HR Agency Nurse Proposal

HR AGENCY NURSE PROPOSAL

Agency Name:    Client Name:

Proposal Date:    Candidate Name:

Candidate Profile — Personal Information

Position Information — Proposed Assignment

Position Title:    Department/Unit:

Proposed Start Date:    Assignment Length (weeks):

Scope of Services

The Agency will furnish the Candidate to perform professional nursing services at the Client's facility in accordance with applicable licensure, facility policies, and the assignment description below. The Candidate will provide services under the clinical direction and supervision defined by the Client for the specified unit and shift. The Agency retains responsibility for payroll, payroll taxes, workers' compensation, and compliance with employment law for the Candidate.

Terms of Engagement — Key Provisions

Duration and Termination: This engagement commences on the Proposed Start Date and continues for the term stated above unless earlier terminated. Either party may terminate the assignment for convenience upon providing the other party with 48 hours' notice, except where different notice is required by law. Client agrees to pay for all hours worked through the effective date of termination and any contractual replacement fees where applicable.

Replacement and Continuity: If the Candidate is unable to perform the assignment for reasons other than Client's breach, Agency will use commercially reasonable efforts to provide a replacement candidate within a reasonable period. Client shall not directly hire the Candidate without Agency's prior written consent for a period of 12 months following assignment; direct hire provisions and fees are set forth below.

Invoicing & Payment: Agency will invoice Client weekly in arrears for hours worked at the Agency Bill Rate. Invoices are due net 30 days from date of invoice unless otherwise agreed in writing. Late payments accrue interest at 1.5% per month or the maximum rate allowed by law, whichever is less. Client shall be responsible for reasonable collection costs and attorneys' fees for overdue accounts.

Insurance & Liability: Agency represents that it maintains professional liability (malpractice) insurance and workers' compensation as required by law. Liability of Agency for professional negligence or breach is limited to the greater of the amount of fees paid by Client for the assignment or the limits of applicable insurance; neither party shall be liable for consequential damages except for willful misconduct or gross negligence.

Compliance, Credentialing & Background Checks: Candidate has provided current licensure, certifications, and employment history. Client may require additional credentialing steps. Agency will obtain or has obtained background checks, drug screening, and verification of education and licensure as required. Client may request documentation and may condition assignment on completion of additional screening. Candidate must meet immunization and training requirements specified by Client prior to assignment.

Employment History (Most Recent — Provide at Least Two)

Education & Certifications

Professional References (Provide Three)

Legal Disclosures & Consent

Employment Relationship: The Candidate shall remain an employee or contractor of the Agency for all payroll, benefits, tax withholding, and workers' compensation purposes unless otherwise agreed in writing. Client acknowledges it will not direct wages or benefits for the Candidate outside this Agreement.

Equal Opportunity: Agency and Client comply with applicable equal employment opportunity laws. Selection and placement decisions are made without regard to protected characteristics. Client will not discriminate in assignment supervision or credentialing.

Authorization to Obtain Information: Candidate authorizes Agency and Client to obtain background checks, reference checks, employment verification, licensure verification, drug screening, and any credentialing information necessary to evaluate suitability for assignment. Candidate further authorizes third parties to disclose such information to Agency and Client.

Applicant Certification & Authorization

I certify that all information provided in this Proposal and accompanying documents is true, complete, and accurate to the best of my knowledge. I understand that misrepresentation or omission of material facts may be grounds for withdrawal of this Proposal or termination of any assignment. I authorize Agency and Client to contact former employers, educational institutions, licensing authorities, and references to verify the information provided. I consent to the release of any such information for purposes of credentialing and placement.

Fee Schedule, Replacement & Direct Hire

Direct Hire Fee: If Client hires the Candidate directly within 12 months of assignment, Client agrees to pay Agency a direct hire fee equal to a percentage of the Candidate's first year annualized compensation or a fixed placement fee as mutually agreed. Replacement Fee: If Candidate terminates assignment within the first 7 days through no fault of Client, Agency will use reasonable efforts to provide a replacement at no additional Agency placement fee for the replacement period.

Acceptance & Authorization to Proceed

By signing below, Client authorizes Agency to assign the Candidate under the terms set forth in this Proposal. This Proposal constitutes an agreement for the provision of staffing services by Agency to Client, subject to the terms and conditions contained herein. Acceptance is effective upon signature by authorized representatives of both parties.

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