Create ShopperAgreement

Shopper Agreement

This Agreement (“Agreement”) is between the specified person (“Contractor”) and Consultants for Long Term Care, Inc. (“CLTC”). It sets forth the terms and conditions whereby, at CLTC’s request, Contractor shall conduct a mystery shopping assignment(s), hereinafter “Assignment(s)”, as an independent contractor of CLTC, as may be mutually scheduled by CLTC and Contractor on behalf of CLTC's client ("Client").

Contractor acknowledges and agrees that he/she (please check the boxes):

Has never filed legal action against a senior living property;

Has no criminal conviction or current charges for any felony offense, or for any misdemeanor offense related to theft, deception or abuse, neglect or exploitation against any person;

Has no communicable or contagious disease, or any health condition that may be harmful to other persons;

Shall not perform an Assignment(s) under the influence of illegal drugs, alcohol, medications or any substance that might impair one's abilities or conduct;

Shall conduct oneself with appearance, language and behavior that is appropriate and respectful;

If Contractor is going to operate a vehicle to perform an Assignment(s), has a valid driver's license and automobile insurance (including liability coverage), and understands that a copy of both must be provided to CLTC upon request prior to performing any Assignment(s);

Is available to perform an Assignment(s) between 9:00 am-4:00 pm local time on non-holiday weekdays, unless mutually scheduled by CLTC and Contractor;

Has legal permission and access to the internet to complete the online mystery shop questionnaire(s); and,

Has the ability to scan or save documents as a PDF, then upload to the online mystery shop questionnaire(s).

Contractor acknowledges and agrees that he/she shall (please check the boxes):

Review and comply with all provisions of this Agreement and the instructions provided by CLTC;

Follow CLTC's assigned scenario in performing the Assignment(s);

By CLTC's specified deadline, conduct the required telephone call(s) and on-site tour(s) with the assigned senior living property(ies), and complete the associated online mystery shop questionnaire(s); and,

Respond to all Assignment(s)-related communication from CLTC in a timely manner.

Contractor acknowledges and agrees that (please check the boxes):

For services rendered, CLTC agrees to pay Contractor the confirmed fee for the completed Assignment(s). If Contractor fails to submit the online mystery shop questionnaire(s) by the stipulated deadline, or fails to comply with any other provision of this Agreement, CLTC shall withhold payment until all matters are satisfactorily resolved.

Contractor acknowledges and agrees that he/she (please check the boxes):

Understands this Agreement solely creates an independent contractor relationship and he/she shall provide services hereunder only as an independent contractor;

Shall be solely responsible for any payments and filings under applicable federal, state or local laws and regulations concerning all matters related to taxes, FICA, worker's compensation, unemployment compensation, self-employment taxes and any other government programs, and further agrees to hold CLTC and Client harmless from any and all related liability;

Assumes all risks and accepts sole responsibility for any injury (including, but not limited to, personal injury, disability and death), illness, damage, loss, claim, liability or expense that Contractor may experience or incur in connection with providing services hereunder, including but not limited to, all transportation and while conducting the on-site tour. Contractor hereby releases, covenants not to sue, discharges, and holds harmless the employees, agents and representatives of CLTC and Client, of and from any such claims, including all liabilities, claims, actions, damages, costs, or expenses of any kind arising out of or relating thereto;

Shall not disclose any information learned or solicited by him/her to any other person, third party or government agency, unless such disclosure is required by law, and further agrees that all information and access that he/she shall be provided are confidential and proprietary in nature. Contractor shall immediately contact CLTC regarding any related questions or concerns that may arise;

Shall not disclose to the assigned senior living property(ies) that he/she is conducting the Assignment(s); and,

Understands this Agreement constitutes the entire arrangement between the parties and there are no other agreements or understandings, written or oral, between them. It may mutually be modified only in writing executed by CLTC and Contractor.

First Name*

Middle Initial*

Last Name*

Mailing Address*

City*

State*

Zip Code*

Email*

Cell Number*

LinkedIn Profile

Shop location(limit of five)*

Shop Websites That You Check For Jobs (Click + to add new)

Website

Names & Emails Of Other Potential Shoppers (Click + to add new)

First & Last Name

Summarize your mystery shopping qualifications, including number of years, training/certifications, and experience with senior living community, hotel and/or apartment assignments. If none, explain why you’d be a great mystery shopper.*

Upload a current and valid government-issued photo ID*

Drop files here or click to upload.