Background Check Consent Form
I hereby acknowledge that any offer of employment made to me ________ (hereafter “the Company”) is conditioned upon the successful completion of a background check which is acceptable to the Company, and upon the successful completion of a Level 1 Background Check in accordance with Florida state law, and that information obtained during this process may disqualify me from being employed by the Company.
I hereby acknowledge that the Company and/or its designated representatives will conduct pre-employment background checks thoroughly and within the confines of all applicable state and federal laws.
I hereby acknowledge that the Company will maintain any information obtained as a result of my signing this Consent in a confidential file whether electronic or physical, in the Human Resources Department.
I understand that a background check will be performed as part of the process to evaluate me prior to any offer of employment, and it is not conducted for any other purpose.
I authorize the Company, or its designated representative presenting this consent or a photocopy thereof, to obtain the following records and information in connection with my application for employment with the Company insofar as the records and information are relevant to the position for which I am applying:
• Criminal History and Convictions
• Motor Vehicle Operation
• Certification and Licensing
• Educational History and Credentials
• Employment Eligibility
• Prior Employment Information
If the position for which I am applying specifically requires a personal credit history acceptable to the Company, I understand that I will be required to sign a separate Fair Credit Reporting Act Consumer Report Disclosure authorizing the Company to obtain the same. No personal credit history will be obtained by the Company without this authorization, unless the initial Level 1 background check identifies publicly available liens, bankruptcies, or public judgments in matters involving me.
I authorize all persons who are the custodians of these records, or who may have information relevant to my application for employment, to provide records or disclose such information to the Company and/or its designated representative.
I release the Company, its employees, designated representatives, agents, officers and trustees, as well as all persons or entities who provide records or disclose information, from any and all claims of liability or damage due to either the procurement or the true and accurate disclosure of such records or information.
INDEPENDENT CONTRACTOR AGREEMENT
This Independent Contractor Agreement (“Agreement”) is
made and entered into between
Health Professional Connect, a Florida corporation, doing
business as FitnessAtYourDoor
(the “Company”) and ___________________
(“Contractor”) (hereinafter collectively referred to as
“Parties”). The Parties, therefore, agree as
follows:
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Services.
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During the Term of this Agreement, Contractor will perform
for the Company the Contracting services, as directed by the
Company, and as more particularly described in Exhibit A to
this Agreement (the “Services”). The Services have been specially ordered and
commissioned by Company.
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The content, style, form, and delivery of the Services shall
be completely satisfactory to Company and shall be consistent
with Company's standards as more particularly described
in Exhibit A.
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Status as an Independent Contractor.
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The Parties intend that the Contractor be engaged as an
independent contractor of the Company. Nothing contained in
this Agreement will be construed to create the relationship of
employer and employee, principal and agent, partnership or
joint venture, or any other fiduciary relationship.
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The Contractor may not act as agent for, or on behalf of, the
Company, or to represent the Company, or bind the Company in
any manner.
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The Contractor will not be entitled to worker's
compensation, retirement, insurance, or other benefits
afforded to employees of the Company.
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Contractor shall be responsible for providing, at
Contractor's expense, and in Contractor's name,
unemployment, disability, worker's compensation, and
other insurance, as well as licenses and permits usual or
necessary for conducting the Services.
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Expectations of Contractor.
Contractor understands and agrees that as a condition of their
contract with the Company, they will undergo the Company’s
FitnessAtYourDoor Certification and will comply with all rules and
expectations as discussed therein.
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Compensation.
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The Contractor shall be compensated at an agreed-upon hourly
rate as determined by the Company and based on the
Contractor’s skill, experience, certifications,
compliance with FitnessAtYourDoor policies, and results
obtained for Clients.
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The Contractor shall be paid via direct deposit every third
week of each month.
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No other fees and/or expenses will be paid to Contractor,
unless such fees and/or expenses have been approved in advance
by the appropriate Company executive in writing.
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The Company shall not be responsible for federal, state, and
local taxes derived from the Contractor's net income or
for the withholding and/or payment of any federal, state and
local income and other payroll taxes, workers'
compensation, disability benefits or other legal requirements
applicable to the Contractor.
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Contractor shall be solely responsible for any and all taxes,
Social Security contributions or payments, disability
insurance, unemployment taxes, and other payroll type taxes
applicable to such compensation pursuant to this Agreement.
