Employee Fieldprint Services Agreement

Employee Fieldprint Services Agreement

This Employee Fieldprint Services Agreement (the Agreement) is entered into between the Employer and the Employee identified below for the purpose of obtaining Fieldprint fingerprinting and related consumer background screening services in connection with employment. The parties agree as follows.

Parties and Contact Information

Position Information

Reporting Manager:    Start Date:    Salary / Rate:

Employment History (Most Recent)

Title:    Dates Employed: From to

Title:    Dates Employed: From to

Education

Graduation Date:

References (Professional)

Fieldprint Services and Consent

Services Requested: The Employer requests that the Employee submit to Fieldprint fingerprinting and consumer background screening services, which may include: fingerprint capture and transmission to government and third-party reporting agencies, name-based criminal history searches, identity verification, and other pre-employment checks as required by the Employer. Selected services:
Fingerprint-based criminal background check
Name-based criminal history search
Drug screening authorization (if applicable)

Consent to Collection and Disclosure: By executing this Agreement the Employee expressly consents to the collection of biometric data (including fingerprints), personal identifiers, and other personal information and to the disclosure of such information to Fieldprint, law enforcement agencies, federal and state repositories, and other entities for processing and reporting purposes. Employee acknowledges that such data may be retained and used in accordance with applicable law and this Agreement.

Fees, Billing and Payment

Responsibility for Fees: The Employer is responsible for payment of vendor fees unless otherwise agreed in writing. If the Employee is responsible for any portion of the fee, the amount and payment method must be specified below.

Privacy, Data Retention and Security

Data Security and Retention: Fieldprint and the Employer will maintain reasonable administrative, technical, and physical safeguards to protect personal information. Employee data may be retained for the period required by law and for a commercially reasonable period thereafter. Information may be disclosed as required by law or to investigate disputes and prevent fraud.

Legal Disclosures and Acknowledgments

At-Will Employment: Nothing in this Agreement amends or supersedes any separate employment agreement between the Employer and Employee. Employment remains at-will unless an express written agreement signed by both parties states otherwise.

Equal Opportunity Statement: The Employer is an equal opportunity employer and makes employment decisions without regard to protected characteristics. Background check results will be assessed consistent with applicable law and the Employer's policies.

Applicant Certification and Authorizations

I certify that all information provided on this form is true, correct and complete to the best of my knowledge. I authorize the Employer and its agents, including Fieldprint, to obtain and verify consumer reports, criminal history records, driving records, and other background information for employment purposes. I further authorize prior employers, educational institutions, and references to disclose information about my employment, education, and qualifications.

Employee acknowledges receipt of a copy of any privacy disclosure or summary required by law and understands that they may contest the accuracy of any consumer report and obtain a copy of the report from the reporting agency if required by law.

I authorize previous employers and references to provide information requested by the Employer or Fieldprint. This authorization shall remain in effect for the duration of my employment application process.

Employee Initials:

Representations, Indemnity and Limitations

Representations: Employee represents that the information provided is accurate and complete. Employee understands that false statements or omissions may constitute grounds for withdrawal of an offer of employment or termination.

Indemnity: To the extent permitted by law, the Employer and Employee each agree to indemnify and hold harmless Fieldprint and its affiliates from claims arising from misuse of reports or unauthorized disclosure of data by the indemnifying party.

Limitation of Liability: Except as prohibited by law, neither Fieldprint nor the Employer shall be liable for incidental, consequential, special, or punitive damages arising from provision or receipt of background screening services.

Dispute Resolution and Governing Law

Governing Law: This Agreement shall be governed by and construed in accordance with the laws of the state identified by the Employer below, excluding choice-of-law rules. Any dispute arising under this Agreement shall be resolved in the appropriate state or federal court located in that state, unless the parties agree in writing to arbitration.

Revocation and Amendments

Revocation of Consent: Employee may revoke consent in writing; however, revocation will not affect information already obtained or processed and may result in withdrawal of employment consideration. Any amendment to this Agreement must be in writing and signed by both parties.

Acknowledgment and Certification

I certify under penalty of perjury that the information I have provided on this form is true and correct and that I have read and understand the terms of this Agreement. I authorize the release of consumer reports and criminal history information as described above.

Date Signed:

Miscellaneous

Severability: If any provision of this Agreement is held to be invalid or unenforceable, the remainder of the Agreement will remain in full force and effect. Entire Agreement: This Agreement contains the entire agreement between the parties regarding the subject matter herein.

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