HR Vendor Credentials Form

HR VENDOR CREDENTIALS FORM

Complete this Vendor Credentials Form in full. Provide accurate legal and business information for evaluation of vendor qualification to provide services to the organization. The individual signing at the end certifies under penalty of perjury that the information is true, that the vendor accepts the terms and authorizations below, and that the vendor will maintain all required insurance and compliance obligations while performing services.

Vendor Contact & Business Information

Vendor Company Legal Name:

Services, Scope & Capacity

Insurance, Bonding & Financial Controls

Provide current insurance coverage details. Attach certificate(s) of insurance where indicated and maintain coverage during the term of any engagement.

Contractor Engagement History (Minimum two engagements)

Provide at least two recent client engagements where substantially similar services were provided.

Key Personnel — Education & Qualifications

Provide credentials for primary personnel who will deliver services.

Professional References (3 required)

Legal Disclosures, Certifications & Authorizations

At-Will Employment Statement: Submission of this Vendor Credentials Form does not create an employment relationship. Any individual assigned by the vendor remains an employee or contractor of the vendor and, unless otherwise agreed in a separate written employment agreement signed by the organization, any employment relationship is at-will and may be terminated by either party at any time.

Equal Opportunity Certification: Vendor certifies that it is an equal opportunity employer and does not unlawfully discriminate in hiring, promotion, compensation or other employment practices. Vendor will comply with applicable anti-discrimination and labor laws in the performance of services.

Background Checks and Authorizations: Vendor authorizes the organization to obtain background checks, reference checks, and verification of professional credentials for listed personnel and key personnel. Vendor certifies that it has obtained all necessary consents from its personnel to permit such checks and that it will notify the organization of any adverse information that would reasonably affect performance of services.

Data Protection and Confidentiality: Vendor will maintain reasonable administrative, physical, and technical safeguards to protect organization data. Vendor agrees to execute a separate confidentiality or data processing agreement when required and to comply with applicable privacy laws and contractual obligations regarding personal data.

Insurance & Indemnity Representation: Vendor represents that the insurance information provided above is accurate and that vendor will maintain required insurance during performance. Vendor agrees to indemnify and defend the organization from claims arising from vendor's negligent acts, omissions, or willful misconduct in connection with services, subject to the terms of any written agreement between the parties.

Subcontracting and Staffing: Vendor will not subcontract any portion of the services that involve access to sensitive information or to the organization's premises without prior written consent. Vendor remains responsible for all subcontractor acts and compliance as if performed by vendor.

Authorization to Verify: By signing below, the undersigned authorized representative certifies that all information supplied is true and complete. The undersigned authorizes the organization to contact references, clients, insurers, and prior employers or contracting entities listed in this form, and to obtain background checks on the vendor and its personnel where permitted by law.

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