Employment Screening Services Agreement

 

Company Information
 

Please print, sign and Fax Completed Document to (813) 886.2610
 

1. Company Name:____________________________________________________
 

2. Company web site URL: www._________________________________________
 

3. Name of Company  Representative_____________________________________
 

4. Title: ____________________________________
 

5. E-Mail address of Company Representative:___________________________

 

6. Employer Federal ID#, _________________________________________________________
 

7. Employer's Street Address: _____________________________________________________
 

8. City: __________________________State:___________Zip: __________________________
 

7.Phone: ( ___ )_____________________________
 

8. Fax#: ( ___ ) _____________________________
 

9. Billing Address (if Different from Above):______________________________________________________

 

10. Types Of Searches offered: Criminal Background Checks, Workers' Comp Claims History, Motor Vehicle Records (MVRS), Credit Reports,Social Security Number Trace, Civil records, Previous Employment Verification, and Other legally permissible checks.

11. State the Authorized Purpose of Searches: Employment Related or credit application related

12. Permissible Purpose Code (Fair Credit Reporting act):Pre Employment/credit application                  

13. EMPLOYMENT SCREENING AGREEMENT FOR SERVICE

The undersigned Company ("End User") has entered into an agreement with Premium Bonding And Insurance Services and or Premium Background Checks. and or its data providers pursuant to which End User may order certain consumer information through provider. End User / Company would like the ability to obtain consumer information ("Repository Information") from Trans Union LLC, Equifax Credit Information Services, Inc., and/or Experian Information Solutions, Inc. if and when available (or their contractual affiliates)

through Provider separately or as part of or in combination with other consumer information. Provider obtains Repository Information and other consumer information through multiple sources, and passes through such information to end-users. As a condition to permitting provider to provide End User with Repository Information and other consumer information (together, "Credit Reports"), Provider requires End User to enter into this agreement and, End User agrees to do so in order to obtain such information through Provider. 
End User agrees to the following:

14. A. End User (Employer) agrees not to resell or otherwise distribute any Credit Reports to any third party except as required by law.

15. B. End User represents that until it notifies Provider otherwise in writing, End User is not a private detective, agency, Investigative company, bail bondsman, attorney or law firm, credit or financial counseling firm, "credit repair clinic" (each, a "Restricted Company"), and that End User will be the sole end user of all Credit Reports for "employment purposes", i.e., for the purpose of evaluating the subject "Consumer") for employment, promotion, reassignment, or retention as an employee.

18. E. In connection with ordering Credit Reports for employment purposes, End User agrees:

19. End-User certifies that each time it orders Credit Reports for employment purposes:

20. (a) End User is ordering Credit Reports solely for employment purposes, and will not use the Credit Reports for any other purpose.

21. (b) Prior to ordering Credit and or other Background Reports, (i) End User/Company has given a clear and conspicuous disclosure to the Consumer, in a document that consists solely of the disclosure, that End User is obtaining a consumer report on the Consumer for employment purposes, and, (ii) the Consumer has authorized End User in writing to obtain the report(s) for such purposes.

22. (c)  Prior to taking any adverse action based in whole or in part on such Credit Report, End User will provide the Consumer with a copy of the credit Report, and a description in writing of the rights of the Consumer under the FCRA in the form published by the Federal Trade Commission.

23. (d) End User will not use any Credit Report in violation of any federal or state equal opportunity law or regulation; order any workers' compensation information on a Consumer unless End User has made a conditional offer of employment to the Consumer; or use such information in violation of the FCRA, ADA, or any applicable state law.

24. End User will retain the consumer authorizations described in Section E.1(b) above for at least two (2) years, and will make available copies or originals of any or all such authorizations as may be requested from time to time by Provider. Prior to destroying any such authorization, End User will notify Provider and give Provider a reasonable opportunity to obtain the authorization at their expense.

