Independent Contractor Agreement printable pdf download

[COMPANY NAME]

INDEPENDENT CONTRACTOR AGREEMENT

In consideration of payment by the [COMPANY] (“[COMPANY INITIALS]”) to

_____________________________________, an independent contractor (“Contractor”).

Consideration: Fixed fee ($) or Commission (%) (describe)

_________________________________________________________________________

For consideration, you agree to perform the following work:

_________________________________________________________________________

[COMPANY INITIALS] has no right to control the work described above. Contractor is solely

responsible for providing the labor to achieve the contractual obligations described above.

Contractor has the right to hire and fire assistants and will treat any assistants as its own

employees and be responsible for all tax reporting requirements for such workers. This

agreement will terminate upon the earliest of the completion of the work described above or

31 December ____.

Payments will be made based on invoices submitted by Contractor. In consideration of

payment by the [COMPANY INITIALS], Contractor agrees that it is an independent

contractor and will hold itself out to the public as an independent contractor (attach

proof). Contractor is not an employee, agent, or representative of [COMPANY INITIALS].

Contractor is responsible for all federal and state payroll taxes and insurance.

Contractor - on behalf of itself, its assigns, and its estate - waives and releases any and all

claims or rights whatsoever Contractor may have against [COMPANY INITIALS].

Certification Regarding Debarment, Suspension, and Other Responsibility Matters

Contractor certifies, to the best of its knowledge and belief, that it and its principals:

1. Are not presently debarred, suspended, proposed for debarment, declared ineligible,

or voluntarily excluded from covered transactions by any Federal department or

agency;

2. Have not within a three-year period preceding this agreement been convicted of or

had a civil judgment rendered against them for (i) commission of fraud or criminal

offense in connection with obtaining, attempting to obtain, or performing a public

(Federal, State, or local) transaction or contract under public transaction; or (ii)

violation of Federal or State antitrust statutes or commission of embezzlement, theft,

forgery, bribery, falsification or destruction of records, making false statements, or

receiving stolen property;

3. Are not presently indicted for or otherwise criminally or civilly charged by a

governmental entity (Federal, State, or local) with the commission of any of the

[COMPANY] Initials _____

Page: 1

Customer’s Initials ____

[STREET ADDRESS] • [CITY, STATE] • [ZIP CODE]

[PHONE] • [FAX] • [URL]

Independent Contractor Agreement