KCS In-Home Care Services, LLC.
Client: Responsible Person:
_________________________________ _____________________________________
Address: Address:
_______________________________ ______________________________________
City__________ State___ Zip_______ City_________________ State___ Zip_______
Home Phone _________ Cell _________ Home Phone ____________ Cell ____________
Signature __________________________ Signature _______________________________
Service Invoices will be mailed to: (Address, City, State, Zip. Code) ______________________________________________________________________________________________________________________________________.
Desires to enter into Service Contract Agreement with _________________________ (agency)
The following non-medical and Home Care Giving services:
SERVICES TO BE PROVIDED
☐Meal Preparation and Feeding
☐Bathing and Personal Care and Grooming
☐Light Housekeeping
☐Bedside Care for minor temporary illness
☐Errands and Groceries
☐Medication Supervision and Dispensing
☐Day shifts
☐Long term care and short term care
Rates:
$ ____25______ per hour (minimum 4 hours a day)
$_____________ per day
$_____________ 24 Hour care (contingent upon services rendered)
Starting Date of Services: From ____March 18. 2019_________ to _____March 21, 2019____________
Rates are subject to change upon 7 days of notice depending on the actual level of care and services required, as assessed by the actual Caregiver. KCS in Home Care will provide a reliever on the day offs, if applicable.
PAYMENT
Payment options:
____ Bi- Monthly Payment The payment is twice a month, every two weeks in a month. Payment will be due on the 15th and the 30th of every month, (exception Feb. payment due On the 28th of month.) The first (2) two weeks payment shall be due at the time of signing this Service Agreement contract and considered as the advance payment. _____ (initial)
_____ Weekly Payment The payment is once a week. The billing cycle is on every Friday of the week. The first (1) week payment shall be due at the time of signing this Service agreement Contract and considered as the advance payment. _____ (initial).
The check for the payment can be mailed to:
____ Mailed to: KCS In-Home Care, LLC. 6105 Hyattsville, MD 20781
Or
____Submitted by hand to Owner of KCS in Home Care LLC, Kathryn Spann
REFUNDS
Any refunds shall be prorated based on a daily basis from the notice of termination of contract.
PIRATING CLAUSE
Pirating practices or hiring the caregiver directly and secretly, inside this agreement is strictly prohibited. In the event that the undersigned, family, or anyone directly in relation to the client, secretly hires the agency’s caregiver in the absence of any written notice whatsoever, the action will be considered a breach of contract. A fee of $10,000 will be due based upon the financial losses to business and opportunities caused by the violation. A direct violation of this clause will be considered a breach of contract and will be given to our legal counsel for the due legal process of attention and collection. _____ (initial)
DIRECT HIRING CLAUSE
In the event that the undersigned desires to hire the agency caregiver directly within the said written agreement, the undersigned is required to give a written 7 days’ notice of the request addressed to the agency and agrees to the pay the referral fee equivalent to two (2) months’ pay or two (2) months service contract. Said payment will be given upon the direct hiring of the caregiver. If the undersigned fails to pay and remit the payment within seven (7) working days,
The non-payment will be given to our legal counsel for the due legal process of attention and collection. ______ (initial)
LIMITATION OF LIABILITY.
The provider shall work with partners, contractors, employees, venders and affiliates to offer the undersigned the best services. Undersigned shall not hold the provider liable for any loss and/or damages caused by the partners, contractors, employees, venders and affiliates while they perform their obligations. The aforementioned associates shall take full responsibility in case of any loss and/or damages caused. The undersigned shall indemnify provider against any loss and/or damage claims caused by the partners, contractors, employees, venders and affiliates.
TERMINATOR OF SERVICES
In the event that the undersigned desires to terminate the Services provided under this contract, the undersigned agrees to give the agency seven (7) days advance notice. ______ (initial) CLIENT In the event of termination caused by the death of the client within seven (7) days upon the start of service, there shall be a 50% refund of the said payment. ______ (initial)
COMPLIANCE WITH COVID-19 REGULATION.
