BKL IC SLP Agreement 2020-2021 2x with COVID Waiver
***SLP INDEPENDENT CONTRACTOR AGREEMENT 2020-2021 Payment 2x with Covid Waiver***
This Agreement is made between Brooklyn Letters Speech Language Pathology PLLC, 1139 Prospect Avenue, 2i, Brooklyn, NY 11218, and ("Independent Contractor"), on . This Agreement shall not render the Independent Contractor an employee, partner, agent of, or joint venturer with the Brooklyn Letters Speech Language Pathology PLCC for any purpose.
RELATIONSHIP BETWEEN BROOKLYN LETTERS SLP PLLC AND THE INDEPENDENT CONTRACTOR Brooklyn Letters SLP PLLC (Brooklyn Letters) is a private practice offering speech language pathology and literacy services. These services are offered in homes and in schools. Brooklyn Letters presents the worker as an Independent Contractor (IC) and the worker provides these services under their own business name. The IC is a professional who uses his or her own professional and business methods to perform services. The IC has not and will not receive training from Brooklyn Letters regarding how to perform the services. Brooklyn Letters does not control, supervise or otherwise interfere with the IC’s mode of effecting performance under this Agreement. Brooklyn Letter’s only concern is the result of the IC’s work, and not the means of accomplishing it. The IC maintains his/her own establishment and contacts Brooklyn Letters for work leads. Licensure: The IC represents that he/she is licensed and certified to practice Speech Language Pathology in the State of New York. The New York State Speech Language Pathology license and the clinician’s Clinical Core Competence are both required in good standing to work for Brooklyn Letters. It is the IC’s responsibility to inform Brooklyn Letters of any change in the IC’s licensure and related certificates.
SERVICES The IC has no set hours of work. Nor is there a requirement that the IC work full time or otherwise account for work hours. The IC has control over work assignments, approves who he/ she works with, determines methods to perform his/her own services, determines their territory, works with the client until the IC and the client end their relationship based on their discretion, determines level of payment with clients, sets work hours. Clients pay the IC directly. The IC takes responsibility for making up missed sessions with his/her own clients, has freedom to provide services to other businesses. The IC invests in his/her own materials and equipment. No oral or written reports are due to Brooklyn Letters. There are no requirements for attendance at Brooklyn Letters meetings. For quality control purposes, Brooklyn Letters solicits feedback from its ICs and from their clients. All services provided by the IC to the client will be under the IC’s own name, and the IC shall represent that he/she is an independent contractor, and not an employee of Brooklyn Letters. The IC acknowledges and agrees that the services performed are performed as an independent contractor. The IC is solely responsible for any and all taxes, Social Security and Medicare contributions and payments, and other payroll taxes applicable to such compensation. The IC agrees that he/she has no right to, nor will he or she seek benefits or any form of payment under the State Unemployment Coverage or Workers’ Compensation Coverage upon expiration or termination of this Agreement. Brooklyn Letters will not provide fringe benefits, including, but not limited to, health insurance benefits, paid vacation, or any other employee type benefit, for the benefit of the IC. The IC shall provide professional services to his/her clients in compliance at all times with ethical standards, laws, rules and regulations applicable to the operations of the practice. All professional matters relating to the operations of the Practice and the performance of services for his/her clients shall be the sole responsibility of the IC. Nothing in this Agreement shall be construed to transfer responsibility for the practice (or any respect of the Practice) to Brooklyn Letters. The IC agrees to perform the following services within their professional purview: assess, evaluate, and treat, from infancy through adulthood, depending on the IC’s level of professional experience, speech, language, literacy, and feeding delays and its disorders. This includes working one on one with the client in their home, office (when the IC works out of his/her private practice office), providing parent training, consultation, running small group therapy (when applicable), discussing the individual’s development and progress with the parent/ caregiver, updating short term and long term goals, maintaining session notes, recording and maintaining data on the client’s progress, developing a discharge plan when therapeutic goals are met and when the client no longer exhibits a significant speech, language, and feeding delay, or terminating services when the client isn’t benefiting from speech language therapy. Since Brooklyn Letters does not offer services through in-network insurance, Early Intervention, Board of Education, RSAs, ICs are forbidden to work with any Brooklyn Letters’ clients outside of private pay circumstances through Brooklyn Letters.