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Contractor hereby indemnifies and holds Company harmless
from, any claims, losses, costs, fees, liabilities, damages or
injuries suffered by Company arising out of Contractor's
failure with respect to its obligations in this Section.
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Noncompete. For a period of one (1) year after the Contractor is no longer
engaged as an Contractor by the Company, the Contractor will not,
directly or indirectly, either as proprietor, stockholder,
partner, officer, employee, Contractor or otherwise, distribute,
sell, offer to sell, or solicit any orders for the purchase or
distribution of any products or services which are similar to
those distributed, sold, or provided by the Company.
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Ownership of Work Product.
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As a result of providing the Services, the Contractor may
create certain work product (the "Work Product").
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The Parties intend that, to the extent the Work Product or a
portion of the Work Product qualifies as a “work made
for hire,” within the definition of Section 101 of the
Copyright Act of the United States (17 U.S.C. § 101), it
will be so deemed a work made for hire. If the Work Product or
any portion of the Work Product does not qualify as work made
for hire, and/or as otherwise necessary to ensure the
Company's complete ownership of all rights, titles and
interest in the Work Product, the Contractor hereby transfers
and assigns to the Company all rights, titles and interests
throughout the world in and to any and all Work Product. This
transfer and assignment includes, but is not limited to, the
right to publish, distribute, make derivative works of, edit,
alter or otherwise use the Work Product in any way the Company
sees fit.
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Upon Company's reasonable request, and at Company's
sole cost and expense, Contractor shall take such steps and
actions, and provide such cooperation and assistance to
Company and its successors, assigns, and legal
representatives, including the execution and delivery of any
affidavits, declarations, oaths, exhibits, assignments, powers
of attorney, or other documents, as may be reasonably
necessary to effect, evidence, or perfect the assignment of
the Work Product to Company or any assignee or successor
thereto.
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The Company grants the Contractor, a limited, non-exclusive,
non-transferable, non-assignable, royalty-free, worldwide
license to display the Work Product on a platform personally
controlled, in whole or in part, by the Contractor. The
Company may revoke this license at any time by requesting the
removal of the Work Product displayed by the Contractor. Upon
such request, the Contractor shall remove the Work Product
from the platform, and provide written notification of such
removal.
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Confidentiality.
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Contractor acknowledges that Contractor will obtain the
Company's confidential information, which includes, but
is not limited to, (i) business, product and marketing plans
or proposals, (ii) customer lists and customers' personal
information, (iii) software and hardware prototypes, samples
and specifications, (iv) research and development information
(including studies, records, reports and drawings), (v) trade
secrets and all other proprietary information whether embodied
in the Company's products or otherwise, and (vi) ideas,
concepts, strategies and recommendations relating to products
or services offered, developed or planned by the Company
(collectively, the “Confidential Information”).
Contractor agrees that the Company is the owner of all
Confidential Information and all copyrights, trade secrets,
patents, trademarks, and other associated intellectual
property rights.
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Company acknowledges that its Confidential Information does
not include information that (i) was rightfully in
Contractor's possession before receipt from the Company,
(ii) is or becomes a matter of public knowledge through no
fault of Contractor, (iii) is rightfully received by
Contractor from a third party without a duty of
confidentiality, and/or (iv) is independently developed by
Contractor without use of the Company's Confidential
Information.
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Contractor agrees that following receipt of Confidential
Information, Contractor shall not, without the Company's
written consent, (i) disclose Confidential Information or any
portion of it to any person or entity, (ii) assist others to
develop, produce, market, or sell any product based on or
utilizing it, (iii) make any other use of it in any way or for
any purpose, or, (iv) reverse engineer, decompile or
disassemble any of the Company's products.
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Contractor agrees that all Confidential Information is and
shall remain the Company's property. Upon termination of
this Agreement by either party, or at the Company's
request at any time during the term of this Agreement,
Contractor and Contractor Staff shall promptly return to
Company all copies, whether in written, electronic or other
form or media, of Company's Confidential Information, or
destroy all such copies and certify in writing to Company, at
Company's request, that such Confidential Information has
been destroyed.
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Contractor shall not wrongfully use or disclose to the
Company any proprietary information or trade secrets of
Contractor's former employer(s). Contractor shall not
bring onto the Company's premises any such information
without first obtaining the express written consent of former
employer(s).
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Contractor acknowledges that the Company has and will receive
confidential information from others. Contractor agrees to
treat such information as the Company Confidential
Information.
