(Person completing these forms or contact person)
- Job Order Recruiter
- Client Company Information
- Candidate Information
Job Order Recruiter
Split Placement Candidate Recruiter Info
Address at work location:
(No PO Boxes)
Many locations throughout the United States have passed laws that require employers to provide mandatory paid sick time to their employees. Top Echelon complies with all State and Municipal Paid Sick and Safe time laws and ordinances. Sick and Safe time rights are specific to the city or state in which the employee works. If your contractor is working in a location that requires mandatory paid sick time, Top Echelon will be providing paid leave to satisfy the sick time requirements. This will reduce your recruiter profit.
Is the Client Company sales tax exempt?
If yes, please fax the exemption certificate or applicable tax exempt document to fax number (330)455-2374
We recommend that the recruiter negotiates a Conversion Fee Agreement directly with the client company so that the recruiter's conversion fee is in place in the event the client would like to hire the candidate as their employee.
A suggested Letter Agreement for Contract Staff Recruiting Services is located here to assist the recruiter in this process.
If necessary, we can accommodate adding the recruiter's conversion fee into our Client Services Agreement.
Please note however, Top Echelon Contracting does not take any responsibility for invoicing a conversion fee or enforcing any conversion fee in our Agreement.
(No PO Boxes)
NOTE: Top Echelon Contracting conducts a drug screen and criminal background
check on every healthcare worker we employ. The cost will be split between Top
Echelon Contracting (30%) and the recruiter (70%). The recruiter's share will be
deducted from his or her first recruiter check from Top Echelon Contracting.
Due to the new healthcare reform, Top Echelon Contracting must adhere to a minimum pay rate. Please contact our office if you anticipate paying the contractor less than $16.00 per hour to discuss.
Indicate if you want the candidate to receive Paid Leave Days.
Note: This will reduce your recruiter commission.
Please include any specific details pertaining to this placement
NOTE: The information provided on these forms is used to generate binding legal documents. Please confirm that all information supplied to Top Echelon Contracting is accurate.