Fill and Sign the Agreement Independent Contractor Form

- 1 – INDEPENDENT CONTRACTOR NURSING AGREEMENT THIS AGREEMENT made and entered into on the date last written below, by and between (hereinafter "Employer"), and , an independent contractor (hereinafter "Nurse"); WHEREAS, the Employer desires to retain the services of Nurse, and Nurse desires to render servi ces to the Employer, upon the terms and conditions hereinafter stated: NOW, THEREFORE, the parties hereto, intending to be legally bound hereby, do hereby promise and agree as follows: SECTION 1 – SCOPE OF DUTIES TO BE PROVIDED 1.1 Term . Employer agrees to hire Nurse, at will, for a term commencing on , 20    and continuing until terminated in accordance with Section 4 of this agreement. 1.2 Duties . Nurse agrees to perform work for the Employer on the terms and conditions set forth in this agreement and agrees to devote all necessary time and attention (reasonable periods of illness excepted) to the performance of the duties specified in this agreement. Nurse's duties sha ll include the following: Nurse further agrees that in all such aspects of such work, Nurse shall comply with the polici es, standards, regulations of the Employer from time to time established, and shall perform the duties assigned faithfully, intelligently, to the best of his/her/their ability, and in the best interest of the Employer. While Nurse is performing said nursing services, he/she is representing himself/herself and utilizing professional judgment as an independently contracted nurse. SECTION 2 - COMPENSATION 2.1 Compensation . In consideration of all services to be rendered by Nurse to the Employer, the Employer shall pay to said the amount of $ per hour week bi-weekly month year other Nurse further aggress that he/she will be entitled to charge specialty premiums for ce rtain shifts and holidays, which shall be paid as follows: $ 2.2 Withholding; Other Benefits . Compensation paid pursuant to this Agreement shall not be subject to the customary withholding of income taxes and other employment taxes. Nurse sha ll be solely responsible for reporting and paying any such taxes. The Employer shall not provide - 2 – Nurse with any coverage or participation in the Employer's accident and health insurance, life insurance, disability income insurance, medical expense reimbursement, wage continuat ion plans, or other fringe benefits provided to regular employees. Nurse shall be responsible for obtaining his/her own professional liability insurance at his/her own expense. The limit must be$ . SECTION 3 - TERMINATION 3.1 Termination at Will . This Agreement may be terminated by the Employer immediately, at will, and in the sole discretion of Employer. Nurse may terminate this Agreement upon days written notice to Employer. This Agreement also may be terminated at any tim e upon the mutual written agreement of the Employer and Nurse. SECTION 4 - INDEPENDENT CONTRACTOR STATUS 4.1 Nurse acknowledges that he/she is an independent contractor and is not an agent, partner, joint venturer nor employee of Employer. Nurse shall have no authority to bind or otherwise obligate Employer in any manner nor shall Nurse represent to anyone that it has a right to do so. Nurse further agrees that in the event that the Employer suffers any loss or damage as a result of a violation of this provision Nurse shall indemnify and hold harmless the Employer from any such loss or damage. Employer shall not direct, supervise, or control, or be responsible for the supervision, direction, or control of the Nurse while said Nurse is performing the nursing services as per this Agreement. Said Nurse shall be responsible for providing his/her own uniforms, tools, transportation, instruments, and written professional materials required in the practice of professional nursing. 4.2 Assignment. The Nurse shall not assign any of his/her rights under this agreement, or delegate the performance of any of his/her duties hereunder, without the prior written consent of the Employer. SECTION 5 - REPRESENTATIONS AND WARRANTIES OF NURSE 5.1 Nurse represents and warrants to the Employer that there is no employment contract or othe r contractual obligation to which Nurse is subject, which prevents Nurse from entering into thi s Agreement or from performing fully Nurse's duties under this Agreement. 5.2 Nurse represents that he/she is licensed by the appropriate licensing agency for the nursing profession or nurse licensing board and that he/she is in good standing with such agency. SECTION 6- MISCELLANEOUS PROVISIONS 6.1 The provisions of this Agreement shall be binding upon and inure to the benefit of the heirs, personal representatives, successors and assigns of the parties. Any provision hereof which - 3 – imposes upon Nurse or Employer an obligation after termination or expiration of this Agreement shall survive termination or expiration hereof and be binding upon Nurse or Employer. 6.2 No waiver of any provision of this Agreement shall be deemed, or shall constitute, a waiver of any other provision, whether or not similar, nor shall any waiver constitute a continuing wai ver. No waiver shall be binding unless executed in writing by the party making the waiver. 6.3 This Agreement shall be governed by and shall be construed in accordance with the laws of the State of . 6.4 This Agreement constitutes the entire agreement between the parties pertaining t o its subject matter and supersedes all prior contemporaneous agreements, representations and understandings of the parties. No supplement, modification or amendment of this Agreement shall be bi nding unless executed in writing by all parties. 6.5 Severability. If any provision of these policies and regulations or the application thereof to any person or circumstances is held invalid, such invalidity shall not affect other provisions or applications of these policies and regulations which can be given effect without the i nvalid provision or application, and to this end the provisions of these policies and regulations are severable. In lieu thereof, there shall be added a provision as similar in terms to such illegal, invalid and unenforceable provision as may be possible and be legal, valid and enforceable . WITNESS OUR SIGNATURES, this the day of , 20 . ___________________________ EMPLOYER ___________________________ NURSE