Agreement between Care Giving Organization and Nurse Staffing Agency Agreement made on the ____________________________ (date), between
____________________________________ (Name of Nurse Staffing Agency), a
corporation organized and existing under the laws of the state of ______________, with
its principal office located at ________________________________________________
_______________________________ (street address, city, county, state, zip code),
referred to herein as Staffing Agency, and ___________________________________
(Name of Care Giving Organization), a corporation organized and existing under the
laws of the state of ___________________, with its principal office located at
_____________________________________________________________________________________________________ (street address, city, county, state, zip code),
referred to herein as Organization .Whereas, Organization wishes to contract with Staffing Agency for the services
of Staffing Agency in providing registered nurses (RN), licensed practical nurses (LPN)
and nursing assistants (NA) to Organization; and Whereas, Staffing Agency is ready, willing, and able to provide such services as
may be required by Organization. Now, therefore, for and in consideration of the mutual covenants contained in this
agreement, and other good and valuable consideration, the receipt and sufficiency of
which is hereby acknowledged, the parties agree as follows: 1. Services A.Staffing Agency understands and agrees that services to be provided
Organization under and pursuant to this Agreement shall be so provided on a day-to-
day, as-needed, basis and that Organization in its sole discretion shall determine its
need, if any, for services or the continuation of services as may be provided by Staffing
Agency under and pursuant to this Agreement.B. Staffing Agency agrees to provide services upon the written request of
Organization and further agrees that the cost of such services shall not exceed the
limitation of the cost set forth by Organization’s request.C. When requesting services, Organization shall specify the nursing
classifications required (e.g., RN, LPN and/or NA); the applicable hourly or daily price for
each specified nursing classification; the maximum allowable cost for each nursing
classification; and the duration of services applicable to the request, including beginning
dates and, when applicable, ending dates.D.Organization shall have sole discretion to establish the minimum
qualifications necessary for the performance of any service to be rendered under and
pursuant to this Agreement. Further, if at any time and at its sole discretion, Organization
determines that the services performed under and pursuant to this Agreement by any of
the persons provided by Staffing Agency are not satisfactory, Organization will so notify
Staffing Agency in writing and Staffing Agency shall immediately withdraw such
individual and, at Organization’s option, furnish an individual who meets the
qualifications required.2. Compensation For services provided under and pursuant to this Agreement and the written
requests of Organization, Staffing Agency shall be compensated as provided below:A.For labor expended by Staffing Agency in providing services under and
pursuant to this Agreement, Staffing Agency shall be paid an amount equal to the
applicable hourly or daily rate multiplied by the total number of hours or days actually
worked by persons provided by Staffing Agency. The hourly or daily rate shall not
exceed those rates set forth by Exhibit A attached hereto that are applicable to the labor
classifications set forth by Organization’s written requests. B. Actual expenses of persons provided by Staffing Agency incurred in the
providing of services and directly related to such services shall be reimbursed by
Organization to Staffing Agency at actual cost when supported by appropriate receipts.3. Payment Payment for services provided Organization under and pursuant to this
Agreement shall be net ________ (number) days from the date of receipt by
Organization of Staffing Agency's invoice. Staffing Agency's invoice shall set forth, as a
minimum, details of labor expended and expenses actually incurred as provided below:A.Staffing Agency's invoice shall set forth the date or dates that persons
provided by Staffing Agency actually worked in providing services under and pursuant to
this Agreement. Beginning and ending dates shall be shown whenever services are
provided uninterrupted over a period of time and individual dates shall be shown
whenever services have been provided on a day-to-day basis. Staffing Agency's invoice
shall clearly show the nursing classification, names of Staffing Agency-provided workers,
applicable labor rates, and the total dollars claimed for the period. Whenever Staffing
Agency provides services for an extended period of time, Staffing Agency shall submit
its invoices for labor expended no less often than once each calendar month.B. The expenses incurred by Staffing Agency- provided workers directly
related to the providing of services under and pursuant to this Agreement shall be
reimbursed by Organization to Staffing Agency. Such expenses shall be supported by
appropriate receipts and such other supporting details as may be required by
Organization. Payment shall be net _______ (number) days from the date of receipt of
invoice.4. Workers Provided by Staffing Agency Workers provided by Staffing Agency who perform services for Organization
under and pursuant to this Agreement shall be bound by the provisions of this
Agreement and Staffing Agency shall, at the request of Organization , furnish to
Organization satisfactory evidence to that effect.5. Representations by Staffing Agency Staffing Agency represents and warrants that Staffing Agency and the workers it
supplies have the right to perform the services required under and pursuant to this
Agreement without violation of obligations to others, and that Staffing Agency and its the
workers it provides have the right to disclose to Organization all information transmitted
to Organization in the performance of services under and pursuant to this Agreement. 6. Duration and TerminationThis agreement shall become effective as of the date stated above and shall
continue for a period of ________________________________ (period of agreement) .
