RCUH Policies and Procedures
REQUEST FOR AN EIC DETERMINATION – INDEPENDENT CONTRACTOR
Instructions: Complete all Yellow boxes and check applicable all boxes in (h). Email your EIC Memo/Attachment to RCUH Human Resources Department at least 7 working days prior to engagement of services ([email protected]).
DATE: 1
TO: Nelson Sakamoto
Director of Human Resources
FROM: 2a, Principal Investigator
Project: (name of school/institute/project)
Contact information: 2b name, 2c email, 2d phone number.
SUBJECT: Request of EIC Determination – Independent Contractor ( )3
(a) Method and Reason of Selection: We require the services of an expert in 4 to provide the following services not found in our UH or RCUH staff or infrastructure. Selection of this individual was done by 5.
(b) Description of work to be performed: Individual will perform 6 services to the project. This work is consistent with the description in the Scope of Services in the RCUH Services Agreement. Work will be performed in Hawaii or 7 (specify location, State, Country).
(c) Supervision of work in progress: No supervision of work is necessary since the contractor must comply with the Agreement and schedule of deliverables.
(d) Evaluation of results: No evaluation of work in progress, except as agreed to in RCUH Services Agreement. Final payment may be a condition of final evaluation to ensure work complies with the RCUH Services Agreement.
(e) Duration of Action: This is a fixed period agreement from 8a to 8b.
(f) Method of Compensation: Based on a negotiated rate as specified in the Agreement. Specify and describe compensation: 9.
(g) Travel & Per Diem: None provided, all expenses are included in Contractor’s fees.
(h) (Current) Business License or Employment Status: NOT AN EMPLOYEE of UH or RCUH. Contractor’s Hawaii General Excise Tax Number is 10. I have attached a copy of contractor’s GET from State Tax Dept. website. Attached are the Individual’s business card, and other evidence of business activities (including but not limited copy of business website, advertisement, CV listing consulting services, etc.). Check if individual is a former RCUH, UH, State, or County employee. Individual was employed by 11. Date of termination: 12.
(i) Tools & Equipment: Contractor will provide own tools and equipment. (If not explain).
(j) Termination at Will: Terms of termination is specified in Agreement.