EXPENSES PAID BY CONTRACTOR. The IC is responsible for all expenses which he/she may incur, including but not limited to, professional licenses and registrations, continuing education classes, professional liability insurance, general liability, travel and educational/therapeutic supplies, e.g. toys and activities. Insurance: The IC will carry Professional Liability insurance. The IC will also carry General Liability insurance relative to any service that they shall perform for Brooklyn Letters providing a minimum of $1 million liability insurance per loss for each occurrence, and no less than $3 million in the aggregate and will name Brooklyn Letters as an additional insured. Additional Requirements The IC must have his/her own EIN numbers for tax purposes, stationary, media advertising, a business account, business cards, and solicit business outside of Brooklyn Letters. The IC can’t copyright language from the Brooklyn Letters website for his/her own media advertising purposes. The IC may not employ others to perform the services for referrals from Brooklyn Letters.
The IC must have his/her own EIN numbers for tax purposes, stationary, media advertising, a business account, business cards, and solicit business outside of Brooklyn Letters.
The IC can’t copyright language from the Brooklyn Letters website for his/her own media advertising purposes.
The IC may not employ others to perform the services for referrals from Brooklyn Letters.
PAYMENT FOR SERVICES. Payment is due two times per month. The 1st installment is payment for the 1st of the month-15th of the month due between the 15th-18th of the month through . IC and Brooklyn Letters must agree upon an alternative electronic payment method (Brooklyn Letters does not incur any fees for e-payments). An invoice with session dates is required with submission of payments. The 2nd installment is payment from the 16th-the last day of the month due by the 1st-3rd of the following month through Zelle. IC and Brooklyn Letters must agree upon an alternative electronic payment method (Brooklyn Letters does not incur any fees for e-payments). An invoice with session dates is required with the submission of payments. Late payments and invoices are subject to a $25 fee per late invoice or payment.
Brooklyn Letters is not responsible for paying the IC when the client fails to pay him/her. The IC and Brooklyn Letters both take the loss when clients fail to pay the IC. It is the IC’s responsibility to collect weekly payments from his/her clients. If the IC fails to pay Brooklyn Letters in a timely fashion, Brooklyn Letters reserves the right to ask the client to pay Brooklyn Letters directly. Once Brooklyn Letters receives payment from the client, Brooklyn Letters will pay then pay the IC his or her share until the IC pays past due monies owed to Brooklyn Letters. The IC hereby agrees to pay Brooklyn Letters:
Assessment:10% of the total price due to Brooklyn Letters. The evaluation price is set by the Brooklyn Letters evaluator. THERAPY: Brooklyn Letters will be paid % for all 45 and 60 minutes sessions % or all 30 minute sessions. These rates are subject to be increased at a later date by Brooklyn Letters one year post signing of this contract. Brooklyn Letters can also agree upon the rate in writing (email) before starting with a new client if a session rate is established by Brooklyn Letters and the IC.
If sessions are longer than 60 minutes, please pay Brooklyn Letters additional monies at your hourly prorated rate.
REFERRALS A Brooklyn Letters referral comes from any parent, professional, school that is directly connected with Brooklyn Letters, and the referral source directly contacts the IC for services. The IC must notify Brooklyn Letters that a Brooklyn Letters referral contacted him or her. If the IC accepts these services, payment to Brooklyn Letters is expected as stipulated under this Agreement. For referrals outside of this Brooklyn Letters’ network, the IC does not need to inform Brooklyn Letters when he/she receives these solicitations and the IC is not responsible for paying Brooklyn Letters for these services.
