Fill and Sign the Supported Employment Building Your Program Samhsa Form

Placement Contract between Virtual Staffing Agency and Virtual Employee Agreement made on the _______________________ (date), between ______________ ____________________________ (Name of Staffing Agency) of _______________________ _____________________________________ (street address, city, county, state, zip code) , referred to herein as Agent, and _________________________ (Name of Virtual Employee), of __________________________________________________________________________ (street address, city, county, state, zip code) , referred to herein as Employee. For and in consideration of the mutual covenants contained in this agreement, and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the parties agree as follows: 1. Employee hereby authorizes Agency to assist Employee in securing employment as a virtual employee. 2. There is no charge for the services of Agency unless, verbally or in writing, Employee agrees to begin work with an employer as a result of an interview scheduled or a resume’ sent to such employer by Agency, provided employment by such employer is offered and accepted within ____________ (period of time) of the date of original referral, even though the position accepted may not be the position discussed originally. 3. Employee understands and aggress that Agency does not promise any amount of work for the contractors. Assignments to a job are not guaranteed. 4. Employee agrees that all information regarding employment opportunities is considered confidential and that it is to Employee’s benefit to keep such information solely between Employee and Agency . Employee agrees that she will not discuss such information with any third party or with any other employment agency. 5. Confidentiality Employee agrees that: (i) all knowledge and information that Employee may receive from its temporary Employer by virtue of the performance of services under and pursuant to this Agreement, relating to inventions, costs, business affairs, future plans, or technical data belong to the Employer or to those with whom Employer has contracted regarding such information; and (ii) all information provided by Employee to Employer , directly or indirectly, in reports of work done, together with any other information acquired or gained by Employee as a direct result of Employee's assignment to provide services under and pursuant to this Agreement and during the term of such assignment, shall for all time and for all purposes be regarded by Employee as strictly confidential and held by Employee in confidence, and solely for Employer’s benefit and use, and shall not be used by Employee or directly or indirectly disclosed by Employee to any person whatsoever except to Employer or with Employer’s prior written permission. 6. Disclosure of Information A.Employee hereby authorizes the release of all high school, college, or other educational records pertaining to Employee’s attendance, course work, and other school activities. Employee further consents to the disclosure of any and all information about Employee contained in private and governmental files relative to this application for employment or relating to Employee’s present and former employment history and Employee does hereby request all former employers and federal, state, and local government agencies to supply such information to Agency upon her request. Agency is also authorized to make any investigation of my personal history and financial and credit record through any investigative or credit agencies or bureaus of its choice. B.Employee authorizes my former employers to furnish Agency personal information requested by Agency, and Employee hereby releases Agency and such former employers for any and all liability that may arise as a result of providing such information to Agency . C. Employee hereby authorizes Agency to supply said employment records, in whole or in part, to any prospective employer, governmental agency, or any other party with a proper and appropriate interest and Employee does hereby release Agency from any and all liability that may arise as a result of its providing such information to any prospective employer, governmental agency, or to any other party with a proper and appropriate interest. 7. When placed with an Employer, Employee will be paid by Agency at the rate of $_________ per hour which amount will be paid to Employee on a ______________________ (weekly, monthly, etc.) The parties acknowledge and agree that Employee shall be providing services to Employer as an independent contractor and not as an employee. Accordingly, Agency shall have no responsibility for the collection or payment of any federal, state or local payroll tax in connection with any fees paid to Agency pursuant to this Agreement. Employee shall be responsible for any and all federal, state or local employment or other taxes incurred in connection with any fees paid to her in connection with this engagement. The Employee further agrees to indemnify and hold Agency harmless from and against any and all liability, cost or expense incurred by Agency, including reasonable attorneys fees, in connection with any income or employment taxes, penalties or interest, tax audit, re-determination, appeal or litigation arising out of any fees paid by Agency to Employee in connection with this Agreement. 