Vendors, please complete entire application.
Please fill out the following payment information.
Please fill out the following order information.
I hereby authorize the City of Jacksonville to initiate deposits to the checking account described below:
I hereby authorize the following individual to receive notification via email of payment details of all funds deposited to the above account:
This authority will remain in full force and effect until the City of Jacksonville has received written notification of discontinuation and in such manner as to afford the City of Jacksonville and Depository a reasonable opportunity to act on it.
Whenever the City of Jacksonville retains an independent contractor who does not carry workers’ compensation insurance and the owner or an employee of that contractor is injured, a determination must be made as to whether the injured worker is truly an independent contractor or, in fact, is an employee of the City of Jacksonville. The North Carolina Industrial Commission and North Carolina Courts have used the following tests to make this determination. Please complete the information below for your company.
None of these factors is controlling, but each is to be considered in determining the relationship between the parties.
The essential issue is whether the alleged employer has the right to control the method and means by which the “employee”
performs their work. By choosing yes, you agree to these terms.
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