Due to the health risks posed by Covid-19, the undersigned understands that they shall be responsible with complying with the regulations set by the World Health Organization which include but are not limited to using a sanitizer all the time, wearing a mask while in the company of others and keeping distance. The undersigned shall not hold the provider liable in the event they contract covid-19 while engaging with the provider unless such events are as a result of the provider’s negligence. The provider may provide the undersigned with special accommodation in case the undersigned contracts covid-19. The undersigned agrees to indemnify the provider against any and all claims that may arise relating to contracting covid-19 while the performing their obligations under this Agreement.
INDEMNIFYING CLAUSE
The undersigned fully understands that the provider (a) is a non-medical provider, (b) is not licensed to perform medical services, and (c) the undersigned, indemnify, jointly, and severally hereby forever release, discharge, acquit, and forgive any and all claims, actions, suits, demands, liabilities, judgment, and proceedings both at law and in equity, arising from the beginning of time to the date of termination of this agreement with the Agency Provider, such are caused directly by the negligent acts or omissions by the above items and “Services” and the “agency caregivers” and which result in bodily injury or property damage. This release shall be binding upon insured to benefit the parties, their successors, assigns and personal representatives. ______ (initial) ATTORNEY’S FEES
In any cases of any litigation, in prevailing party the “Agency Provider” shall recover the cost and attorney’s fees arising from any lawsuits brought against the agency. ______ (initial)
GOVERNING LAW.
This Agreement shall be governed by and construed in accordance with the laws of the ____________ [State/Country]. Exclusive jurisdiction and venue shall be in _____________ [State/Country].
The undersigned has read, fully understood and by signing below, accepts the terms of this Service Agreement Contract.
_______________________________ BY: ________________________ Signature of responsible party of client (Care Provider Agency) (or Client’s legal representative)
___________________ Date (Day/Month/Year)
KCS In-Home Care Services, LLC.
Client: Responsible Person:
_________________________________ _____________________________________
Address: Address:
_______________________________ ______________________________________
City__________ State___ Zip_______ City_________________ State___ Zip_______
Home Phone _________ Cell _________ Home Phone ____________ Cell ____________
Signature __________________________ Signature _______________________________
Service Invoices will be mailed to: (Address, City, State, Zip. Code) ______________________________________________________________________________________________________________________________________.
Desires to enter into Service Contract Agreement with _________________________ (agency)
The following non-medical and Home Care Giving services:
SERVICES TO BE PROVIDED
☐Meal Preparation and Feeding
☐Bathing and Personal Care and Grooming
☐Light Housekeeping
☐Bedside Care for minor temporary illness
☐Errands and Groceries
☐Medication Supervision and Dispensing
☐Day shifts
☐Long term care and short term care
Rates:
$ ____25______ per hour (minimum 4 hours a day)
$_____________ per day
$_____________ 24 Hour care (contingent upon services rendered)
Starting Date of Services: From ____March 18. 2019_________ to _____March 21, 2019____________
Rates are subject to change upon 7 days of notice depending on the actual level of care and services required, as assessed by the actual Caregiver. KCS in Home Care will provide a reliever on the day offs, if applicable.
PAYMENT
Payment options:
____ Bi- Monthly Payment The payment is twice a month, every two weeks in a month. Payment will be due on the 15th and the 30th of every month, (exception Feb. payment due On the 28th of month.) The first (2) two weeks payment shall be due at the time of signing this Service Agreement contract and considered as the advance payment. _____ (initial)
_____ Weekly Payment The payment is once a week. The billing cycle is on every Friday of the week. The first (1) week payment shall be due at the time of signing this Service agreement Contract and considered as the advance payment. _____ (initial).
The check for the payment can be mailed to:
____ Mailed to: KCS In-Home Care, LLC. 6105 Hyattsville, MD 20781
Or
____Submitted by hand to Owner of KCS in Home Care LLC, Kathryn Spann
REFUNDS
Any refunds shall be prorated based on a daily basis from the notice of termination of contract.