8. Benefits Because Employee will be providing independent services to Agency's clients as an independent contractor and not as an employee of Agency, she shall not be entitled to participate in any benefit program (i.e., health insurance, sick days, vacation days, etc.) which Agency may, from time to time, establish and maintain for the benefit of its employees. The Employee hereby releases and relinquishes any claim that she may now or may hereinafter have and forever discharges Agency from any obligation to her in connection with any employee benefit program established or maintained by Agency on behalf of its employees. 9. Independent Contractor The parties acknowledge and agree that Employee shall be at all times hereunder an independent contractor and not an employee of Agency. Agency shall have no direct control over the methods or means by which Employee shall perform the services hereunder, and at all times during this engagement, Employee shall exercise her own independent professional judgment in connection with the performance of her services. 10. Employee agrees to perform all of her services in connection with the Employer in a diligent manner using her best efforts and attention to the performance of the services 11. Employee agrees that for a period of two year following her engagement with Employer, she will not work directly or indirectly for the Employer other than through Agency. 12.If Employee is not able to finish her job assignment with Employer, she is responsible to reimburse Agency for any losses incurred by Agency. 13. Any bond or insurance required by Employer before Employee will be allowed to work for Employer will be paid for by Employee. 14. Employee shall indemnify and hold harmless Agency harmless from and against any and all liability, damages, costs, losses and expenses arising out of or in connection with any personal injury, including death, or any damage to property or business which may be the direct or indirect result of Employee’s work for Employer . 15. Employee agrees not to disclose to Employer or to anyone in the general public any trade secrets, customer lists, and/or technical information held or controlled by Employer and relating to the business of Employer. 16. Should the Employee desire no more assignments from Agency she shall promptly notify Agency of this fact. Should Agency no longer desire to use Employee’s services, Agency with promptly notify Employee of this fact. 17. Employee shall generate no information, positive or negative about Agency, for a public forum similar to Facebook, Twitter, etc. 18. Paragraphs 5, 6, 11, 14, 15 and 17 shall survive termination of this Agreement. 19. No Waiver The failure of either party to this Agreement to insist upon the performance of any of the terms and conditions of this Agreement, or the waiver of any breach of any of the terms and conditions of this Agreement, shall not be construed as subsequently waiving any such terms and conditions, but the same shall continue and remain in full force and effect as if no such forbearance or waiver had occurred. 20. Governing Law This Agreement shall be governed by, construed, and enforced in accordance with the laws of the State of ______________. 21. Notices Any notice provided for or concerning this Agreement shall be in writing and shall be deemed sufficiently given when sent by certified or registered mail if sent to the respective address of each party as set forth at the beginning of this Agreement. 22. Attorney’s Fees In the event that any lawsuit is filed in relation to this Agreement, the unsuccessful party in the action shall pay to the successful party, in addition to all the sums that either party may be called on to pay, a reasonable sum for the successful party's attorney fees. 23. Mandatory Arbitration Any dispute under this Agreement shall be required to be resolved by binding arbitration of the parties hereto. If the parties cannot agree on an arbitrator, each party shall select one arbitrator and both arbitrators shall then select a third. The third arbitrator so selected shall arbitrate said dispute. The arbitration shall be governed by the rules of the American Arbitration Association then in force and effect. 24. Entire AgreementThis Agreement shall constitute the entire agreement between the parties and any prior understanding or representation of any kind preceding the date of this Agreement shall not be binding upon either party except to the extent incorporated in this Agreement. 25. Modification of Agreement Any modification of this Agreement or additional obligation assumed by either party in connection with this Agreement shall be binding only if placed in writing and signed by each party or an authorized representative of each party. 26. Assignment of Rights The rights of each party under this Agreement are personal to that party and may not be assigned or transferred to any other person, firm, corporation, or other entity without the prior, express, and written consent of the other party. In this contract, any reference to a party includes that party's heirs, executors, administrators, successors and assigns, singular includes plural and masculine includes feminine. WITNESS our signatures as of the day and date first above stated. __________________________ ___________________________ (Printed name) (Printed name) __________________________ ___________________________ (Signature of Agency) (Signature of Employee)