Employment Police Record Check

Employment Police Record Check Agreement

Employer Name:   Employer Address:

Screening Provider Name:   Provider Address:

WHEREAS

WHEREAS, the Employer seeks to obtain an employment-related police record check of specified applicants for the purpose of evaluating suitability for employment; and

WHEREAS, the Screening Provider is duly authorized and qualified to perform background and police record searches and agrees to perform such services in accordance with applicable law and the terms set forth in this Agreement; and

WHEREAS, the parties desire to set forth their respective roles, responsibilities, and the terms and conditions of engagement for the performance of police record checks.

Scope of Work

The Screening Provider shall perform police record checks and related background screening services as requested by the Employer. Services may include local police checks, state criminal history checks, national database searches, fingerprint processing where required, and the retrieval and delivery of official dispositions and charge histories. The Screening Provider shall use reasonable efforts to obtain accurate and complete results and shall document the sources searched and the dates of searches.

Applicant Information (for each individual subject to check)

Date of Birth: Month   Day   Year

Identification provided:    ID Number:    Issuing Jurisdiction:

Authorization and Consent

The Applicant hereby authorizes the Screening Provider to obtain police record information, court records, fingerprint submissions if required, and other relevant public records for employment screening purposes. The Applicant acknowledges that refusal to consent may affect employment eligibility.

I, , authorize the release of my police records to the Employer and Screening Provider named above. I certify that the information provided on this form is true and correct.

Applicant Signature:    Date:

Search Options (select all that apply)

Local police department records    State criminal history    National database search

Fingerprinting and submission to authorized fingerprint repository    Court records and dispositions

Payment Terms

Fee per check: $    Minimum retainer (if applicable): $

Late payment fee: . Employer shall reimburse Provider for reasonable collection costs and attorney fees incurred to collect overdue amounts.

Term and Termination

Commencement Date:    Termination Date (if any):

Either party may terminate this Agreement for convenience upon days' written notice to the other. Either party may terminate immediately for material breach that is not cured within days after receipt of written notice of such breach.

Confidentiality

Each party shall maintain as confidential all non-public information received from the other party in connection with the performance of this Agreement, including applicant data and screening results, and shall use such information solely for the purposes set forth herein. Confidential information shall not be disclosed except to officers, employees, agents or subcontractors with a legitimate need to know and who are bound by confidentiality obligations at least as protective as those contained in this Agreement, or as required by law or court order, in which case the disclosing party shall promptly notify the other party to permit seeking a protective order.

Compliance and Certification

The Screening Provider represents and warrants that it will perform searches and handle personally identifiable information in compliance with all applicable laws and regulations governing background checks, privacy, and record retention. The Provider shall maintain appropriate security measures and will provide certifications of results or records only to authorized recipients as permitted by law and this Agreement.

Limitation of Liability

Except for willful misconduct or gross negligence, neither party shall be liable to the other for incidental, consequential, punitive or special damages arising from performance of this Agreement. Provider's aggregate liability for claims arising out of this Agreement shall not exceed the total fees paid by Employer to Provider under this Agreement in the six months preceding the claim.

Governing Law

This Agreement shall be governed by and construed in accordance with the laws of the state or jurisdiction where the Employer's principal place of business is located, without regard to conflict of law principles.

Notices

Entire Agreement

This Agreement, including any schedules, attachments, and purchase orders incorporated by reference, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements, proposals, and communications, whether written or oral. Amendments must be made in writing and signed by authorized representatives of both parties.

Miscellaneous Provisions

If any provision of this Agreement is held invalid or unenforceable, the remaining provisions shall remain in full force and effect. Neither party may assign this Agreement without the prior written consent of the other, except to an affiliate or in connection with a merger or sale of substantially all assets, provided the assignee assumes all obligations hereunder.

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