TERM/TERMINATION. This Agreement may be terminated by the IC upon 30 days written notice to the other party. Brooklyn Letters can terminate this Agreement at will. Upon termination of this Agreement Brooklyn Letters will cease referring clients to the IC. However, the terms and conditions of this Agreement shall survive for 30 days after the termination date with respect to any clients referred by Brooklyn Letters to the IC. Upon termination of this Agreement Brooklyn Letters will notify each of the IC’s clients that the IC is no longer contracting with Brooklyn Letters and that a new provider will be assigned. Alternatively, after terminating with Brooklyn Letters, the IC can continue to work with Brooklyn Letters client(s) by paying Brooklyn Letters up to one year for these services. In other words, the IC can continue to pay Brooklyn Letters for one year post termination if the IC chooses to work with the Brooklyn Letters client.
INDEMNIFICATION. The IC agrees to indemnify and hold harmless Brooklyn Letters, its owners, independent contractors, and employees for liabilities or losses which may result or arise out of any alleged malfeasance, negligence, willful actions caused or alleged to be caused by the IC in connection with the rendering or omission to render any of the services to any client. This subparagraph will survive the termination or expiration of this Agreement. NEITHER PARTY TO THIS AGREEMENT SHALL BE LIABLE TO EACH OTHER OR THIRD PARTIES FOR THE OTHER'S LOST PROFITS OR SPECIAL, INCIDENTAL OR CONSEQUENTIAL DAMAGES, WHETHER IN AN ACTION IN CONTRACT OR TORT, EVEN IF THE PARTY HAS BEEN ADVISED BY THE OTHER PARTY OF THE POSSIBILITY OF SUCH DAMAGES. The indemnity provisions shall survive the termination or expiration of this Agreement Miscellaneous The IC will not assign his/her rights or interests under this Agreement, or subcontract with or employ another individual to provide the services without prior written consent from Brooklyn Letters. The HIPPA Privacy Compliance “Business Addendum” is hereby incorporated and made part of this Agreement. Arbitration: If a dispute or controversy arising under this Agreement, the parties agree to first try to resolve the dispute with the help of a mutually agreed-upon mediator in Kings County, New York in accordance with the rules of the American Arbitration Association. Any costs and fees other than attorney fees, associated with the mediation shall be shared equally by the parties. If it proves impossible to arrive at a mutually satisfactory solution through mediation, the parties agree to submit the dispute to a mutually agreed-upon arbitrator in Kings County, New York. Judgment upon the award rendered by the arbitrator may be entered in any court in Kings County, New York having jurisdiction to do so. Costs of arbitration, including attorney fees, will be allocated by the arbitrator. Confidentiality and Non-Compete: -5- For valuable consideration and as an inducement for entering into this Agreement, IC, agrees not to disclose trade secrets, client lists, vendor lists or other confidential material, and agrees to retain said information as confidential, and agrees not to disclose same to any third party, without the prior written consent of Brooklyn Letters and further agrees to make every reasonable effort to prevent accidental disclosure. The IC agrees not to solicit or engage in providing any additional services to clients by IC or other third party, without permission from Brooklyn Letters for one year after termination of the Agreement, while the IC is performing services under this Agreement or is at any of the client locations. The IC agrees that for one year after this termination of this Agreement he/she will not knowingly solicit entities or individuals who serve as independent contractors for Brooklyn Letters. The IC can’t copyright the language in this independent contract for his or her own business when hiring his or her own independent contractors. Upon the termination of this agreement, the IC agrees to: (a) return to Brooklyn Letters all documents and property of the Company, including but not necessarily limited to: tests, books, drawings, blueprints, reports, manuals, correspondence, customer lists, computer programs, and all other materials and all copies thereof relating in any way to Brooklyn Letters’ business, or in any way obtained by him/her during the course of the assignment. The IC further agrees that he/ she shall not retain copies, notes or abstracts of the foregoing.
