INDEPENDENT CONTRACTOR AGREEMENT UNIVERSITY FOUNDATION , Chico Project # IC Agreement # All information below to be completed by IC Agreement is hereby made between the Independent Contractor (IC) and the CSU, Chico Research Foundation, (CLIENT) according to the following terms, conditions, and provisions including any attachments which are incorporated and made a part of this agreement: IDENTITY OF INDEPENDENT CONTRACTOR Relevant Business Identification: Business Name: Type of Entity Sole Proprietorship Partnership Corporation Business Address (Street): (Not P O Box) Mailing Address if Different: Business Phone #: ( ) - Fax #: ( ) - Email: Employer Identification #: Business License #: City: Exp. Date: Relevant Personal Information if different from Name: SSN (enter last 4 digits) Home Address (Street): (Not P O Box) Mailing Address if Different: Home Telephone #: ( ) - Email: WORK HISTORY Please list the last three clients (other than the CSU, Chico Foundations) for whom IC has provided service as an Independent Contractor: Date: Date: Date: How many times in the last 12 months have you worked as an Independent Contractor for the University Foundation or the CSU, Research Foundation? Where are you currently employed? CLIENT IDENTITY Name: The CSU, Research Foundation Address: , , Business Telephone Numbers: Sponsored Programs: (530) 898-5700 Fax: (530) 898-6804 Foundation Administration: (530) 898-6811 Fax: (530) 898-6021
INDEPENDENT CONTRACTOR AGREEMENT UNIVERSITY FOUNDATION , Chico Project # IC Agreement # All information below to be completed by IC Agreement is hereby made between the Independent Contractor (IC) and the CSU, Chico Research Foundation, (CLIENT) according to the following terms, conditions, and provisions including any attachments which are incorporated and made a part of this agreement: IDENTITY OF INDEPENDENT CONTRACTOR Relevant Business Identification: Business Name: Type of Entity Sole Proprietorship Partnership Corporation Business Address (Street): (Not P O Box) Mailing Address if Different: Business Phone #: ( ) - Fax #: ( ) - Email: Employer Identification #: Business License #: City: Exp. Date: Relevant Personal Information if different from Name: SSN (enter last 4 digits) Home Address (Street): (Not P O Box) Mailing Address if Different: Home Telephone #: ( ) - Email: WORK HISTORY Please list the last three clients (other than the CSU, Chico Foundations) for whom IC has provided service as an Independent Contractor: Date: Date: Date: How many times in the last 12 months have you worked as an Independent Contractor for the University Foundation or the CSU, Research Foundation? Where are you currently employed? CLIENT IDENTITY Name: The CSU, Research Foundation Address: , , Business Telephone Numbers: Sponsored Programs: (530) 898-5700 Fax: (530) 898-6804 Foundation Administration: (530) 898-6811 Fax: (530) 898-6021
independent_agreement_08_19_2016_UF.docx