Spreadsheet: 33d7c541-cb5d-44ef-85c1-a28226e04982
Sheet: Sheet1

PERSONAL SERVICES CONTRACT | Unnamed: 1 | Unnamed: 2 | Unnamed: 3 | PSC# (B/O Use Only) | Unnamed: 5 | Unnamed: 6 | Unnamed: 7 | Unnamed: 8
Whitman College Business Office |  |  |  | Contractor
(Not to be used when required to compensate a person as an employee through payroll.)
This agreement is entered into this |  |  |  | day of |  | 20 |  | by and between Whitman College,
hereinafter called the College, and |  |  |  |  |  |  |  | , hereinafter called the Contractor.
Whereas the College has need for the professional services of a business with the necessary expertise,
ability, and experience.  Now, therefore, in consideration fo the sum of  $
to be paid to the Contractor by the College, the Contractor agrees to perform during the period
 | 20 |  | through |  |  | 20 |  | inclusive, the following personal and/or
professional services for the following purpose:
In performing the above services it is understood and agreed that:
1) |  | The Contractor is engaged as an independent contractor and will be responsible for
 |  | any federal or state taxes applicable to this statement.
2) |  | The Contractor will not be eligible for any federal Social Security, and may not be
 |  | eligible for industrial accident or unemployment insurance benefits from this
 |  | contract, except as a self-employed individual.
3) |  | If this payment is to be charged against federal funds, the Contractor certifies that
 |  | he or she is not currently employed by the federal government and the amount
 |  | charged does not exceed the normal charge for the type of service performed.
4) |  | The College will report the total amount of all payments applicable, including any
 |  | expenses, in accordance with Federal Internal Revenue Service rules.
5) |  | The College will not assume any liability for damage or loss of property belonging to
 |  | the Contractor.
This contract and any amendments to this contract will not be effective until approved by the
Department Administrator.
Contractor
Signed |  |  |  |  |  | TIN or Social Security Number Required
Name (Print or Type) |  |  |  |  |  | UBI (Business License Number)
Mailing Address |  |  |  |  |  | L & I Account Number
City, State, Zip |  |  |  |  |  | Contractor Number
Is the Contractor a Sole Proprietor? |  |  |  |  |  | ____Yes | ____No
College
Department Administrator |  |  |  |  |  | Date
To effect payment, a copy of this form, when approved, must be sent to the Business Office with
a Vendor Payment Authorization form.
PERSONAL SERVICES CONTRACT
WHITMAN COLLEGE
PAGE 2
A Contractor who satisfies all six of the following requirements will generally be considered an independent
Contractor and may be excluded from; workers' compensation (L&I coverage), unemployment compensation
coverage as well as regular employee federal income tax withholding and Social Security benefits.
If any "no" responses, the Business Office must review and make a determination.
Circle One
Yes | No | 1 | He or she is free from control and direction over the performance of the services
 |  |  | AND
Yes | No | 2 | The service provided is outside the usual course of business OR it is performed
 |  |  | outside all of the places of business of the hiring enterprise OR the hired
 |  |  | individual is responsible, both under the contract and in fact, for the costs of the
 |  |  | principal place of business from which the service is performed
Yes | No | 3 | The individual is engaged in an independently established trade of the same
 |  |  | nature as the contract, OR the individual has a principle place of business
 |  |  | eligible for IRS business deduction, AND
Yes | No | 4 | The individual is responsible for filing a schedule of expense and income with
 |  |  | the IRS for the business, AND
Yes | No | 5 | On the effective date of contract or within a reasonable period, has established
 |  |  | required accounts with state agencies, AND
Yes | No | 6 | The individual maintains a separate set of books and records that reflect items of
 |  |  | income and expense for the business
Contractor or business name:
Will this service be performed on the Whitman College campus? |  |  |  |  |  | Yes | No | (circle one)
If no, [NAME] does not need to provide L & I account number and does not complete the time
sheet below.
If yes, does the Contractor provide L & I coverage for all persons working under this contract?  If so,
provide the Labor & Industries account number
If no, the Contractor must complete the following time reporting section in order to receive coverage by
Whitman College.
Days of the Month
Hours Reported
Days of the Month
Hours Reported
Contractor Signature |  |  |  |  |  |  | Date
GL Account Number for Worker's Comp