ENTIRE AGREEMENT. This Agreement constitutes the entire contract between the parties. All terms and conditions contained in any other writings previously executed by the parties regarding the matters contemplated herein shall be deemed to be merged herein and superseded hereby. No modification of this Agreement shall be deemed effective unless in writing and signed by the parties hereto.
WAIVER OF BREACH. The waiver of a breach of any provision of this Agreement by either party shall not operate or be construed as a waiver of any subsequent breach. SEVERABILITY. If any provision of this Agreement shall be held to be invalid or unenforceable for any reason, the remaining provisions shall continue to be valid and enforceable. If a court finds that any provision of this Agreement is invalid or unenforceable, but that by limiting such provision it would become valid and enforceable, then such provision shall be deemed to be written, construed, and enforced as so limited. Notices. Any notices required or permitted to be sent under this Agreement, shall be delivered in person or by overnight courier service or overnight mail, charges prepaid to the following addresses ( or to any other addresses that either party permits in advance and in writing to the other party): If to Brooklyn Letters: Brooklyn Letters Speech and Language Pathology, PLLC Attention: Craig Selinger 1134 Prospect Avenue, #2i Brooklyn, NY 11218 If to : Name Address Amendment; Waiver: No amendment or waiver by any holder shall be binding unless in writing. Descriptive Headings and Language: The descriptive headings used herein are for convenience of reference only and they are not intended to have any effect whatsoever in determining the rights or obligations under this Agreement.
APPLICABLE LAW. This Agreement shall be governed by the laws of the State of New York.
SIGNATORIES. This Agreement shall be signed by Craig Selinger, Member on behalf of Brooklyn Letters Speech Language Pathology PLLC and by . This Agreement is effective as of the date first above written.
IN WITNESS WHEREOF the undersigned have executed this Agreement as of the day and year first written above. The parties hereto agree that this Agreement may be executed in counterparts and facsimile or email signatures shall be as effective as if originals.
RECIPIENT: Brooklyn Letters Speech Language Pathology PLLC By: Craig Selinger Member
By: Print Name
and title (see below about Covid Waiver)
If you provide in-homes services, you are required to fill out this waiver below.
Waiver and Release of Liability Page 1 of 2
WAIVER AND RELEASE OF LIABILITY
IN CONSIDERATION OF the risk of illness or injury from Covid 19 that exists while participating in for (hereinafter the "Service"); and
AND IN CONSIDERATION OF my choice for myself or my child/dependent to participate in said Service and being given the right to participate in same;
I HEREBY, for myself, my heirs, executors, administrators, assigns, or personal representatives (hereinafter collectively, "Releasor," "I" or "me", which terms shall also include Releasor's parents or guardian if Releasor is under 18 years of age), knowingly and voluntarily enter into this WAIVER AND RELEASE OF LIABILITY and hereby waive any and all rights, claims or causes of action of any kind arising out of my participation in the Service; and
I HEREBY release and forever discharge Brooklyn Letters SLP PLLC, located in Brooklyn Letters, New York, their affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors and assigns (collectively "Releases"), from any physical or psychological injury that I may suffer as a direct result of participation in the aforementioned Service.
I AM VOLUNTARILY PARTICIPATING IN THE AFOREMENTIONED SERVICE AND I AM PARTICIPATING IN THE SERVICES ENTIRELY AT MY OWN RISK. I AM AWARE OF THE RISKS ASSOCIATED WITH PARTICIPATING IN THIS SERVICE DUE TO COVID-19, WHICH MAY INCLUDE, BUT ARE NOT LIMITED TO: PHYSICAL OR PSYCHOLOGICAL INJURY, PAIN, SUFFERING, ILLNESS, TEMPORARY OR PERMANENT DISABILITY, ECONOMIC OR EMOTIONAL LOSS, AND DEATH. NONETHELESS, I ASSUME ALL RELATED RISKS, BOTH KNOWN AND UNKNOWN TO ME OR THE RELEASEE, DUE TO MY PARTICIPATION IN THIS SERVICE.
