Employee Responsibility Form

EMPLOYEE RESPONSIBILITY FORM

Employer Name:    Employee Name:

Employee ID:    Job Title:

Department:    Supervisor:

Recitals

WHEREAS, the Employer and the Employee desire to set forth the Employee's duties, obligations, compensation structure and conditions of employment to ensure mutual understanding and to protect the Employer's legitimate business interests;

WHEREAS, the Employee will perform services on behalf of the Employer in the position identified above and acknowledges that adherence to the duties and policies described in this document is a condition of continued employment; and

WHEREAS, the parties intend that this form, together with any attached job description and policies the Employer distributes, govern the Employee's responsibilities and the Employer's expectations during the term of employment.

Scope of Work

Payment Terms

Base Compensation Amount:

Bi-weekly    Monthly    Semi-monthly    Other:

Payroll deductions required by law and authorized deductions will be withheld. Employee acknowledges that compensation is subject to applicable tax withholding and other authorized deductions.

Late fee on reimbursable payments: per month on overdue amounts.

Term and Termination

Employment Start Date:    Expected End Date (if applicable):

Notice Period to Terminate Without Cause: days' written notice by either party.

Termination for Cause: Employer may terminate employment immediately for cause, including but not limited to willful misconduct, material breach of policy, theft, violation of law in the course of employment, or breach of confidentiality obligations.

Confidentiality

Definition: "Confidential Information" means non-public business information, trade secrets, customer lists, pricing, technical data, financial information, business plans, proprietary software, and other information designated as confidential or that reasonably should be understood to be confidential given the nature of the information and the circumstances of disclosure.

Employee Obligations: Employee shall not disclose, use, copy or permit access to Confidential Information except as necessary to perform duties for the Employer. Employee shall take commercially reasonable measures to safeguard Confidential Information and shall return all materials containing Confidential Information upon termination or upon Employer's request.

Duration: The obligations in this clause shall continue during employment and for a period of three (3) years after termination, except for trade secrets which shall remain protected for as long as they qualify as trade secrets under applicable law.

Remedies: Employee acknowledges that breach of confidentiality may cause irreparable harm and that Employer is entitled to injunctive relief in addition to other legal remedies.

Governing Law

This Agreement shall be governed by and construed in accordance with the laws of the State of without regard to its conflict of law principles.

Entire Agreement

This Employee Responsibility Form, together with any written job description and employment policies provided to the Employee, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior agreements, understandings and representations, whether written or oral. Any modification must be in writing signed by both parties.

Acknowledgment and Certification

By signing below, Employee acknowledges receipt of this Employee Responsibility Form, certifies that the information provided is true and complete to the best of Employee's knowledge, and agrees to perform the duties and comply with the obligations contained herein.

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