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1040 Avenue of the Americas, New York, NY 10019 351 West Hubbard Street, Chicago, IL 60610 1614 East Bell Road, Phoenix, AZ 85022 Phone: 718-673-6124 Fax: (866) 447-6751
ADDRESS (street, city, state, zip):
ARE YOU LEGALLY ELIGIBLE FOR EMPLOYMENT IN THE U.S.A.?
(If yes, verification will be required.)
I AM SEEKING A PERMANENT POSITION: IF NECESSARY FOR THE JOB I AM ABLE
E-mail:_______________________ Cell phone:_____________________________ Home Phone:___________________________ Are you able to perform the essential functions Of the position with or without accommodations?
TO: Work (which shifts)? W ork overtime? Name of the bank where you have an account
EDUCATION: High School College/University Business/Technical Other
(May include grammar school)
Field of Study
Graduate or Degree
MILITARY SERVICE: Duty/Specialized Training:
INDEPENDENT CONTRACTOR AGREEMENT This contract made between Mystery Shopping Providers Association™, an LLC organized and existing under the laws of the USA with its principal place of business USA, herein referred to as “Corporation” and you, Independent Contractor hereinafter referred to as “Independent”. 1. Corporation is in the business of providing customer service evaluations and undisclosed examinations of client’s businesses and the operation and in the conduct of said business desires to have the following services to be performed by the Independent. 2. Independent agrees to perform these services for Corporation under the terms set forth this contract. In consideration of the mutual promises set forth herein, Corporation and Independent agree as follows:
LOCATIONS OF ASSIGNMENTS: It is understood that Independent’s services will be rendered at various locations throughout the state (or wherever Independent states their availability). customer/shopper for given Corporation’s client and report his/her experiences to Corporation in a timely fashion (by deadline date established at time of schedule acceptance). NATURE OF WORK: Independent will secretively shop client’s establishment and accurately and honestly document his/her factual experiences as such. Independent will not disclose. or whenever requested by Corporation. that he/she is a contract employee. This information is optional and failure to provide it will have no affect on your application for employment.000$ payable by no later than 25th of each month. that is in Independent’s possession or under his/her control. Independent will not be considered an employee of the Corporation for any reason. Mystery Shopper. LIABILITY: Corporation disclaims any liability for any injury that is either in an automobile. STATUS OF SHOPPER: This contract calls for understanding and recognition of Independent as an Independent Contractor. and Corporation will rely upon Independent to fulfill their responsibility upon accepting an assignment. CONFLICT OF INTEREST: If at any time Independent becomes employed or has a relative or friend that is employed by a client that the Corporation has assigned the Independent to. including. and used by Independent in rendering services hereunder or otherwise. race and sex for planning and reporting purposes only. Corporation will not be responsible for automobile accident. corporation. all employers are required to provide equal employment opportunity and may ask your national origin. the hours Independent is to work on any given day will be solely up to the Independent. 8. to any person. the Independent agrees to decline the assignment and/or notify the Corporation of such employment. Mystery/Secret Shopper or anything pertaining to description of his/her purpose for Corporation. association. Employer Section: . INSURANCE: Each Independent is responsible for carrying his/her own automobile insurance and annually will provide proof of insurance to Corporation. 6. NON-REPRESENTATION/DISCLOSURE: Independent will not disclose the confidentiality of Corporation information or any part thereof. 9. Corporation will provide an IRS-1099 Miscellaneous Form representing Independent’s earnings over $600. PAY STRUCTURE: The Company is obliged to pay the Manager a monthly payment at a rate of 3. but not with limitation to all materials related to Mystique Shopper. Signature: Date: Equal Employment Opportunity: While many employers are required by federal law to have an Affirmative Action Program.00 in any calendar year and Independent will be responsible for reporting and paying his/her applicable taxes. firm. 3. regardless of how termination is effected. If Independent works for another Secret Shopper’s company or one offering similar services. at an assignment or in the office which injury may occur to Independent.1. 10. workman’s compensation of any sort and/or insurance coverage. Customer Service Evaluator or anything of the like for Corporation. or other entity for any reason or purpose whatsoever. 2. RETURN OF CORPORATION’S PROPERTY: On termination of this agreement. during the course of the job assigned. LLC. Independent shall immediately return to Corporation all of Corporation’s property. 7. 4. he/she will not disclose any information about the Corporation to the opposing company. on-site assignment accidents. 5. without the consent of the Corporation. Under no circumstances will Independent reveal that he/she is a Secret Shopper. HOURS: In the performance of the aforementioned services.