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Contractor acknowledges that money damages for a breach of
this Paragraph would not be adequate relief, and therefore
agrees that the Company shall be entitled to injunctive relief
in case of any such breach or threatened breach by
Contractor.
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Non-Solicitation.
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The Contractor agrees that at all times during the Term and
for a period of two (2) years thereafter, they will not,
without the Company's prior written consent, on behalf of
any individual, partnership, corporation, association, limited
liability company, or entity that provides services
competitive with the Company's business within fifty (50)
miles of the Company's studio location, which competitive
services include, but are limited to, group fitness classes or
services, high-intensity interval training classes or
services, and boutique fitness services (a “Competitive
Business”), solicit, directly or indirectly, the
business of any person who was a client or customer of the
Company during the Term.
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The Contractor further agrees that at all times during the
Term and for a period of two (2) years thereafter, he will
not, without the Company's prior written consent, (i)
serve as a partner, employee, consultant, employment, officer,
director, manager, agent, associate, or otherwise work for a
Competitive Business or (ii) directly or indirectly, own,
purchase, organize or take preparatory steps for the
organization of, any competitive business.
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If in any judicial proceeding, a court shall refuse to
enforce this or any other restrictive covenant in this
Agreement, whether because the time limit is too long or
because the restrictions contained in such other covenant are
more extensive (whether as to geographic area, the scope of
business, or otherwise) than is necessary to protect the
business or goodwill of the Company, it is expressly
understood and agreed between the parties hereto that this
Agreement is deemed modified to the extent necessary to permit
the greatest restriction possible to be enforced in such
proceedings
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If the Company or its successors in interest shall
successfully make application to a court of competent
jurisdiction for injunctive relief to enforce this provision,
hen the period of time from the time of breach until the date
on which the court grants injunctive relief shall be added to
the duration of the non-competition restriction.
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The Contractor covenants and agrees that if they shall
violate any of the provisions herein, the Company shall be
entitled, in addition to any other appropriate relief, to an
accounting and repayment of all profits, compensation,
commissions, remuneration, or other benefits that the
Employment directly or indirectly has realized and/or may
realize as a result of, or growing out of, or in connection
with, any such violation. These remedies shall be in addition
to, and not in limitation of, injunctive relief or other
rights or remedies to which the Company is or may be entitled
at law or in equity under this Agreement.
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Equipment. Contractors shall supply at their expense all other equipment
that may be required to perform the Services.
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Termination. The term of this Agreement will commence on
the date of signing by both Parties (the “Effective
Date”) and will continue until such time as either of the
Parties terminate the Agreement (“Termination Date”).
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The Company may terminate this Agreement at any time for any
reason, with or without cause, effective immediately upon
notice to the Contractor.
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This Agreement is terminable at any time by Contractor upon
thirty (30) days written notice to Company.
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Upon termination, Contractor shall submit to Company any
documents, equipment, materials, and information that Company
requests that is related to the Services within forty-eight
(48) hours of such written request, including but not limited
to contracts, invoices, car decals, shirts, workout plans,
contact information, written plans, and works in progress. The
confidentiality provisions of this Agreement shall remain in
full force and effect after the termination of the
Agreement.
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Representations and Warranties. Both Parties represent and warrant to the other that (a) each
has full power and authority to enter into this Agreement, and (b)
neither will violate the terms of any agreement with any third
party. Contractor represents and warrants that the Services and
the performance of their duties and obligations hereunder will not
breach or be in conflict with any other agreement to which the
Contractor is a party or by which the Contractor is bound, and
that Contractor is not now subject to any covenant against
competition or similar covenant which would affect the performance
of his duties under this Agreement, irrespective of
Contractor's belief that such agreement or covenant is
unenforceable.
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Indemnification. Contractor shall defend, indemnify and hold Company and its
successors, assigns and licensees harmless from any and all
claims, actions and proceedings, and the resulting losses,
damages, costs and expenses (including reasonable attorneys'
fees) arising from any claim, action or proceeding based upon or
in any way related to Contractor's, or Contractor's
employees, breach or alleged breach of any representation,
warranty or covenant in this Agreement, and/or from the acts or
omissions of Contractor or Contractor's employees.
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Limitation of Liability.