In addition, this Agreement may be terminated by either party, with or without cause at
any time, upon _______ (number) days' prior written notice.7. Independent Contractor The status of Staffing Agency is that of an independent contractor and not of an
agent or employee of Organization and, as such, Staffing Agency shall not have the right
or power to enter into any contracts, agreements, or any other commitments on behalf of
Organization. 8.Health Insurance Portability and Accountability Act (HIPPA) Staffing Agency agrees to execute a HIPPA business associate's agreement
should it now, or hereafter, be classified as a business associate as defined by HIPPA.
9. Insurance
Staffing Agency shall maintain in full force and effect, and upon the request of
Organization, shall furnish evidence satisfactory to Organization that Staffing Agency
maintains the following insurance coverage:A. Comprehensive general liability insurance in the minimum amount of
$_______________ combined single limit that will cover any and all losses to
Organization property, property of third parties, or personal injuries caused by the acts or
omissions of Staffing Agency.B. Staffing Agency will carry workers' compensation and employer's liability
insurance in accordance with applicable law.10.Agreement Not to Hire Nurses or Nurse’s Assistants of Staffing AgencyOrganization acknowledges that the nurses and nurse’s assistants to be supplied
by Staffing Agency have been or will be recruited, oriented, and trained at great expense
by Staffing Agency, and Staffing Agency has a compelling interest in maintaining its
contractual relationship and expectancy of future contractual relationships with said
nurses and nurse’s assistants it supplies to Organization. In addition, if the nurses and/or
nurse’s assistants supplied by Staffing Agency were to terminate their relationships with
Staffing Agency and render services to the hospital as employees of the Organization,
the Organization would be unfairly benefited, without adequate compensation to Staffing
Agency. Accordingly, Organization covenants that it shall not, during the term of this
agreement and any renewals of it, and for a period of (e.g., one year) ______________
after such term and renewals, directly or indirectly, impair or initiate any attempt to impair
the relationship or expectancy of a continuing relationship which exists or will exist
between Staffing Agency and the nurses and/or nurse’s assistants it supplies to
Organization. Organization further covenants that during such term it shall not make
offers or contracts of employment with said nurses and nurse’s assistants for a period of
(e.g., one year) ____________ after the initial term and any renewal of this Agreement.
11.No Waiver The failure of either party to this Agreement to insist upon the performance of any
of the terms and conditions of this Agreement, or the waiver of any breach of any of the
terms and conditions of this Agreement, shall not be construed as subsequently waiving
any such terms and conditions, but the same shall continue and remain in full force and
effect as if no such forbearance or waiver had occurred. 12. Governing Law This Agreement shall be governed by, construed, and enforced in accordance
with the laws of the State of ________________. 13. Notices Any notice provided for or concerning this Agreement shall be in writing and shall
be deemed sufficiently given when sent by certified or registered mail if sent to the
respective address of each party as set forth at the beginning of this Agreement.
14. Mandatory Arbitration
Any dispute under this Agreement shall be required to be resolved by binding
arbitration of the parties hereto. If the parties cannot agree on an arbitrator, each party
shall select one arbitrator and both arbitrators shall then select a third. The third
arbitrator so selected shall arbitrate said dispute. The arbitration shall be governed by
the rules of the American Arbitration Association then in force and effect.
15. Entire Agreement
This Agreement shall constitute the entire agreement between the parties and
any prior understanding or representation of any kind preceding the date of this
Agreement shall not be binding upon either party except to the extent incorporated in
this Agreement. 16.Modification of Agreement Any modification of this Agreement or additional obligation assumed by either
party in connection with this Agreement shall be binding only if placed in writing and
signed by each party or an authorized representative of each party. 17. Assignment of Rights The rights of each party under this Agreement are personal to that party and may
not be assigned or transferred to any other person, firm, corporation, or other entity
without the prior, express, and written consent of the other party. 18. Counterparts This Agreement may be executed in any number of counterparts, each of which
shall be deemed to be an original, but all of which together shall constitute but one and
the same instrument. WITNESS our signatures as of the day and date first above stated._______________________________ _____________________________(Name of Organization) (Name of Nurse Staffing Agency)
By: _____________________________ By: _________________________ (Printed or typed name) (Printed or typed name) _________________________________ ___________________________________________________________________________________________(Name & Office in Corporation) (Name & Office in Corporation)
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