Change To Independent Contractor Agreement Template
Download a blank fillable Change To Independent Contractor Agreement Template in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Change To Independent Contractor Agreement Template with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2Foothill - De Anza Community College District
PURCHASE ORDER NO. ___________CHANGE NO. ____ TO INDEPENDENT CONTRACTOR AGREEMENT
Foothill-De Anza Foundation
De Anza College
Foothill College
District Office
The Agreement entered into on ______ day of ________________, 2_____ between the Foothill-De Anza Community
College District, hereinafter referred to as the "DISTRICT", and the following named independent contractor; hereinafter
referred to as the "CONTRACTOR" is changed as follows but all other terms, conditions, and prices remain the same.
1.
CONTRACTOR INFORMATION:
Contractor'sName ________________________________Company Name_____________________________
Address ________________________________________City ______________________ Zip ___________
Business Phone ________________ Fax No ________________Email _______________________________
Social Security Number _______________________*Fed. Tax I.D. Number ___________________________
CONTRACTOR MUST PROVIDE W-9
Business License Number _______________________________
DIR Registration Number _______________________________
Are you a current or former employee of the DISTRICT?
Yes
No
If yes, date last worked ____________________________
If yes, specify last work location ____________________________________________________________
Work Assignment ________________________________________________________________________
Are you related to any employee(s) in the DISTRICT? Yes
No
If yes, please identify the individual(s)________________________________________________________
2.
CONTRACTOR SERVICES, FEE, AND CONTRACT STARTING AND ENDING DATES:
A. Description of Additional services and deliverables to be provided by contractor (refer to and attach
contractor’s signed proposal or quotation for this change):
B. Contractor Fee for Services:
Original Amount of Contract:
$___________________
Additive or Deductive Amount for previous Changes: $___________________
Additive or Deductive Amount for this Change:
$___________________
New Total:
$___________________
(Indicate a fixed fee to be paid for all of the described services or indicate hourly or other periodic billing rate(s)
plus a maximum total dollar cost, i.e. the “not to exceed” amount, to be paid to the contractor. If travel or other
expenses will be reimbursed they should conform to Board Policy AP3152.) NEW TOTAL CANNOT EXCEED
$14,999 FOR PUBLIC PROJECTS.
Rev. 1/19/16
ICA Change form
Page 1 of 2
Project or Bid ___________________________
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business