Waiver and Release of Liability Page 2 of 2
I FURTHER AGREE to indemnify, defend and hold harmless the Releasees against any and all claims, suits or actions of any kind whatsoever for liability, damages, compensation or otherwise brought by me or anyone on my behalf, including attorney's fees and any related costs.
I FURTHER ACKNOWLEDGE that Releases are not responsible for errors, omissions, acts or failures to act of any party or entity conducting a specific service or activity on behalf of Releases.
I HEREBY ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS 'WAIVER AND RELEASE" AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY.
EXPRESSLY AGREE TO RELEASE AND DISCHARGE Brooklyn Letters SLP PLLC AND ALL OF ITS AFFILIATES, MANAGERS, MEMBERS, AGENTS, ATTORNEYS, STAFF, VOLUNTEERS, HEIRS, REPRESENTATIVES, PREDECESSORS, SUCCESSORS AND ASSIGNS, FROM ANY AND ALL CLAIMS OR CAUSES OF ACTION AND I AGREE TO VOLUNTARILY GIVE UP OR WAIVE ANY RIGHT THAT I OTHERWISE HAVE TO BRING A LEGAL ACTION AGAINST Brooklyn Letters SLP PLLC FOR PERSONAL INJURY OR ILLNESS.
I agree that this Release shall be governed for all purposes by New York State law, without regard to any conflict of law principles. This Release supersedes any and all previous oral or written promises or other agreements.
THIS WAIVER AND RELEASE OF LIABILITY SHALL REMAIN IN EFFECT FOR THE DURATION OF MY PARTICIPATION IN THE SERVICE, DURING THIS INITIAL AND ALL SUBSEQUENT SERVICES.
Name Brooklyn Letters SLP PLLC
Company Name if Applicable
Please read the attached COVID-19 Reopening Safety Plan and verify that you have read it in its entirety and will abide by its provisions. *
COVID-19 Reopening Safety Plan Page 1 of 4
Name of Business: Brooklyn Letters SLP PLLC
Industry: Tutoring/Educational Support Services. NAICS Code 611710
Address: 1139 Prospect Avenue. #21, Brooklyn NY 11218
Owner/Manager of Business: Craig D. Selinger
X - Ensure 6 ft. distance between clients, unless safety or core function of the work activity requires a shorter distance.
X - Any time clients are less than 6 ft. apart from independent contractors, both must wear acceptable face coverings.
X - Tightly confined spaces will be occupied by only one individual at a time. unless all occupants are wearing face coverings.
X - While services are conducted in the home or in small spaces, and occupied by more than one person, both the independent contractor and clients will keep occupancy to only those necessary for the purpose of the services being provided.
X - Make every effort to set up work space for services being provided 6 ft. from other commonly used areas.
X - Limit in-person gatherings as much as possible and use tele- or video-conferencing whenever possible.
X - Essential in-person gatherings (e.g. meetings) should be held in open, well-ventilated spaces with appropriate social distancing among participants.
COVID-19 Reopening Safety Plan Page 2 of 4
X - Limit contact to the extent possible in the exchange of all physical items necessary for the services being provided.
List common situations that may not allow for 6 ft. of distance between individuals. In the providing of services it may be necessary for the independent contractor, clients, and/or family members to make observations or assist in implementing services in close proximity to one another in order to properly and adequately facilitate said services.
What measures will you implement to ensure the safety of your independent contractors in such situations? Educate that all services should be provided cautiously in a way that is intended to keep both the independent contractor and client safe; to wear safety masks; to wash hands when entering. exchanging physical items in the facilitation of the services, and when leaving the session: wearing gloves when appropriate.
X - Independent contractors must provide themselves with an acceptable face covering at no-cost to Brooklyn Letters SLP PLLC and have an adequate supply of coverings in case of replacement.
How will you procure these supplies? Independent contractors will be responsible for all personal procurement of such supplies.
X - Face coverings must be cleaned or replaced after use or when damaged or soiled. may not be shared, and should be properly stored or discarded.
