Independent Contractor Invoice/pay Sheet Template
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1
2
3Independent
Contractor
Invoice/Pay
sheet
Show/Event Name: ___________________________________________________________________
Chapter:________________________________ Event Date(s): _______________________________
Event/Show Manager’s Name:___________________________________Cell Phone:__________________________
Fax/Other phone #:____________________________________email:_____________________________________
Individual Name:___________________________________________________________________________________
Business Name (doing business as):____________________________________________________________________
Check payable to (if different):_______________________________________________________________________
Address:__________________________________________________________________________________________
City/State/Zip:_____________________________________________________________________________________
SSN / EIN #:__________________________________________Telephone:___________________________________
JOB (CHECK ONE):
( ) JUDGE
( ) TD
( ) FARRIER
( ) SCORER
( ) VET
( ) RING STEWARD
( ) ANNOUNCER
( ) SHOW MANAGER
( ) CLINICIAN
( ) MODERATOR
( ) OFFICE
( ) ENTRY/EXBHIBITOR MANAGER
( ) Other/explain:____________________________________
Disclaimer: I am not receiving compensation of any kind for unemployment, disability or workman’s
compensation.
Initial’s of contractor:_________________________ Date:_______________
Day Fee: ________________________________ X __________________________ = _________________________
(# OF DAYS)
TOTAL OFFICIALS FEES =_________________________
EXPENSES:
Per Diem $___________________per day (when meal not provided) $_______________________
Travel
$___________________
Other
$___________________
TOTAL EXPENSES = _______________________
TOTAL COMBINED FEES & EXPENSES = ________________________
I hereby acknowledge and agree that I am retained by California Dressage Society (CDS)__________ Chapter as an
Independent Contractor and not as an Employee of CDS or said chapter. I shall be responsible for all with-holding or
income taxes owed by reason of the amounts I receive hereunder. I also acknowledge that because I am retained as an
Independent Contractor, CDS and/or said chapter do not provide Workmen’s Compensation, I agree to look solely to my
own Insurance, Workmen’s Compensation or otherwise, for recovery and hereby release, CDS and ___________chapter
from responsibility or liability with respect thereto.
Signature:_________________________________________________________Date:__________________________
REV: 3-2012SO
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