Form Ic-03 - Independent Contractor Agreement Form printable pdf download

Independent Contractor Agreement

AMERICAN CORRECTIONAL SOLUTIONS (hereinafter referred to as “ACS”), and

________________________ (hereinafter referred to as the “Contractor”), hereby agree

as follows:

RECITALS

A. ACS is engaged in the business of referring qualified medical and psychological

personnel to correctional institutions in the State of California;

B. Contractor is a resident of California, duly licensed by the State of California to

provide medical or psychological care, as may be appropriate based upon this

license;

C. Contractor as an independent contractor desires to contract with ACS to provide

services pursuant to the terms and conditions set forth in this Agreement, and ACS

so desires to contract with Contractor.

NOW, THEREFORE in consideration of the foregoing recitals and the mutual covenants,

agreements, representations and promises set forth herein, ACS and Contractor hereby

agree as follows:

AGREEMENT

In consideration of the foregoing set forth herein, the parties agree as follows:

1. Services. During the term of this Agreement, Contractor agrees to provide medical or

psychological care and counseling, as appropriate to Contractor’s license and in a

professional and ethical manner, to inmates housed at the correctional institution/s

assigned by ACS, based upon direction, supervision, policies, protocol and scheduling

provided by the management representatives of the assigned correctional institution;

2. Payment. For the services rendered as described in this Agreement, ACS agrees to

pay Contractor as follows:

_____________________________________________________________________

____________________________________________________________________.

3. Independent Contractor. ACS understands and hereby warrants that it retains no

right to control Contractor, Contractor’s agents, employees, or assistants in the

performance of the above-described services. By the signing of this agreement,

Contractor and ACS agree and acknowledge that Contractor controls the manner,

details, means and method of the services performed and is only responsible for the

results of the services provided. ACS and Contractor agree that ACS will not control

how Contractor performs the services. ACS understands and warrants that it has no

right to control Contractor, Contractor’s agents, assistants or employees in the

performance of the above-described services. ACS acknowledges and understands

Form Ic-03 - Independent Contractor Agreement Form