' clainllkllt m-r result from aleg:otlons th~I Ihe Con\1ilclor
f$ no1 an Independent cor'llraetor. ~ucn cI.rlN may comfl from Intem81 Revenue Service, SlIik: of WBlIhlnglQn lIbor :a"d IncluS:lries
and 1(1(1 agGl1vf... Tha Contr.c:tor llgreM 10 comply wUh _II QOvemmentsl reQuireml!lnle nl!leessitoted by ind~pend.1'1t contractor
~llltlJliIlllnClu~~1 not limNed tt! the PZ,.xas. . ,.tf Ul() ~
/;~-~
conttaet~ SIOPlature 02ta
DQP~"mel'lt HQlild Dllfe -
L1Employment/ContractualA3reemenblIndepContrAgrccmallTemp late090 1
OR/O?/?OOR I<RT 1 1 . !'l!l I'T'X/RX NO 70~!l1
"."--..-.,.,.-----
I