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1.The undersigned individual (hereinafter referred to as Contractor) wishes to enter into a non-exclusive placement contract with NOD to have it find limited contractual engagements for nursing / care work for which the Undersigned holds the applicable license
2. The undersigned individual understands that this engagement is as an independent contractor, and not as an employee of NOD or a contracting (client) Nursing Home. As such, the Contractor understands that he or she will be solely responsible for all payment of income and self-employment taxes. No taxes will be held from your income. NOD will report all income over $600.00 per year or over to the Internal Revenue Service and the State of Florida and will provide you with a form 1099 for their records, to assist them in filing their taxes.
3. NOD shall act solely as a contracting agent to sub-contract Nurse to the facility or home
4. Nurse is being compensated for the service at a per deim rate and the contractor appoints NOD as his/her agent to find contracts for him/her and to receive compensation on his/her behalf. The agency appointment is irrevocable as to that particular contract. NOD agrees to pay the Contractor for his/her time. Payment shall be made every two weeks, or within 48 hours after NOD receives collected funds from the facility/client for which the contract was performed, if later
5. The Contractor agrees not to perform duties at the facility/client outside the scope of his/her license.
6. Each Contractor represents to NOD that:
A. They are licensed as required in the State of Florida to perform the type of service for which they are placed, and their license is not suspended or revoked, and has never been suspended or revoked. B. The Contractor is not covered by worker's compensation insurance through NOD for being an independent contractor. C. The Contractor has a minimum of one-year experience in one of the areas listed above. D. The Contractor agrees that unless they are told otherwise, they are to wear standard attire, including ID nametag while on contract.
7. The Contractor agrees to supply any information necessary to insure that the Contractor is meeting their contractual obligation, such as any disciplinary proceedings initiated against the contractor, malpractice coverage documents, employment history , etc.
8. The Contractor understands that he/she may provide services in a private home under any contract for which they are sent by NOD.
9. The Contractor agrees to supply the time card, signed by the patient each Monday to NOD.
10. The Contractor agrees that NOD is not responsible for any employment or lack of employment.
11. If a client cancels within two hours of a scheduled shift and the Contractor is unable to be placed anywhere else, the Contractor will be paid for a minimum of two hours. If a client cancels more than two hours before the beginning of a shift, the Contractor will not receive any compensation even if he/she is not informed of the cancellation. The Contractor must be verified one and one half hours (1.5) before the start of the shift.
12. If a Contractor fails to show up for work, or cancels within four hours, the Contractor agrees to reimburse NOD for an amount of equal to two hours of the pay by deductions from payroll.
13. The Contractor has an absolute right to accept or reject any contract for any reason whatsoever, but once a contract is accepted, the Nurse agrees that he/she or another nurse will show up at the appointed time. The Contractor is free to subcontract with any nurse which is registered with NOD in advance, and who is acceptable to the Nursing Home Client.
14. This agreement is to be construed under laws of the State of Florida.
I agree to this contract and understand its terms. I have a license as is indicated above.
Name
*
First
Last
Social Security Number
Signature
Clear Signature
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Non-Compete Agreement INDEPENDENT CONTRACTOR
The Independent Contractor, acknowledges that the services to be rendered to the Agency (Nursing on Demand Inc.) hereby referred to as "Agency" had a significant and material value to the loss of which cannot adequately be compensated by damages alone. In view of the significant and material value of the services of Independent Contractor for which Agency has contracted; Independent Contractor and the confidential information obtained by or disclosed to Independent Contractor as an Independent Contractor of Agency; and as a material inducement to Agency to employ Independent Contractor and to pay to Independent Contractor compensation for such services to be rendered for Agency by Independent Contractor.
AGENCY: Authorized Representative of Nursing on Demand Inc.
AGREED TO AND ACCEPTED.
Name
*
First
Last
Signature
Clear Signature
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INDEMNITY AGREEMENT HOLD HARMLESS AND INDEMNITY AGREEMENT
This agreement made in the state of Florida by and between NURSING ON DEMAND, INC. (here on after referred to as the "Owner'') and here referred to as the "Independent Contractor").
Name of Independent Contractor
*
First
Last
Date
WITNESSETH: This Agreement constitutes a Hold Harmless Agreement with Indemnity between the parties.
The parties hereto expressly intend and agree that this Agreement establishes an independent contractor relationship between them and that no employer/employee or master/servant relationship shall be created between the parties.
The Independent Contractor shall indemnify, hold harmless, and defend the Owner from and against any and all losses, claims, damages, liabilities, costs, attorney's fees and other expenses of every nature whatsoever incurred by or asserted against the Owner by the Independent Contractor, its agents or employees or any third persons due to personal injury or property damage arising out of the Independent Contractor's performance of the Work contemplated.
The Independent Contractor hereby represents to the Owner that the Independent Contractor's Social Security or Federal Employer's Identification Number is:
Social Security Number or Federal Employer's Identification Number
Signature
Clear Signature
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ATTESTATION OF COMPLIANCE with Background Screening Requirements
I hereby attest to meeting the requirements for employment and that I have not been arrested for or been found guilty of, regardless of adjudication, or entered a plea of nolo contendere, or guilty to any offense listed below
Under penalty of perjury I hereby swear or affirm that I meet the requirements for qualifying for employment in regards to the background screening standards set forth in Chapter 435 and section 408.809, F.S. In addition, I agree to immediately inform my employer if arrested or convicted of any of the disqualifying offenses while employed by any health care provider licensed pursuant to Chapter 408, Part II F.S.
Signature
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Date / Time
See Chapter 435 Statutes
See Chapter 408 Statutes
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