EXCEPT FOR THE PARTIES' INDEMNIFICATION, OBLIGATIONS, CLAIMS
PERTAINING TO CONFIDENTIAL INFORMATION, OR DAMAGES RESULTING FROM
A PARTY'S GROSS NEGLIGENCE OR WILLFUL MISCONDUCT, NEITHER
PARTY WILL BE LIABLE TO THE OTHER PARTY FOR ANY SPECIAL, INDIRECT,
PUNITIVE, EXEMPLARY, CONSEQUENTIAL OR INCIDENTAL DAMAGES OF ANY
KIND, INCLUDING, WITHOUT LIMITATION, ANY LOSS OF PROFIT, LOST
SAVINGS, LOSS OF USE, OR BUSINESS INTERRUPTION, BASED ON ANY CLAIM
UNDER THIS AGREEMENT, WHETHER ARISING FROM BREACH OF CONTRACT,
WARRANTY, TORT, STRICT LIABILITY, OR OTHERWISE, EVEN IF SUCH PARTY
HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSS OR DAMAGE, OR IF
SUCH LOSS OR DAMAGE COULD HAVE BEEN REASONABLY FORESEEN.
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Attorneys' Fees. If any action is brought relating to this Agreement, the
prevailing party shall be entitled to recover reasonable
attorneys' fees and costs of suit.
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Assignment. Neither this Agreement nor any duties or obligations under this
Agreement may be assigned by Contractor to a third party without
the prior written consent of the Company. It shall be binding upon
and shall inure to the benefit of the Company and its successors
and assigns, and its economic rights and benefits shall inure to
the benefit of the Contractor or her heirs and duly constituted
legal representatives.
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Severability. If any term or provision of this Agreement shall be held
invalid or unenforceable to any extent, the remainder of this
Agreement shall not be affected.
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Amendment.
This Agreement may be amended only by written agreement, including
but not limited to email, duly executed by an authorized
representative of each party.
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Waiver.
A failure or delay in exercising any right, power or privilege in
respect of this Agreement will not be presumed to operate as a
waiver, and a single or partial exercise of any right, power or
privilege will not be presumed to preclude any subsequent or
further exercise, of that right, power or privilege or the
exercise of any other right, power or privilege.
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Binding Effect. This Agreement shall be binding on and shall inure to the
benefit of the Parties hereto and their respective heirs,
representatives, successors, and permitted assigns.
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No License. The Parties agree that no license, by implication or otherwise,
is granted to Contractor under this Agreement or through any
disclosure of information in the course of his performing
Services. No license or permission is given to Contractor to
export any of the Company products or information in violation of
any applicable law.
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Governing Law. This Agreement shall be governed by the laws of the State of
Florida applicable to contracts made and to be performed in this
state.
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Jurisdiction and Venue.
The parties agree that the exclusive venue for any litigation,
proceeding, claim, or controversy that arises out of or relates to
the Contractor's engagement, this Agreement, or the breach of
this Agreement, will be in the State of Florida. The parties each
hereby submit to the jurisdiction at the state and federal courts
in the State of Florida.
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Entire Agreement. This Agreement, together with the Offer Letter Agreement,
constitutes the entire agreement between the Parties with respect
to the subject matter hereof, and supersedes all prior and
contemporaneous agreements, representations and
understandings.
Agreed upon by:
FOR CONTRACTOR
____________________________________
Date: ________________________________
Address: _____________________________
FOR COMPANY
_____________________________________
Kashawn Fraser, Owner
Date: ________________________________
Address: _____________________________
EXHIBIT A TO INDEPENDENT CONTRACTOR AGREEMENT
DESCRIPTION OF SERVICES (“SERVICES”)
The Contractor will provide the services outlined below and any
additional services as deemed appropriate during the term of this
Agreement.
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Services.
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The Contractor shall perform the duties and have the
responsibilities as directed by the Company including personal
training services delivered to the Company’s
Clients.
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The Contractor shall devote their business time, skill,
energy, business judgment, knowledge, and best efforts for the
Company in the advancement of the best interests of the
Company and the performance of the Services.
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The Contractor shall comply with all policies, standards, and
regulations of the Company as they are established from
time-to time and shall perform his duties in accordance with
the laws, rules, and regulations of the State of Florida and
the United States.
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Changes to Contractor Schedule.
In the event that there are changes to Contractor’s schedule
that could adversely affect the availability of Contractor, the
Contractor agrees to notify the Company of any such change(s) no
later than seven (7) days prior to such change(s), or promptly and
without delay if Contractor becomes aware of such change(s) within
the seven (7) day period.