25. End User will verify the identities of the subjects of all Credit Reports, obtain the permission of each Consumer to obtain the Credit Reports when required under applicable federal and state laws in the form required under such laws, provide all notices and disclosures required under such laws, refer Consumers to Provider for all inquiries regarding Credit Reports, and permit Provider to audit End User's procedures related to this agreement.

26. ALL CREDIT, CRIMINAL AND PUBLIC RECORDS REPORTS ARE PROVIDED "AS IS."  PROVIDER AND OR PREMIUM BONDING/PREMIUM BACKGROUND CHECKS DOES NOT MAKE ANY REPRESENTATION OR WARRANTY, EXPRESS OR IMPLIED, INCLUDING bUT NOT LIMITED TO IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR ANY PARTICULAR PURPOSE, AND IMPLIED WARRANTIES ARISING FROM THE COURSE OF DEALING OR A COURSE OF PERFORMANCE WITH RESPECT TO THE ACCURACY, VALIDITY, OR COMPLETENESS OF ANY REPORT, THAT WILL MEET END USER'S NEEDS, OR THAT THEY WILL BE PROVIDED ON AN UNINTERRUPTED BASIS, AND PROVIDER/DEALERS INSURANCE EXPRESSLY DISCLAIMS ALL SUCH rEPRESENTATIONS AND WARRANTIES. 

27. Provider/Premium Bonding/Dealers insurance Services will not be liable for any indirect, consequential, or special damages or damages for loss of profits, whether incurred as a result of negligence or otherwise, even if they have been advised of the possibility of such damages. Provider's maximum aggregate liability for damages in connection with Credit Reports will not exceed an amount equal to the price paid by End User to Provider for such information.

28. End User /  Company indemnifies, agrees to defend, and holds harmless Premium Bonding And Insurance Services/Premium Background Checks and its associates and affiliates from and against any and all claims, suits, proceedings, damages, costs, expenses (including, without limitation, reasonable attorney fees and court costs) brought against, or suffered by, any such person arising or resulting from, or otherwise in connection with, any breach by End User Dealer of any of its representations, warranties, or agreements in this agreement.

29.  End User will pay Provider directly for Provider's charges in connection with Credit Reports ordered by End User. This agreement constitutes the entire agreement of the parities with respect to its subject matter, and supersedes any contemporaneous or prior written or oral proposals, representations, or other

communications regarding such subject matter, whether by Provider, or any other person, except that the terms of End-User's existing agreement with provider will continue in full force and effect; provided, however, that in the event of an irreconcilable inconsistency between a provision of such agreement and this agreement, the provisions of this agreement shall control.

30.  Provider may assign this agreement and all of its rights and obligations hereunder to any of its affiliates without notice to End User. No change may be made to this agreement except in writing executed by End User, Provider, and the Compliance Officer or other authorized officer of Provider.

This agreement shall be interpreted in accordance with the laws of the state of Florida, without reference to principles of conflict of laws of such state. 

31. Any party may terminate this agreement without cause or penalty, effective upon prior written notice to the other parties.  Upon any such termination, end User will no longer have access to Credit or other Reports that contain any Provider information. 

32. Termination of this agreement will not effect any obligations arising prior to the effective date of termination with limitations of liabilities set forth above

33. Company agrees to pay invoices from provider on a monthly basis by check (Due Upon Receipt), and must be received within 10 days of billing or an accounting bar will be placed on the account.

 

 

 

 

 

To be completed by Company/ End User:
 

Agreed to by: _____________________________________________Title _________________
                                            (please print)

Company Name _____________________________________________________
 

Address: ______________________________City ________________  State ____  Zip_______
 

Signature __________________________________________ Date________________________

 

Not valid until accepted by PROVIDER:
 

Accepted by: ___________________________ Title ___________________
                       (please print)

Signature ______________________________ Date ________________

 

Please note you must maintain an appropriate signed release in your records for two years as they are subject to FCRA audit.. In most cases we will not require a copy of the release form for our files.

Some States will require release forms specific to their state.

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