PIRATING CLAUSE
Pirating practices or hiring the caregiver directly and secretly, inside this agreement is strictly prohibited. In the event that the undersigned, family, or anyone directly in relation to the client, secretly hires the agency’s caregiver in the absence of any written notice whatsoever, the action will be considered a breach of contract. A fee of $10,000 will be due based upon the financial losses to business and opportunities caused by the violation. A direct violation of this clause will be considered a breach of contract and will be given to our legal counsel for the due legal process of attention and collection. _____ (initial)
DIRECT HIRING CLAUSE
In the event that the undersigned desires to hire the agency caregiver directly within the said written agreement, the undersigned is required to give a written 7 days’ notice of the request addressed to the agency and agrees to the pay the referral fee equivalent to two (2) months’ pay or two (2) months service contract. Said payment will be given upon the direct hiring of the caregiver. If the undersigned fails to pay and remit the payment within seven (7) working days,
The non-payment will be given to our legal counsel for the due legal process of attention and collection. ______ (initial)
LIMITATION OF LIABILITY.
The provider shall work with partners, contractors, employees, venders and affiliates to offer the undersigned the best services. Undersigned shall not hold the provider liable for any loss and/or damages caused by the partners, contractors, employees, venders and affiliates while they perform their obligations. The aforementioned associates shall take full responsibility in case of any loss and/or damages caused. The undersigned shall indemnify provider against any loss and/or damage claims caused by the partners, contractors, employees, venders and affiliates.
TERMINATOR OF SERVICES
In the event that the undersigned desires to terminate the Services provided under this contract, the undersigned agrees to give the agency seven (7) days advance notice. ______ (initial) CLIENT In the event of termination caused by the death of the client within seven (7) days upon the start of service, there shall be a 50% refund of the said payment. ______ (initial)
COMPLIANCE WITH COVID-19 REGULATION.
Due to the health risks posed by Covid-19, the undersigned understands that they shall be responsible with complying with the regulations set by the World Health Organization which include but are not limited to using a sanitizer all the time, wearing a mask while in the company of others and keeping distance. The undersigned shall not hold the provider liable in the event they contract covid-19 while engaging with the provider unless such events are as a result of the provider’s negligence. The provider may provide the undersigned with special accommodation in case the undersigned contracts covid-19. The undersigned agrees to indemnify the provider against any and all claims that may arise relating to contracting covid-19 while the performing their obligations under this Agreement.
INDEMNIFYING CLAUSE
The undersigned fully understands that the provider (a) is a non-medical provider, (b) is not licensed to perform medical services, and (c) the undersigned, indemnify, jointly, and severally hereby forever release, discharge, acquit, and forgive any and all claims, actions, suits, demands, liabilities, judgment, and proceedings both at law and in equity, arising from the beginning of time to the date of termination of this agreement with the Agency Provider, such are caused directly by the negligent acts or omissions by the above items and “Services” and the “agency caregivers” and which result in bodily injury or property damage. This release shall be binding upon insured to benefit the parties, their successors, assigns and personal representatives. ______ (initial) ATTORNEY’S FEES
In any cases of any litigation, in prevailing party the “Agency Provider” shall recover the cost and attorney’s fees arising from any lawsuits brought against the agency. ______ (initial)
GOVERNING LAW.
This Agreement shall be governed by and construed in accordance with the laws of the ____________ [State/Country]. Exclusive jurisdiction and venue shall be in _____________ [State/Country].
The undersigned has read, fully understood and by signing below, accepts the terms of this Service Agreement Contract.
_______________________________ BY: ________________________ Signature of responsible party of client (Care Provider Agency) (or Client’s legal representative)
___________________ Date (Day/Month/Year)
At Legal writing experts, we would be happy to assist in preparing any legal document you need. We are international lawyers and attorneys with significant experience in legal drafting, Commercial-Corporate practice and consulting. In the last few years, we have successfully undertaken similar assignments for clients from different jurisdictions. If given this opportunity, The LegalPen will be able to prepare the legal document within the shortest time possible. You can send us your quick enquiry ( here )