HR Supplier Packet

HR SUPPLIER PACKET

This HR Supplier Packet must be completed by any individual or entity providing goods or services to the Company's Human Resources function. Completion and signature of this document authorizes the Company to onboard the supplier, verify representations and, where applicable, initiate background and compliance checks required for access to HR systems or employee data.

Supplier Company Information

Business Type: Sole Proprietor LLC Corporation Partnership Other

Primary Contact (for HR)

Services & Engagement Information

Primary Service / Position Title:

Department Served:

HR Reporting Manager:

Payment Terms: Net 30 Net 45 Other

Insurance, Compliance & Indemnity

Supplier shall maintain, at its expense, insurance coverages appropriate to the services provided, including commercial general liability insurance with limits not less than $1,000,000 per occurrence and $2,000,000 aggregate, and professional liability/errors & omissions insurance where applicable. Supplier agrees to provide certificates of insurance naming the Company as additional insured where required by contract.

Indemnification: Supplier agrees to defend, indemnify and hold harmless the Company, its officers, directors and employees from and against any claims, damages, losses and expenses arising out of Supplier's gross negligence, willful misconduct, breach of this packet's representations, or violation of law in the performance of services.

Compliance with Laws & Data Protection: Supplier warrants compliance with all applicable laws, regulations and data-protection requirements. Where Supplier will access, receive or process personal data of the Company's employees, Supplier shall implement administrative, physical and technical safeguards reasonably necessary to protect personal data from unauthorized use or disclosure.

Insurance Certificate Provided:

Employment History (Primary Contact)

Education

Professional References

Legal Disclosures & Company Policies

At-Will Employment Statement: The Company retains the right to determine employment status of any individual engaged through Supplier and, except as otherwise expressly provided in a written contract executed by the Company's authorized representative, all employment relationships with the Company are at-will. Supplier acknowledges and accepts that engagement of Supplier personnel does not create any guarantee of employment by the Company.

Equal Opportunity: The Company is an equal opportunity organization. Supplier agrees that the conduct of its employees and representatives assigned to the Company shall comply with the Company's nondiscrimination and harassment policies and applicable employment laws.

I acknowledge and accept the At-Will and Equal Opportunity statements: Acknowledge

Applicant Certification & Authorizations

Certification: By signing below, the undersigned certifies that all information provided in this Supplier Packet is true, complete and correct to the best of the undersigned's knowledge. Supplier understands that any material misrepresentation or omission may constitute grounds for termination of engagement or contract, and may subject Supplier to liability.

Authorization to Verify: Supplier authorizes the Company and its agents to verify any information provided, to contact references and prior employers, and, where required for access to HR systems or employee data, to obtain background checks, criminal history checks, and credit checks as permitted by law. Supplier also authorizes the release of employment, education, and other relevant information to the Company upon request.

I certify the above and authorize verifications: Certify & Authorize

Attachments & Onboarding Requirements

Please indicate which documents are attached or will be provided prior to commencement of services:

W-9 or tax documentation
Certificate of Insurance (COI)
Business license or professional license(s)
Background check consent forms (if required)

Banking & Payment Remittance

Account Type: Checking Savings

Representations & Warranties

Supplier represents and warrants that: (a) it has authority to enter into agreements and to perform the services; (b) services will be performed in a professional manner consistent with industry standards; (c) Supplier will comply with all applicable laws and regulations; and (d) Supplier has not been debarred, suspended, or otherwise prohibited from contracting with governmental entities where applicable.

Additional Notes / Special Conditions

Sign Now