Independent Contractor (Ic) Checklist (Page 3 of 10) in pdf

INDEPENDENT CONTRACTOR AGREEMENT

This A GREEMENT i s e ntered i nto o n t his _ ____ D ay o f _ _____________, _ __________ b etween t he S an M arcos U niversity

Corporation ( UCORP), a nd _ _________________________________________ ( Contractor).

THE P ARTIES M UTUALLY A GREE A S F OLLOWS:

Terms o f A greement: T his A greement c overs s ervices r endered f rom _ ___________ t hrough _ __________.

The s ervices t o b e p erformed b y C ONTRACTOR c onsist o f t he f ollowing: ( Scope o f w ork m ay b e a ttached)

_______________________________________________________________________________________________________

_______________________________________________________________

Compensation: C ONTRACTOR s hall b e c ompensated a s f ollows:

Amount: _ ______________________________________________________dollars ( $________________).

b. Payment d etails:_________________________________________________ ( Please s pecify amount f or d eposits,

multiple p ayments a mounts a nd/or t iming, e tc..)

Payment T erms: A ll p ayment t erms a re N et 3 0 a fter t he w ork i s c ompleted. P ayments w ill b e m ade w ithin 3 0

days o f c ompletion o f w ork a s l ong a s P rocurement/Accounts P ayable h as r eceived a ll r equired f orms.

CONTRACTOR m ay e lect t o r eceive p ayment v ia D irect D eposit/Electronic F und T ransfer ( ACH), b y c ompleting

and a ttaching t he f orm, I ndependent C ontractor D irect D eposit A uthorization, C ONTRACTOR s hall b e

responsible f or a ny b ank w ire o r t ransfer f ees, i f a pplicable. M issing o r i ncorrect f orms w ill d elay p ayment.

d. Tax W ithholding: P ayment t o N on-‐California R esident o r N onresident A lien C ONTRACTOR p erforming s ervices i n

California m ay b e r educed b y a ny r equired S tate T ax W ithholding ( 7% f or i ndividuals) o r F ederal T ax W ithholding

(up t o 3 0%), o r b oth. T he O ffice o f G lobal E ducation m ust b e c ontacted i f t he C ONTRACTOR i s n ot a U S C itizen

or n ot a P ermanent R esident A lien p rior t o c ompleting t his p acket i n o rder t o v erify e ligibility t o r eceive

payment f or s ervices.

Insurance R equirements:

4.1 Workers' Compensation Insurance: For the duration of this Agreement, CONTRACTOR must maintain Workers'

Compensation I nsurance i f a pplicable.

4.2 Insurance Amounts: CONTRACTOR must maintain and provide proof to UCORP of the following insurance if

applicable:

If y ou a re d riving o n C ampus, p lease c omplete t he A utomobile I nsurance S ection b elow:

Policy N umber: _ ____________________________________________________

Insurance P rovider: _ _________________________________________________

Expiration D ate: _ ____________________________________________________

Name o f I nsured: _ ___________________________________________________

Address o f I nsured____________________________________________________

I f y ou A RE N OT d riving o n c ampus, i nitial t his b ox

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