What policy will you implement to ensure that PPE is appropriately cleaned, stored, and/or discarded? Independent contractors will provide clients and family members with their individual policies in regard to the use and care of PPE.
X - Limit the sharing of objects and discourage touching of shared surfaces; or, when in contact with shared objects or frequently touched areas, wear gloves (trade-appropriate or medical); or. sanitize or wash hands before and after contact.
List common objects that are likely to be shared between independent contractors.
COVID-19 Reopening Safety Plan Page 3 of 4
Independent contractors will determine on a case-by-case basis what common objects will be necessary for the facilitation of services.
What measures will you implement to ensure the safety of your independent contractors when using these objects? Independent contractors will provide clients and family members with their individual policies in regard to how such common items will be used/shared during the implementation of services.
X - Independent contractors will adhere to hygiene and sanitation requirements from the Centers for Disease Control and Prevention (CDC) and Department of Health (DOH) and maintain their own independent cleaning logs on their person that document date, time, and scope of cleaning of any items used in the implementation of the services.
X - Independent contractors will provide and maintain hand hygiene products for themselves and clients, including handwashing with soap, water, and paper towels, or an alcohol-based hand sanitizer containing 60% or more alcohol for areas where handwashing is not feasible.
Where on the work location will you provide independent contractors with access to the appropriate hand hygiene and/or sanitizing products and how will you promote good hand hygiene? Independent contractors will be responsible for educating their clients and families on the importance of good hand hygiene and will provide such products at each session.
X - Independent contractors will provide clients and families with a consistent means to provide updated information.
X - Independent contractors will maintain a continuous log of every person, including clients and visitors. who may have close contact with other individuals at the location of services during the timeframe of services; excluding deliveries to the location during said services that are performed with appropriate PPE or through contactless means. Said log will be kept at the individual office location(s) of the independent contractors.
X - If an independent contractor tests positive for COVID-19, the independent contractor must immediately notify Brooklyn Letters SLP PLLC, the client and client's family members (if the client is a minor), and state and local health departments and cooperate with contact tracing
COVID-19 Reopening Safety Plan Page 4 of 4
efforts, including notification of potential contacts, such as delivery personnel, critical care workers of the client, or visitors who had close contact with the individual, while maintaining confidentiality required by state and federal law and regulations.
X - At the beginning of each session, independent contractors will ask the following in regard to the client and family members of the client who live in the home: (1) COVID-19 symptoms in past 14 days, (2) positive COVID-19 test in past 14 days, and/or (3) close contact with confirmed or suspected COVID-19 case in past 14 days.
X - Independent contractors will maintain such documented reviews.
What type(s) of daily health and screening practices will you implement? Independent contractors will cancel any and all sessions if he or she feels any symptoms of illness. Independent contractors will review and follow the daily guidelines set forth by the CDC: pttos-//www.cdc,00v/coronavinis/2019-ncovklailv-life-coninalchecklist-household-readv.html
X - Independent contractors will have a plan for cleaning, disinfection, and contact tracing in the event of a positive case and report to any clients, family members, close contacts and other required authorities per CDC guidelines.
To ensure that independent contractors stay up to date on the guidance that is being issued by the State, her or she will:
X - Consult the NY Forward website at forward.ny.gov and applicable Executive Orders at govemor.ny.gov/executiveorders on a periodic basis or whenever notified of the availability of new guidance.
If you WILL NOT be able to abide by one or more of the provisions of the COVID-19 Reopening Safety Plan, please state such provisions.
If you WILL NOT be able to abide by one or more of the provisions of the COVID-19 Reopening Safety Plan, please state which such provisions.
Yes, I hereby consent to my typed signature below to act as an electronic signature for the Waiver and Release of Liability and COVID-19 Reopening Safety Statement included herein. *
Type Full Name as Electronic Signature *
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Document Name: BKL IC SLP Agreement 2020-2021 2x with COVID Waiver
Agree & Sign