HR Hosting Program

HR HOSTING PROGRAM AGREEMENT & ENROLLMENT

This HR Hosting Program Agreement and Enrollment form documents the terms under which Client Company: engages HR Hosting Provider: to provide hosted human resources services for employees designated below. Effective Date: .

Personal Information (Employee to be Hosted)

Position Information

Proposed Start Date:

Employment History (Most Recent)

Dates Employed: to

Employment History (Previous)

Dates Employed: to

Education

Graduation Date:

References (Professional)

Program Services (Select Services to be Provided)

Payroll administration (payroll processing, wage disbursement)
Employer tax filings and remittance
Benefits administration (enrollment, billing)
Workers' compensation management
HR policy and handbook maintenance
Recruiting and onboarding support
Other (describe):

Fees, Billing, and Term

This Agreement continues in effect until terminated in accordance with the termination provisions set forth below. Provider reserves the right to suspend services for failure to pay billed fees in accordance with agreed billing terms.

Legal Disclosures and Program Terms

At-Will Employment: Nothing in this Agreement alters or limits the at-will employment relationship between Client Company and any hosted employee unless a separate signed employment agreement explicitly states otherwise. Client Company retains authority over hiring, discipline, job duties, and termination decisions for hosted employees, subject to obligations assumed by Provider under this Agreement.

Equal Opportunity: Provider and Client Company each represent that they will comply with all applicable laws prohibiting discrimination in employment. Provider will administer benefits and payroll in a nondiscriminatory manner consistent with applicable law.

Data Protection and Confidentiality: Each party will maintain reasonable administrative, technical, and physical safeguards to protect confidential employee information. Provider may use employee data only to perform obligations under this Agreement. Provider will not disclose confidential employee data except as required by law or as necessary to provide contracted services.

Compliance with Law: Provider will prepare payroll and related filings based on information provided by Client Company and in accordance with applicable law. Client Company is responsible for the accuracy and timeliness of employee information provided to Provider.

Indemnification: Each party shall indemnify and hold harmless the other from and against claims, liabilities, losses, and expenses arising from the indemnifying party's breach of this Agreement, negligence, or willful misconduct, subject to applicable law and any limitations of liability set forth elsewhere in a separately executed master services agreement between the parties.

Authorization and Background Checks

Client Company authorizes Provider to contact prior employers and references for verification of employment and to obtain credit, criminal history, motor vehicle record, drug screening, and other background reports as permitted by law for the named employee. Client Company warrants it has obtained any required consent from the employee or will obtain consent prior to enrollment.

I authorize Provider to conduct background checks and contact prior employers as described above.

Applicant / Client Certification

I certify that the information contained in this enrollment and the foregoing attachments is true, complete, and accurate to the best of my knowledge. I acknowledge that any material misstatement or omission may result in denial or termination of hosted services. I further authorize Provider to rely upon information provided by Client Company for payroll, tax, and benefits administration and to communicate as necessary with Client Company representatives regarding employee matters.

I certify that all information provided in this form is true and complete.

Additional Notes / Special Instructions

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