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Employment Screening Services Subscriber Agreement
Please print,
sign and Fax Completed Document to South Fl office at (305)
852.6010.
1.
Company/ Employer Name
____________________________________________________
2.
Company web site URL:www.___________________________________________________
3. Name
and Title of Company Representative
____________________________________
4.
E-Mail address of Company Representative
____________________________________
5.
Employer Federal ID#
________________________________________________________
6.
Employer's Street Address:
___________________________________________________
7.
City: _________________________________State:____________Zip:
_________________
8.
Phone: ( ___ )_____________________________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 all Other legally permissible records 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
The
undersigned Company ("End User") has entered into an agreement with
National Employment Screening DBA Premium Background
Checks/Background Check Services/Global Tenant Screening 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), driving records, criminal background checks, social security
information 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:
13. A.
End User (Employer) agrees not to resell or otherwise distribute any
Credit Reports to any third party except as required by law.
14. 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.
15.
C. End User/Company understands its obligations under the federal
Fair Credit Reporting Act ("FCRA"), the Americans With
Disabilities Act ("ADA"), and applicable state laws in ordering and
using Credit Reports for employment and other purposes, will comply with
all such obligations, and will be responsible for its own regulatory
compliance. End user may access a copy of the Federal Trade Commission's
"Notice to Users of Consumer Reports: Obligations of Users Under the
FCRA" by
clicking here and Chapter Nine of
Technical Assistance Manual for the ADA.
16.
D. End User certifies that it will order Credit Reports solely for
employment purposes and for no other purpose unless End User
specifically notifies Provider that End User intends to use Credit
Reports for another purpose. In such case, End User certifies that it
will use the Credit report solely for the other permissible purpose
indicated in its order and for no other purpose.
17.
E. In connection with ordering Credit Reports for employment purposes,
End User agrees:
A.
End User is ordering Credit Reports solely for employment purposes,
and will not use the Credit Reports for any other purpose.
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.
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.
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.
E.
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.
F.
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.
18. ALL
CREDIT, CRIMINAL AND PUBLIC RECORDS REPORTS ARE PROVIDED "AS IS."
NATIONAL EMPLOYMENT SCREENING/PREMIUM BACKGROUND CHECKS/BACKGROUND CHECK SERVICES/GLOBAL TENANT SCREENING THE PROVIDER(S) 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/NATIONAL EMPLOYMENT SCREENING AND AFFILIATED COMPANIES
EXPRESSLY DISCLAIMS ALL SUCH REPRESENTATIONS AND WARRANTIES.
19. Provider
National Employment Screening and or it's affiliated companies
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.
20. End
User/Employer/Company indemnifies, agrees to defend, and holds harmless
National Employment Screening 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/Employer of any of its representations, warranties, or agreements
in this agreement.
21.
End User will pay Provider directly for Provider's charges in connection
with all 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.
22.
Provider may assign this agreement and all of its rights and obligations
hereunder to any of its affiliates or designees 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.
23.
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.
24.
Termination of this agreement will not effect any obligations arising
prior to the effective date of termination with limitations of
liabilities set forth above.
25.
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 Employer/Company/ End User:
Agreed to
by: ___________________________________________Title _____________________
(please print)
Company
Name (Employer) _______________________________________________________
Address:
___________________________________City___________ State ____Zip__________
Signature
__________________________________________ Date________________________
Accepted by
NES (Provider):
___________________________________________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.
None of
the information in this web site should be construed as legal or
insurance advice. All forms, policies, terms, information and
procedures should be reviewed by your legal counsel before being
used in any way.
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