Laserfiche WebLink
110 -23 <br />Contract No. <br />III. FOR CONSULTANTS, PROJECT MANAGERS, PROJECT <br />COORDINATORS <br />1. Is the contractor being hired for a period of time rather than for a ( ) ( ) <br />specific project? <br />2. Will payment be based on a wage or salary (as opposed to a ( ) ( ) <br />commission or lump sum)? <br />IV. FOR PHYSICIANS, PSYCHIATRISTS, DENTISTS, PSYCHOLOGISTS <br />1. Will the agreement be with an individual who does not have an ( ) ( ) <br />outside practice? <br />l.a. Will the contractor work more than an average of ten hours ( ) ( ) <br />per week? <br />IF THE ANSWER TO l.a IS YES, ANSWER QUESTION Lb. <br />l.b. Will the County provide more than 20% of the contractor's ( ) ( ) <br />income? <br />2. If the answer to either question l.a, or if required, question l.b is NO, <br />the entire answer is NO. <br />A "yes" answer to any of the questions in Section II, or, if applicable, Sections III or IV <br />constitutes justification for paying the contractor through the payroll system as an <br />"employee for withholding purposes." <br />CERTIFICATIONS: <br />I hereby certify that the answers to the above questions accurately reflect the anticipated <br />working relationship for this contract. <br />Contractor Signature <br />Lianne Marshall <br />Printed Name <br />Date <br />Agency/Department Head/Designee <br />Signature <br />Alex Briscoe <br />Printed Name <br />Date <br />Page 2 of 2 <br />