Exhibit B - Independent_Contractor Certification.pdf

EXHIBIT B - INDEPENDENT CONTRACTOR STATUS-Part of PO or Contract #

1. DIRECTION AND CONTROL-REPRESENTATION

Vendor (the term “Vendor” includes Contractors and Grantees) shall perform all of its services and other obligations under the Purchase Order (PO) or Contract (the term “Contract” includes Agreements and Grants) to which this Exhibit is attached, free from the direction and control of the State. Vendor represents that it is customarily engaged in an independent trade, occupation, profession, or business related to the services performed. The latter is a material representation made by Vendor to the State, upon which the State relied in issuing this PO or Contract, and without which, this PO or Contract would not have been issued. In accordance with the foregoing, the State does not and shall not:

A. Require Vendor to work exclusively for the State; except to the extent Vendor chooses to work exclusively for the State for a finite period of time specified in the PO or Contract;

B. Establish a quality standard for Vendor; except that the State can provide plans and specifications regarding the work but cannot oversee the actual work or instruct Vendor as to how the work will be performed;

C. Pay a salary or hourly rate but rather a fixed or contract rate;

D. Terminate the work during the PO or Contract period unless Vendor violates the terms of the

PO or fails to produce a result that meets the specifications of the PO or Contract;

E. Provide more than minimal training for Vendor;

F. Provide tools or benefits to Vendor; except that materials and equipment may be supplied;

G. Dictate the time of performance; except that a completion schedule and a range of mutually agreeable work hours may be established;

H. Pay Vendor personally but rather makes checks payable to the trade or business name of

Vendor; and I. Combine the State’s business operations in any way with Vendor’s business, but instead maintain the State’s and Vendor’s operations as separate and distinct.

2. DISCLOSURE

Vendor is not entitled to unemployment insurance benefits unless unemployment compensation coverage is provided by Vendor or some other entity, and Vendor is obligated to pay federal and state income tax on any moneys paid pursuant to the independent contractor relationship created by this PO or Contract. The State shall issue and, Vendor shall accept as proper for tax reporting purposes, a Form 1099 to Vendor for all payments made to Vendor pursuant to this PO or Contract if this payment is 1099 reportable.

VENDOR

INSERT-Vendor's Business Name

By: INSERT-Name of Authorized Individual Title: INSERT-Official Title of Authorized Individual

*Signature

Date: _________________________

* Persons signing for Vendor hereby swear and affirm that they are authorized to act on Vendor’s behalf and acknowledge that the State is relying on their representations to that effect.

2. DISCLOSURE