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Address of property where work will be performed:


The work to be performed on this property, including all terms, is outlined is fully outlined in a separate agreement.

I, ________________________________, hereby acknowledge and agree that I am an independent contractor under IRS regulations and will be fully and solely responsible for any damage, loss or injury the owner or any and all others may suffer or incur either directly or indirectly as a result of my work .I will be fully responsible for myself and all others associated with me for any damage, injury or loss of any kind whatsoever.

Though the owner will request certain work to be performed, I am ultimately responsible and have the authority to determine the method of work, hours worked, and means of performing the work on above premises and control the work of those working under me. The rental owner shall not interfere in this regard and control, direct, or supervise my employees or subcontractors. The owner does reserve the right to inspect the work being performed to determine whether it is being performed in a satisfactory and "workmanlike" manner. I will warrant all work for a period of ____ months following completion.

I agree that I will obtain and provide my own equipment, tools and all necessary materials for any work the owner contracts with me to perform.

I agree to provide the rental property owner with written and itemized invoices for all work performed.

I agree that I am not and will not become an employee, partner, agent, or principal of the rental owner while this agreement is in effect. I understand that I am not entitled to the rights or benefits afforded to any employee benefits, including disability, unemployment insurance, workers compensation, or medical benefits.

I may, at my own expense, employ assistants or subcontractors as may be necessary for performance of work. I acknowledge and agree that I (not the rental property owner) am responsible for paying any wages, taxes, unemployment, withholding taxes and providing any permits and licenses for myself, my employees and subcontractors required by local or state law.

I acknowledge that I am fully insured and my coverage includes workmans compensation, disability and liability insurance for work performed for myself, employees and subcontractors and will name the rental property owner as an additional insured. I have attached a copy of my Workmans Compensation and Certificate of Insurance.

I will furnish owner appropriate releases or waivers of lien for all work performed or materials.

I shall defend, indemnify and hold the rental property owner harmless from all lawsuits, accidents or claims made by any entity for payment of any damages or harm incurred because of my actions or those of my assistants, employees or subcontractors.

Contractors Signature_______________________________ Date _____________

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