Independent Contractor Agreement Page 11
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16IN WITNESS WHEREOF, the parties hereto have executed this Independent Contractor
Agreement by representatives lawfully authorized to do so.
Dated: _______________ ,20
Dated: _______________ , 20___
Contractor
Subcontractor
BY:
BY: ________________________________
Name: _____________________________
Title:____________________________
TITLE:
SS#/Tax ID No.: _________________________
Address:
City:_______________________ State: _____
Zip Code: ___________________________
Phone#:
11
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