THIS SERVICE AGREEMENT,Hereinafterreferredtoas Agreement , Ismadethisnnth Dayofmonth

THIS SERVICE AGREEMENT,Hereinafterreferredtoas Agreement , Ismadethisnnth Dayofmonth

THIS SERVICE AGREEMENT,hereinafterreferredtoas“Agreement”,ismadethisNNth dayofMONTH, 20YY,byandbetweenTheBoardofRegentsoftheUniversitySystemofGeorgiabyandonbehalfof ValdostaStateUniversity,locatedat1500North PattersonStreet,Valdosta,Georgiahereinafterreferredtoasthe“VSU”and SUPPLIER'S FULL LEGAL NAME, hereinafter referred to as “Supplier”. VSU and Supplier shall be jointly hereinafter referred to as “parties”.

WHEREAS,VSU desiresto have Suppliertoprovide certain professionalservicesatthedates and times set forth below, and in accordance with the terms, conditions and specifications provided or incorporatedherein; and

NOWTHEREFORE,in considerationofthemutualagreementsandcovenantshereinafterset forth,andforothergoodandvaluableconsideration,thereceipt,adequacyand sufficiencyof whichare hereby acknowledged,thepartiesdoherebycovenantand agree as follows:

  1. ScopeofWork.
  1. Term of Service.

Service Start Date: / MM/DD/YYYY / Service End Date: / MM/DD/YYYY
  1. Fee for Supplier’s Services Rendered.
  1. Payment Terms.

***NOTE: Unless other payment arrangements are made, such as monthly or quarterly payments, the following payment terms should be used. Delete this note after editing.***

VSU will remit payment to Supplier within thirty (30) calendar days after (i)VSU’s receipt and acceptance of an undisputed invoice; or (ii) Supplier's completion of all services under the Scope of Work and Supplier's Responsibilities sectionsof this Agreement, whichever is later.

  1. Supplier’s Responsibilities.

Supplierwill:

***NOTE: List or describe all specific tasks, responsibilities, project benchmarks, and other obligations the Supplier is required to deliver or perform under this Agreement. Delete this note after editing. ***

  1. VSU’s Responsibilities.

VSUwill:

***NOTE: List or describe VSU's responsibilitiesunder this Agreement. Suggested items are provided below. Delete this note after editing. ***

1. Pay Supplier the Fee for Supplier's Services Rendered in accordance with the terms, conditions, and specifications of this Agreement.

2. Provide access to those VSU facilities and/or properties reasonably necessary for Supplier to carry out Supplier's responsibilities under this Agreement.

  1. IndependentContractorStatus.

Suppliershallnotbedeemedtobecomeanagent,servant,oremployeeoftheStateofGeorgia,andin particular VSU. Suppliershallforallpurposesbedeemedtobeanindependentcontractor,andthis Agreement shallnotbeconstruedsoastocreateapartnershiporjointventurebetweenSupplierandthe State ofGeorgiaoranyofitsagencies. Consequently,Supplierisresponsibleforallapplicablefederaland stateregulationsrelatingtoincometax,socialsecurity,worker’scompensation andunemployment insurance.

  1. Terms& Conditions.

This Agreement is governed by and subject to any and all applicable federal and state laws, VSU policies, and particularly the Valdosta State University Standard Purchase Order Terms and Conditions, which are incorporated by this reference and may be accessed at the following link:

Signatures on following page.

AGREED and ACCEPTED:

SUPPLIER’S FULL LEGAL NAME
Supplier’s PrintedName
Supplier’s Signature / Date
BUDGET MANAGER'S NAME
BudgetManager’s PrintedName
BudgetManager’sSignature / Date
DEPARTMENT'S NAME
DepartmentReceivingofServices
VSUAccount#:
(Acct#-Fund-DeptID-Program-Class-Project)

ADDITIONAL DOCUMENTS AND SUBMISSION INSTRUCTIONS

In order to process and issue a Purchase Order off of a service agreement using this Service Agreement Form, the following additional documents, if applicable, need to be attached to the Requester’s requisition in ePro along with the complete and signed Service Agreement document:

1.VENDOR FORM: Supplier must submit a complete and signed Vendor Form or already have one on file in order to process payment. The Vendor Form may be accessed at the following link:

2.CONTRACTOR AFFIDAVIT: Supplier must submit a signed and notarized Contractor Affidavit for a Service Agreement that exceeds $2,499.99 and involves Supplier’s physical performance of services within the State of Georgia. However, if a Supplier has no employees and no intention to hire employees, Supplier may submit a copy of Supplier’s driver’s license or state issued ID card in lieu of the Contractor Affidavit. The Contractor Affidavit may be accessed at the following link:

3.DETERMINATION OF STATUS FORM: Human Resources (HR) must determine whether an individual Supplier (rather than a business entity) is eligible for independent contractor status. Therefore, for any service agreement with an individual Supplier, the requesting Department must complete and submit a Determination of Status Form along with the Service Agreement Form to Ernest Smith in HR at prior to signingthe Service Agreement or submitting an ePro request. Upon receipt of a written determination of independent contractor status from HR, the Department may proceed with signatures and submission. The Determination of Status Form may be accessed at the following link:

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